Mountain biking is an Olympic discipline and popular world wide. In comparison to conventional road cycling little is reported of overuse injuries. Especially, the set up of the mountain bike seems to play an important role in the onset of overused body regions. Aim of this investigation is to identify overuse injuries in competitive mountain bikers and correlate them with technical settings of their bikes. This prospective field study consists of two phases analyzing volunteer competitive mountain bikers who were interviewed with a preformed questionnaire. In Phase 1 overused body regions were identified. In Phase 2 riders were examined before and after the race for overused body regions which were correlated to the bike`s adjustment. For this reason the athlete was sitting on a fixed mountain bike in riding position and the various distances were individually controlled. 169 competitors were analyzed of whom 87 had overuse injuries after the race. Most injuries concerned the lower back, the buttocks and the knee. There was a significant correlation between inadequate saddle-pedal distance and the incidence of knee pain (p < 0.038), and paraesthetic sensations in the hand (p < 0.023). The saddle inclination increased the incidence of pain in the buttocks (p < 0.014)). Symptoms occurred more frequently in downhill (p < 0.0001) and uphill (p < 0.0007) passages. Overuse injuries are frequently observed in competitive mountain bikers. Certain detailed adjustments have a direct impact on the incidence of overuse injuries in the competitive mountain bike cyclist.

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