Concussion and Cycling – Tour de France Special
As is customary with my French heritage, I spend some time with my family in France over the very long school summer holidays (always very long if you have to entertain three young children!).
A number of things are unavoidable when you spend a prolonged period of time in France like the “journées noires”, or black days, of huge traffic jams as half of France leaves for holidays and the other half seems to return over the very same weekends, the Parisian families invading the countryside, and the never-ending footage of the Tour de France, the world famous cycling race.
Summer in France means long hours watching Le Tour, a tradition and legendary sporting event that the French public adores. My children have literally spent 21 days glued to the small screen watching the yellow, polka dot, green and white jerseys rival for a place in history, or at least a place in the heart of the French public.
Cycling is a pretty safe sport. At least that’s what I used to believe. Le Tour de France changed that for me. Over the last three weeks, I have witnessed dozens of injuries, some of them pretty severe with broken collar bones, fractured knees, broken elbows, too many soft tissue injuries to count (cuts, abrasions and lacerations) and some head injuries. My children of course love watching the riders race down the mountain at nearly 50 miles per hour, while waiting for the next fall or accident to happen. There were indeed a few nasty accidents, enough to keep them on the edge of their seats, but thankfully nothing too serious this year. In 1995, an Italian cyclist died after major head trauma and helmets became compulsory afterwards.
The race is now gruelling and has very little in common with the original event when in July 1903 59 riders started a gentle race, over 6 days, wearing shirts and flat caps. You have to remember that the bicycle was then only 20 years old ! These days the race is incredibly demanding with many riders suffering injuries and illnesses over the three weeks.
What about concussions? I haven’t actually heard the word concussion once while watching all that footage on television. Professional cycling seems to lack an established concussion protocol and there doesn’t seem to be anybody in charge of stopping a cyclist remount his bike after a fall when they might be wobbling all over the road after a crash.
In team sports, like football or rugby for example, when a player suffers from a suspected concussion, it is very likely that the incident is filmed by the media or that multiple witnesses (medical staff, team doctors) are on pitch side and can help take decisions. In outdoor cycling events, like the Tour de France, it is of course a lot harder to spot such incidents. The TV cameras will of course focus on where the action is like the tête de course, or lead group, the échappées, or breakaways, and the peloton. If an accident happens away from those cameras, it might not be seen by the team cars, the TV crews following on motorbikes and even the viewing public who likes to line the roads. How can you then remove a cyclist immediately for a head injury assessment?
At grassroot levels, addressing the issue of concussion is an even greater challenge. Organised team sports have been pro-active in removing players and implementing return to play protocols but we need to continue raising awareness and education about concussions for other sports where it is generally a lot harder to spot the injuries. Parents and children who cycle, regardless of their abilities, need to be informed of the signs and symptoms of concussions and make sure they don’t return to cycling too early if they suffer from a suspected concussion. Like in other sports, “If in doubt, sit them out”.