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During the UCI’s annual Congress at the UCI Road World Championships in Montreal on Wednesday, Medical Director Xavier Bigard presented the results of a survey of the causes of crashes in the men’s and women’s WorldTour pelotons, and pointed to some alarming differences between the injuries suffered.

The survey began with Paris-Nice this year, and sought to find the incidence and type of injuries being sustained, correlate the causes of crashes with the severity of injury and, as a result of the analysis, identify risk factors with the aim of finding preventative measures.

The study examined 21 men’s races (90 days) and 14 women’s events (37 days) or 12,951 men’s rider-race days and 4,381 women’s rider-race days

“The main takeaway from this slide, which shows crash incidence rates, is that crashes occurring in women’s races involve more riders than in men’s races,” Bigard said during his presentation, pointing to a slide that showed that in the women’s peloton, crashes involved an average of 4.7 riders compared with 2.7 for men.

“The second finding is that during these crashes, the number of medical interventions is consistently higher in women’s races than in men’s.”

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Speaking afterward to Cyclingnews, Bigard clarified, “What is important to know is these are only preliminary data, explaining that an ‘incident’ is a crash or fall, whether or not there was an injury.

“What is most important is the rate of incidents and the rate of injuries. The rate of incidents was approximately 1.3 times higher in women compared with men,” he explained.

“Another important piece of information: for one fall or incident, we have more riders involved in women’s races in comparison with men’s races. That is an important finding.

“Then we look at incidents with medical attention or medical intervention – we have incidents, and then incidents with medical contact – the rate is 1.5 times higher in women compared with men.

“And the last piece of information is true injuries – where there is tissue damage, skin abrasion, concussion, fracture, and so on. The rate of injuries is 1.55 times higher in women.

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“To my knowledge, these are clearly the most important pieces of information. After that, the other data concern the type and severity of injuries in women compared with men.”

While men’s crashes, like the one that took Tadej Pogačar out of this year’s World Championships, giving him a concussion, fractured vertebra and collarbone, earn plenty of attention from the world’s media, women are being injured more frequently and more seriously.

Delving deeper into the data, Bigard highlighted an increased level of seriousness of the crashes in the women’s peloton.

“When comparing the differences in the type and severity of these injuries, we observe that there are 4.3 times more head-level injuries occurring in women compared to men; 2.3 times more concussions in women compared to men; and nearly 3 times more severe skin lesions in women than in men,” Bigard said during his presentation.

“Furthermore … there are approximately 2.5 times more fractures occurring in women compared to men.

“The main hypothesis … is an alteration of bone health. For me, yes – we are not certain, of course, but this is a clear hypothesis. This is related to hormonal alterations, a decrease in energy availability, and it is also specific to cycling because cycling is not a weight-bearing sport.

“We know that ground impacts are essential to improve bone health, which isn’t the case in cycling. While that’s observed in both men and women, why we have more fractures in women can be explained, at least partly, by hormonal alterations.”

Why women are crashing more is still to be determined. Bigard suggested there was too much heterogeneity in skill level in the women’s WorldTour compared to the men’s.

There could be other factors, too, like differences in stability between men’s and women’s bike designs. Currently height, weight, and frame geometry are not part of the dataset.

The study looked at conditions: wind, rain, whether the incident was near the end of a race, and rider’s experience, and there was no strong correlation with any factor in the women’s field.

“We attempted to identify a certain number of contributing factors behind these crashes, particularly severe crashes where injuries can be expected.

“Among men, we found only a single contributing factor: the number of riders involved in a crash. Under these circumstances, medical intervention is more frequent, and there are more injuries than in other situations.

“We also found, paradoxically though explainable, a trend among men to have fewer crashes and fewer injuries when it rains, in wet conditions. This can obviously be easily explained [by riders being more cautious] even if the result might seem paradoxical. Among women, we were unable to identify any contributing or protective factors regarding crash and injury risks.”

Both genders had a highest risk for crashing on descents, however.

“In a very reproducible manner across both men and women, we found that crashes occurring on descents were the most severe, requiring medical intervention and resulting in injuries – which once again highlights how speed can be a major injury factor in road racing.”

Bigard continued with presenting the financial impact of crashes, showing that men and women lost a similar number of training days, while women lost more racing days, although what was presented was not normalised.

“We estimated that among women, overall injuries could be valued at a financial budget deficit of €891,000, and approximately €2.3 million for men. This is obviously a result that should carry weight with the teams.

“In conclusion, we face significant difficulty in identifying contributing factors causing these crashes, at least to date based on the collected data.”

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