Extreme mountain bike riding does have its risks as some of the athletes at Crankworx found out.
The Rotorua Hospital emergency department and St John ambulance added extra staff in preparation for the five-day event which saw some of the best mountain bike riders in the world compete.
Most of the events were held at Gravity Park at Rotorua Skyline under safety management company Peak Safety.
Lakes District Health Board communications officer Sue Wilkie said emergency department staff at Rotorua Hospital treated 43 patients thought to have been injured taking part in the lead up to, and the event itself.
"Most of the people presenting to ED had shoulder and wrist injuries. However, staff say there were a few quite serious injuries as well, including femur fractures, chest and head injuries," Miss Wilkie said.