Marine Cabirou Broke 3 Vertebrae at the Leogang DH World Cup

 World Cup racers are just built different.

 +1 Crazy! But also I might have started thinking of better back protection if I had broken my back twice in on year.

 Adrenaline is a powerful painkiller , anyone who’s had a bad crash usually gets up , it’s not until 20/30 mins later the pain sets in .

 @LRod1018: Imagine if that had been a footballer ..... they're at deaths door if the break a nail.

 @LDG: Look at the final photo above, just above her number is what looks like spinal protection

 @Daviek: Yup, but the difference is that they aren't at death's door, they're just acting. They're still athletes, it's just a shame they have to ruin their athletic credibility with their pathetic acts.

 @redrook: That's one reason I can't bare watching football!

"Football is 90mins of pretending you're hurt. Rugby is 80mins of pretending you're not."

 @korev: Agree, same with ice hockey.

 @korev: I know, they need to wear it, that's why I wrote better back protection! A lot of racers use the aboslut minimal protection allowed.

 @LRod1018: Well actually, they're not. It keeps getting repeated but it's not true...

 @LRod1018: …and in this case “re-built”, again. Heal up.

 @redrook: A key difference is that fotballers have something to gain by doing it (free kicks, penalties yellow/red cards for the other team) while cyclists (both road and mtb) have nothing to gain, so they don't. Fotball could create rules to get rid of the problem, like ice hockey has, or just enforce current rules better. But fotball is one of the most conservative sports when it comes to changing the rules, so they won't do it it seems.

It's a shame, really

 @flyingfox49: So true. I went for about a 10 foot Superman flight onto a coral paved road during a mtb stage race in HI when i was a "kid" I picked up my bike and ran in to the finish thinking about how I was gonna get my bike patched up before the next race. About an hour later riding a bike was waaaaaaay out of the question, once the pain from a broken tailbone and a sprained ankle set in.

 @jemscott: wow. Thats a lotta words when "I think brown skinned people cheat more than me and my white friends" would have gotten the job done.

 @LDG: spine injuries aren’t just from direct impact. Spine protection helps a little but its overall ineffective to prevent the main mechanism of injury since you cant stop the body from twisting and compressing when you take a digger like that.

 @lowgear: Oh. So....you mean there could be an explanation OTHER than: soccer's elite players come from "diverse populations" and they bring a lot of cheating and lying from their culture into our pure British game? As opposed to those of us who are wealthy enough to buy $10,000 bicles we ride for fun on weekends and who would NEVER cheat?
I figured there had to be a nonracist explanation, thank you.

 @Lemmyschild: Yeah, who knew, right?

Nobody is cheating in cycling are they?

*Cough* doping *cough*

 @aaronjb: translation: No footballer from the Northern Hemisphere was ever flopper.
RIIIIIIIIIIIIIIGHT.

 @Daviek: footballer as in soccer player or like American football

 @sonuvagun: That's some good irony. I was replying sarcastically to jemscott who made the original post that attempted to make this all about skin color. And you claiming that people from "southern" countries cheat more, with literally no proof, while bewailing people making it about skin color is too precious.

 @sonuvagun: I'm not "trying" to do anything. The ones trying to do something are people like you and jemscott who are too cowardly to say what you think so you hide behind using language that blames "massively diverse elite playing populations" and "southern countries"

I know you haven't, but why don't you think for just a second about what jemscott REALLY meant when they said "...mtbings demographic is the polar opposite" to football's massive diversity?

How odd is it that you are attacking me because in your mind I'm making this all about skin color but you haven't said a peep about the original poster who actually brought up wjere people are from which has always been racists' code for pointing out skin color.

 @LDG: you realize most spinal injuries are due to flexion not direct impact right....

 @sonuvagun: Nope. I'm having the honest conversation. It's people like you and Jemscott who hide behind terms like "southern countries" while accusing their citizens of being more open and susceptible to cheating than the people who played football in the past. Don't get angry at me just because you just don't have the sack to say "I think players from Africa cheat more than domestic Euro players"

 @sonuvagun: basically every country at this point is populated by a lot of people with complexions ranging from fair to dark. But when folks like jemscott says the massive diversity in elite talent that embraces cheating, he's not talking about European countries like Spain Greece and Italy. Those are the places he was talking about that have been "infiltrated." Those countries have been competing against each other for decades in Europe, when they were uninfiltrated, obviously. And we know the infiltrators, with their great love of faking injuries, come from "southern countries" according to you.
Those are essentially all yours and jemscott's words, go ahead, contradict them.

 …”nah, I don’t need a neck brace”.

Just a matter of time folks with these speeds getting faster and faster. Hate to say it, but it’s gonna have to take a really, really bad incident for stuff to become mandatory.

Just sayin.

 @Lemmyschild: Dude wrote me an empassioned PM, unsolicited, to tell me why he's not racist or xenophobic.

 Adrenaline.

 @LDG: I thought they dont wear any back protection? I rarely see pros wearing any body armor. I dont think the league has a requirement either but I really dont know because I don't race or compete. These athletes are on another level to me. Paintball is my main sport years back and safety gear are leagues or even local tournament's number 1 priority. Mountain bike? I think it's all about selling frames.

 @LDG:

Vertebral fractures come in all sorts of variations. They are as minor as transverse or spinous process fractures to essentially unstable dislocations of the segments involved. On the CT scan Marine posted, there is a disruption of the anterior column of the upper thoracic vertebrae. These typically happen with forward bending (flexion) and compression, such as when your head strikes the ground and your upper chest crumples with it.

Modern "back protection" does not adequately protect against this mechanism, as they allow bending (flexion and extension) and rotation, the extremes of which lead to the most common spinal injuries. That also doesn't mean they don't offer any protection. If you were to fly over the bars and land directly on your back, it could theoretically prevent "injury" to the back, but that is not the mechanism by which the vertebral column typically fails. Unfortunately, it is the physics of the sport and the resultant forces that happen when crashing.

A true "back protector" for the fracture she had is called a CTLSO. It has an anterior and posterior restraint. Sometimes we give these to patients, but generally for these upper thoracic compression fractures, they are so restrictive and limiting, that we usually just say avoid bending and twisting until it heals. If you google what this is, you will see how impractical of a device this is to employ while riding.

 @sxy-slo: No racism in Europe? Really? What stone have you been living under?

 @ak-77: a white one

 @LDG: true, though I broke T5-7 in 2018, and back protection wouldn’t have helped, I basically piledrove myself, the top of my head hitting the ground hard.

I’m only now starting to recover properly from this epic slam

All the best to you Marine, & a speedy recovery

 @sxy-slo: everything except gun violence would make me think you were being heavily sarcastic...

 @bcatt: @bcatt: due to spinal compression causing most spine injuries, I don’t understand why more riders don’t wear neck braces

 @duplex: thanks for the insight.

 @duplex: I'd be interested to hear your thoughts on the value/efficacy of neck braces if it's something you feel comfortable commenting on?

 @sxy-slo: I dont have to effing imagine anything and none of what was written was between the lines. its just blantant and obvious. Yeah America has problems. Nice strawmam slaying though.

 @aaronjb: "me thinks he doth protest too much"

 @Woody25:

Sure. The short answer is there is not enough "strong" evidence at the present time to support that neck braces prevent or reduce the risk of cervical spine and/or upper spinal cord injury.

Relative to the back protection, there is at least face validity in the construct. That is to say, it appears to limit the type of range of motion that can lead cervical spine injury. However, to adequately test the efficacy of a neck brace in a robust study design would require a sufficiently large number of participants. They would be randomly chosen to wear a neck brace. They then would incur the same cervical spine injury, of which there are numerous ranging from very mild, to moderate fracture without neurologic injury, incomplete neurologic injury, and complete neurologic injury. Then there would have to be a statistical analysis to evaluate the risk reduction between the brace and not braced group, accounting for many confounding variabilities. This is not a feasible study design in vivo to evaluate the efficacy of a neck brace.

The leader in neck brace design, Leatt corp. conducted a study using computer simulation and surrogate models. They evaluated multiple parameters in specific loading events that that place the cervical spine at risk of injury, such as flexion-compression, extension-distraction, and axial loading. Overall, they demonstrated a reduction in the forces transmitted to the surrogate model and within their computer simulated model for these simulated events.

The primary limitation of the study is it has not undergone rigorous peer review. Their methodology for the biomechanical work has not been evaluated by outside experts in the field. It is easy to discount the value of that, again looking back at the face validity of the design, but for me personally, in an area as complicated as the kinematics and pathophysiology of the cervical spine, the study should be evaluated in a reputable biomechanical journal. Any question of methodology, limitations/bias, and the conclusions would then be addressed independently by those who conduct this type of research.

Where the questions remain is can this work, which is purported to demonstrate reduction in the possibility of neck injury using automotive standards be sufficiently extrapolated to the downhill mountain biker. As in, what is the “clinical” significance? How does the variability of helmet design, fitting of the brace, the role of the dynamic restraint of muscles, variability in bone density and the static ligamentous restraints, the possible negative implications of restricted range of motion with a brace all contribute to cervical spine injury? It appears they did their best given the current technologies, but unfortunately, this is likely too difficult to simulate to the point where such a generalization can ever truly be made.

I do applaud Dr. Leatt and his team, regardless of financial motivation, in tackling this very complicated problem. None of this should be interpreted as the modern neck brace does not work to do its intended job. It’s just my medical training and research background that would like to see more robust critique of the data and less reliance on marketing with an incidence survey which is rife with limitations to support their use. Fortunately, the rate of cervical spine injury leading to devastating neurologic injury is very low. It is my opinion, that this sport can be done in risk mitigated manner by exercising extreme caution when riding. This is where I believe the true value is in preventing these injuries.

 @duplex: ….you so damn smart.

 @duplex: tl;dr racers should go slower?

 @duplex: I just wanted to say, I wrote a 60 pages bachelor thesis about this exact topic, if different back/neck protectors are adequately protect the spine from mtb specific crashes. And absolutely everything @duplex wrote in his comments so far is true. He perfectly summarized most of the results I had, to the point its almost spooky.

Also wanted to add, that there is a Austrian company called adamsfour that is engineering a back protector to prevent torsion fractures, but I don't know why I haven't seen a product from them for sale yet, despite that the company exist for a couple years now.

 @BenPea: maybe not slower but to ride within their physical and psychological limits at a given day, without taking risks that are too big.

Same goes for helmets and concussions. There is currently still no helmet technology that is scientifically and independently peer reviewed to prevent or reduce concussions. Best bet unfortunately is to ride within one's abilities and only take very calculated risks.

 @duplex: That's fascinating, many thanks for taking the time. It's really interesting to hear a commentary from someone without a direct commercial interest.

Your point re risk mitigation is one I've thought about often too, but more from the perspective of skills training and learning how to fall. I look back on my years of throwing myself down downhill tracks with some amount of disbelief. I wouldn't try to learn to ski-jump without coaching, so why I tried probably higher consequence things, on a bike, with no more instruction than a few bike magazine articles I do not know (well, I probably do, optimism bias of the young and all that).

Nowadays I work hard to understand the theory, then build the practical skills based on that, but that's probably just me getting old, slow(er) and knowing I don't heal fast anymore.

 @Pussyslayer: "risks that are too big" is not a unit of measurement. Noone who rides within their comfort zone wins a WC, some turns you're 50/50 on whether you're going to make it or not. Remember the arse-out slides of Hart et al gapping into the bridge section? Science can't account for the urge to win for the sake of it.

 @korev: then american football? 3 hrs of pretending you dont have a concussion?

 @BenPea: "Noone who rides within their comfort zone wins a WC"
I don't think so, some riders especially the top pros ride those race tracks more often on one day than I do my local dh trails in multiple days. They study every stone so to say. I think it was thannee who sayd in a interview on race day there is no section where a pro is still scared or unsure, because that would only mean he/she didn't train the track enough.
Are there some slips here and there even before something like that drop, sure. But pros are used to that kind of situations and have hundreds of similar good outcomes on their shoulders.

 @Pussyslayer: you might be starting a discussion on the difference between male and female attitudes to risk
It probably also depends on how much a track has changed since their last run before the race (rain). Anyhow, to be sure we'd need a qualitative study to gather the thoughts of racers on this.

 @BenPea: there's just no need for that. If riders calculate the risks and only ride under a certain threshold, the chance for a vertebrae fractures becomes lower. I don't think that is for discussion, and that was my only argument in the first comment.

 @redrook: hockey is better than both of those, also GO AVS

 @jemscott: at least mountain bikers don't fall to the ground like they broke their leg when they're touched on the shoulder

 @Lemmyschild: lol

 @Pussyslayer: The esteemed Pussyslayer weighing in with an academic analysis.

 @Bikes-are-awesome: Agreed but can't agree with "go Avs" LGRW

 @Xilema: In Austria you are not allowed to participate in training or racing without a fullface helmet, back protection, elbow and knee guards as well as full finger gloves.

UCI only mandates a full face helmet.

Some (truly idiotic) riders stick cardboard on their back to trick the marshalls...

 @duplex: Just wanted to say what a well thought out and researched answer you've given. Thanks,

 @Lemmyschild: totally did not read jemscott message like that.

 @rvdoever: Really? Interesting. You see no odd juxtopostion between "...massively diverse elite playing population and the background of some global superstars."
And
"MTBings demographic is the polar opposite hence the higher standards (in some ways) that we try and maintain."

What exactly do you imagine the polar opposite of massively diverse to be? And you see no problem them ascribing the alleged higher standards they supposedly posses as being a by product of their polar "opposite-ness"?

This crap is the same codified dog whistling that KKK types have been spewing in America for centuries. Maybe you are just unfamiliar with the dynamic at play.

 Agree. I thought that when it happened. The bike still attached bent her in half!

 Being clipped in caused quite a lot of riders problems, particularly in the woods, when they couldn't get clipped back in after being bucked out.

 The super scorpion. I can see how clipless would be detrimental generally in such sloppy conditions.

 That's what I was thinking, one of the big downsides of being clipped in is catapulting a 15Kg bike over your head. Healing vibes to Marine.

 @Afterschoolsports: Brendan Fairclough raced on flats - came in mid pack but he had a drama free run

 @jokermtb: Connor Fearon as well

 @jokermtb: I forgot that he was out there still.

 Unfortunately riding clipped is almost mandatory these days. It's so competitive the racers just can't take a risk on coming off the bike because that can cost tenths of a second, which is enough to lose. They HAVE to stay on, so got to clip in...

 That was definitely sketchy enough to warrant flats even pros. But in general riding flats at World Cup DH speeds on rough sections is a recipe for the apocalypse. Superman through the rock gardens after you're feet are blown off the flat pedals woohoo

 @philmtb99: and Louise Ferguson in 4th!!

 @Marcencinitas: Seems like a business opportunity in coaching the whole roster by a certain Sam Hill.

 @Marcencinitas: I don't think it's safer to ride clipped in. Imagine your foot coming loose in the middle of a rockgarden and crashing... It comes down to the situation. OTBs on the other side are quite always "safer" without clips.

 Ye id still take the risk of this over my feet blowing off in a rough section. Im picking clipless pedals and being a dick about it

 @Marcencinitas: Sometimes it is more fun to ride clipped in. I switch back and forth and when I go back to clipless I always quickly remember how much easier many types of maneuvers are. Maneuvers I can do with flats, but are just easier when the feet are attached.

I do wonder if a better back protector would have prevented the injury, but hard to say from the video and pictures. It seems a lot of WC Pros wear protection begrudgingly. Personally, I've been saved by my back protection too many times to be comfortable doing gravity riding without it.

 29rs

 @mybaben: I totally get that. Yet, it's very risky in the mud, as many riders who glopped their feet probably lost more time getting clipped back in, than if they'd gambled and run flats....running clippless in horrible mud conditions is a high risk gamble if you come loose....if you don't, then it's still an advantage.

 @jokermtb:

As longs as the mud isn’t too tacky its pretty easy to reclip. I feel like its definitely easier with some shoe and pedal combos than others

 I feel like the MTB industry needs to develop better release mechanisms for MTB clipless pedals (and a better name too).

 @jokermtb: I hear you. I'm not commenting on the best strategy for mud etc. I'm just remarking on super high level professional racing. WC is so crazy competitive these days. There are only tenths of seconds between the top 5-7 riders often times, so coming off your bike and dabbing can literally lose you the race. Cheers.

 Elbow protection is quite nice as well. Super easy to break/chip an elbow and takes like a year to heal. Not worth the fuss.

 Agree. At risk of repeating myself - This happened to me . Headfirst into dirt at stupid speed led to me breaking T5-7.

It’s a nasty injury. Godspeed Marine

 sorry but that's bullshit and you dare promoting that riding without back protection is all good. Had 3 crashes braking overall 6 vertebras, 2 out of 3 were 100% only due to impact, the first one was a crack due to vertebrae compression. Guys, wear back protections whenever you can (for me it is now mandatory for any ride).

 @mariano69id: Agreed. There is a well known case of a rider in the USA who suffered spinal chord damage after crashing with a shock pump in his backpack. We all know you can injure yourself with impacts to the head, bum and overextension as well as direct impacts. Its simple physics.

 I can see her going the way of Emmeline Ragor. The FTS (f*ck this shit) option.

 @BenPea: wouldn't blame her in the slightest, I'd have dipped after the first back break lol

 @rad-but-also-sad: hell yeah. (*Ragot, sorry)

 @BenPea: you're sure about that? I can't remember her having huge crashes. Thought she went on to pursue her career as physio.

 @styriabeef: she was injured a lot, enough for her to sack it off quite young. She took a few hits that made her question the sanity of continuing.

 @BenPea: Nah, Emmeline was more "on the edge" than Marine. Great to watch too, I always rooted for her

I hope Marine gets to full health soon. Gutted she's can't race again, I rooted for her as well

 @chmurka3rg: that time she OTBed on the last jump? Fagettaboutit...

 There is, but its not like they line the whole course...and they typically respond to someone who cant get up or move very far. Not someone who gets up and continues down the track

 Even though she was down for a bit you would need a medic every 100 metres or so in order for them to get to riders in the time it took her to get back up, then you have to get the rider to stop their run in order to assess them. When you get into sections like the steep woods they would need to be at even shorter intervals. The nature of the sport dictates that in most instances the rider themselves have to decide whether to halt their run or not.

 You guys are being a bit ridiculous, this is just the nature of the sport. Maybe some additional rules could be in place but its all way too subjective and easy to play doctor in hindsight. If she didnt break anything, nobody would even be commenting on this. Imagine this situation where a rider crashes, loses about 5-10 seconds, but then a doctor intervenes and shuts the run down when in reality they could have continued on and still contended for the win/podium. Myriam crashed and still took 2nd place, what if a doctor would have shut her down? I dont hear the riders or Marine complaining about this because they accept it as the reality of the sport.
Edit: @commental I realize you are in agreement, didnt mean for this to a rebuttal towards you.

 @LaXcarp: so not like Brook McDonald where it took forever to get him down the mountain in 2019? Did anything actually change in the way races are run from that incident?

 @matadorCE: No, and I don't see any reason why there should.

 @LaXcarp: Ok sure. Let's get these people seriously hurt and not do anything about it in the name of whatever. Lots of that going around.

 @matadorCE: You can make them wear more pads, you can make them sit X amount of time if diagnosed with a concussion...but I'm not sure there are too many practical solutions to in-the-moment race situations. These athletes are competitive beasts with adrenaline pumping and the situations you are bringing up are very one-off scenarios that I dont think require any radical change.

 There where at least 2 teams of paramedics with ambulances parked next to the track in the upper sections. Don't know how close they were to the track in the wood section.

 It's from the weight of carrying the sport. I kid, wishing Cabirou a speedy recovery

 I'd like to see the actual data but I have a feeling that most people just suffer from recency bias when it comes to this type of thing. You always remember the crashes and the injuries when they are recent and fresh in the mind, but forget about the ones from the past. I have a feeling the actual data wouldn't show a big increase.

 @sino428: I disagree, its really stacked up recently. You might be corect, but thats why we need to see data. Im talking head injurys too, they've shot up.

 @inside-plus: I have the same feeling about head injuries. There likely aren’t any more now than there was in the past. I think now they are just being recognized more and riders are taking them more seriously so we are hearing about them more. In the past riders were more likely to just shrug off a hit to the head and just push through and ride.

 She has a few good Ts left - let her decide.

 She was wearing back protection.

Back protection only helps against impacts, not at all against (over)extension.

 Some people wear back protection. Defo saw Baptiste had it on his back but that's understandable given his horrific injury.

 Shut up

@in2falling:

 Actually at dh-races in Austria backprotection is mandatory. So she had to have one, plus it appears in the video she had one, plus I recall Marine to always wear full upper body Armour.
It also appears to me, more and more top tier riders compete with back protection (Bruni, Iles, Pierron,...).

 @styriabeef: and then you see berhard kerr ducktaping a cardboard to his back…great rules

 @styriabeef: they didn't let Cathro on track without elbow pads. I don't know why everyone keeps raving about lack of protection on the pros, they are wearing everything.

 Her back wasn´t even dirty (just watched the replay), so it was the overextension. Against which afaik no known protection equipment helps.

 @skintightleather:
And Bernard crashed exactly at the same place during the quali as Marine.

 @jokermtb: I wear one and I haven’t noticed it once except when I scorpion

 @jokermtb: Uh - BS. People don't want to look scared or orthopedic. Just like lots of skaters and FS BMX riders.

Dog bless &y &erson for llidding up and tearing it up.

 @marincelo: Because it is required in Austria. Some pros wear as little as possible. Some even use cardboard instead of real protection...

 I think they are just trying to be as comfortable, light, free to move without distractions as possible. I think it’s just part of the “rolling the dice” that happens riding at that level. It’s really quiet amazing the risk the elite folks take and don’t stay constantly broke off.

 Many of the more common and/or dangerous injuries in DH can't be countered by protective equipment.
Particularly back injuries from compression of the spine, collarbone fractures and dislocated shoulders.

 Pretty sure they are all wearing mandatory spine protector armor under their jerseys

 She was wearing a back protector (see her instagram).

But her back wasn´t even dirty (just watched the replay), so it was the overextension. Against which afaik no known protection equipment helps.

 The marshal most likely isn't a medic and their role would be to warn or prevent other riders from hitting Marine, if she didn't get up. And to call over the actual medic or doctor.

 @Starch-Anton: The results show a DNF for her.

 @korev: he probably saw tons of people falling in front of him all weekend. And most got up and carried on.