Fear, Anxiety, and Return to Sport After Cycling Crashes: A Survey of Cyclists

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Key points

  • Cycling injuries are complex, sharing characteristics with both sports injuries and traffic collisions, both of which have been associated with post-traumatic symptoms.

  • Psychological factors impact injury occurrence, rehabilitation, and return to play, and should be identified and addressed by sports medicine clinicians.

  • In this survey, fear and anxiety after cycling crashes were reported commonly, but treated infrequently.

  • Factors influencing the development of fear or anxiety after a crash

Methods

We performed a public, online cross-sectional survey of cyclists aged 18 and older, entitled Injury Issues in the Cycling Community using REDCap software,9 institutional review board exemption. This study was hosted by Mass General Brigham, formerly Partners Healthcare (IRB project #2014P002211). The survey was distributed to the cycling community throughout the United States via email, social media, and a cycling health-related website, administered from January 24, 2015, through May 3, 2016.

Results

A total of 781 participants from 32 states in the United States (with 4 participants outside of the United States) completed the survey; the states with the most responses were Massachusetts, Connecticut, Illinois, New York, California, Pennsylvania, and New Hampshire. There were 404 respondents (mean age 41 ± 14 years) who had sustained a crash within the last 2 years. Demographic information is reported in Table 1; those who sustained a crash seem to ride more mileage and are more likely to

Discussion

The results of this survey-based study of bicycle crashes found that bicycle crashes occur frequently and are more common for competitive cyclists during training rides and in high mileage riders. Motor vehicles were the most frequent cause of bicycle crashes either through direct impact with the bicycle or indirectly causing the cyclist to crash. Physical injuries were most likely to occur in the upper extremity and helmet damage was also common. Psychological symptoms of fear and anxiety were

Clinics care points

  • Cycling crashes are common, frequently involving a motor vehicle and resulting in upper extremity and head injury.

  • Cycling injuries are complex, sharing characteristics with both sports injuries and traffic collisions, both of which have been associated with post-traumatic symptoms.

  • Fear and anxiety after cycling crashes are commonly reported, but infrequently treated.

  • Symptoms of head injury overlap with the psychological effects of trauma and careful assessment for head injury must be done to

Summary

Our survey data demonstrate that the development of fear or anxiety after a cycling crash is not uncommon. Cyclists in our survey reported that fear and anxiety have been infrequently addressed after cycling crashes, reflecting a lack of appropriate treatment which could impede return to sport. Factors associated with development of fear or anxiety after a crash include female gender, a history of depression, and greater crash severity. In guiding return to sport, it is important to understand

Acknowledgments

The authors thank Dr Ross Zafonte, Dr Mark Greve, the Medicine of Cycling organization, and Dr Marilou Shaughnessy for their assistance and support with this article.

Disclosure

All authors have no commercial or financial conflicts of interest for this article. No funding sources were used for this article.

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