Rotorua Hospital had to put extra emergency department staff on to accommodate an influx of Crankworx-related injuries, with staff saying this year's festival had been busier than usual.
A total of 51 people went to ED last week with Crankworx-related injuries ranging from grazes to spinal injuries.
Peak Safety director Budgie Woods worked at the onsite medic station and had told the Rotorua Daily Post earlier this week there were slightly fewer injuries this year than previous years.
However, Rotorua Hospital's emergency and medical management clinical director Dr Peter Freeman said the department had put extra staff on to cover patients coming through, and staff said they were busier than in previous years.
Freeman said injuries sustained during the event included spinal, spleen and a severe shoulder injury.
Other injuries included grazes and painful wrists, arms and shoulders.
Crankworx organiser Tak Mutu said while it would be ideal to have no injuries, it was unlikely given the nature of an extreme sport like mountain biking.
"No doubt the hospital would have been busy," Mutu said.
With more than 14,000 people through the gate this year, most of which he said would have also been biking, Mutu said 51 was quite low.
Mutu said an injury report would be provided by their safety director no later than June.
He said the team had already begun the review process of the festival as a whole which would be used to improve on all aspects for future Crankworx.
"We'll just keep trying to minimise the injuries as much as possible."