LET'S TALK ABOUT... CONCUSSION

One of the most common injuries in cycling, concussion is a warning sign that the brain has been subjected to potentially damaging g-force. Ignore it at your peril, warns Josephine Perry

- Josephine Perry

When Romain Bardet crashed on stage 13 of the 2020 Tour de France, live TV footage showed him holding his head before being helped gingerly to his feet. He appeared shaken, unsteady and almost certainly in need of medical assessment. Despite this, he was allowed to ride the remaining 90km.

The next day, the Guardian celebrated Bardet’s having ridden “through the pain barrier”. Scans after the stage diagnosed the French rider with a brain haemorrhage, calling into question the actions of officials at the crash scene in allowing him to continue. Riding with a brain injury is not heroic – it is potentially lethal. Thankfully times are changing: pro cyclists and those around them are starting to take concussion far more seriously. Amateur riders need to be aware of the dangers too.

A few weeks ago, when Tom Pidcock crashed during Tirreno-Adriatico, not only did Ineos-Grenadiers team doctors pull him out of the race as soon as they suspected concussion but also held him back from racing while he recovered, meaning he missed Milan-San Remo. It was a high price, perhaps, but a precaution well worth taking.

Concussion is a brain injury caused by biomechanical forces, e.g. an impact from a crash, resulting in a disturbance in brain function. The brain, which has the consistency of firm jelly, hits the hard sides of the skull, and the impact may cause bleeding, as in Bardet’s case, as well as drowsiness, loss of balance and confusion. There may not be a visible head injury, nor obvious harm to the brain – concussion can occur without structural changes detectable on MRI or CT scans. This makes it a complex injury to diagnose and manage.