Compared to conventional road-cycling, little is known about overuse injuries in mountainbiking. The adjustment of the mountainbike seems to be crucial avoiding these syndromes. No other study has prospectively put overuse injuries into correlation with the mountainbike’s adjustment in a competition setting until now.

Methods: This prospective field study consisted of two phases using preformed questionnaires to interview volunteering athletes in a race. In phase one overused body regions were identified in mountainbikers. In phase two riders were examined before and after the race for overused body regions which were put into correlation with the bike’s adjustments. The statistical analysis comprised a multivariance analysis.

Results: 169 competitors were analyzed of which 87 had after the race. Most injuries inflicted 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 inclination of the saddle has also significant impact on the occurrence of pain in the buttocks (p< 0.014)). Symptoms occurred highly statistically in downhill (p< 0.0001) and uphill (p< 0.0007) passages.

Conclusion: Overuse injuries are frequently observed in competitive mountain bikers. More than half of the investigated athletes had pain at any body region immediately after the race. The bike’s adjustment has a significant impact in the occurrence of overuse injuries.