Abstract
This thesis presents an integrated programme of research investigating injury and illness epidemiology, surveillance, and prevention in competitive cycling. Comprising five published peer-reviewed papers and one manuscript under review, the research addresses critical evidence gaps through three interconnected themes aligned with the Union Cycliste Internationale (UCI) Agenda 2030.First, a systematic review and meta-analysis of 44 studies examined the epidemiology of injury and illness across competitive cycling disciplines. Considerable heterogeneity in surveillance methods and injury definitions was identified, limiting comparisons across studies. BMX demonstrated the highest pooled injury incidence, while para-cycling reported the greatest illness prevalence. Six UCI disciplines had no eligible epidemiological studies, highlighting substantial gaps in the evidence base.
Second, prospective surveillance studies were conducted across professional road cycling, para-cycling, downhill mountain biking, and cyclo-cross, representing 21,316 athlete-days of observation. Racing consistently presented a greater injury risk than training in road cycling, while concussion was identified as a significant burden in para-cycling and downhill mountain biking. Female downhill mountain bikers demonstrated a significantly greater injury and concussion risk than males. Cyclo-cross, a previously unstudied discipline, exhibited a high incidence of acute traumatic injuries, providing the first prospective epidemiological evidence for the sport.
Finally, quantitative and qualitative investigations explored injury prevention practices and stakeholder perspectives. Injury prevention was conceptualised across six interrelated domains, with findings demonstrating that injury risk is shaped not only by physical factors but also by behavioural, cultural, organisational, and environmental influences. These findings highlight the importance of systems-informed, context-specific approaches to injury prevention and implementation.
Overall, this thesis demonstrates the feasibility of implementing standardised injury and illness surveillance across diverse cycling disciplines, provides novel epidemiological evidence to inform discipline-specific prevention strategies, and establishes a foundation for improved surveillance and athlete health governance within competitive cycling. Conducted in partnership with international and national governing bodies, the research has directly informed the development and implementation of surveillance practices in elite cycling.
| Date of Award | Dec 2026 |
|---|---|
| Original language | English |
| Awarding Institution |
|
| Sponsors | Northern Ireland Department for the Economy |
| Supervisor | Michael Donnelly (Supervisor), Christopher Cardwell (Supervisor), Neil Heron (Supervisor) & Debbie Palmer (Supervisor) |
Keywords
- Cycling medicine
- public health
- injury and illness surveillance
- epidemiology
- sport
Cite this
- Standard