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What happens after a bicycle accident?

We do not like to admit it, but crashes at the Tour de France are sometimes just as memorable as a sprint finish or the victorious attack on the last kilometers on the Alpe d & # 39; Huez. (Who else is responsible for looking for "cycling accidents" on YouTube?) While we do not want a cyclist (professional or non-professional) to do what we love most, it's no surprise that I do not want to look, but I can not look the other way.

But what happens after the Tour de France crashed is something we rarely get to see. After the bicycles have driven onto the sidewalk and the bottles fly, the peloton pedals and takes along the television cameras and motorcycles. We rarely know what happens to a crashed cyclist unless he wears the yellow jersey or is a serious competitor.

If you're Lawson Craddock, who suffered a particularly gruesome fall at the 201

8 Tour de France that resulted in a broken shoulder blade and a deep cut over the eye that requires stitches, grab hamburgers.

Then use your misfortune forever and collect over $ 280,000 to repair the Alkek Velodrome in Houston, which was damaged by Hurricane Harvey in 2017.

To get a closer look at the consequences of an accident, we tapped EF Education First Pro Cycling, Kevin Sprouse, team leader for medicine following Craddock's notorious fall, and Nate Brown, American racing cyclist for EF Education First Pro Cycling, who finished the 43rd rd at the 2017 Tour de France, answered all your burning questions. As you might expect, what happens after a crash is extremely cumbersome. Here is a rough breakdown of events.

What happens immediately after a crash?

As we often see in coverage, drivers and team members spend the first few moments after a crash assessing the damage. Is the driver okay? Is the bike okay? "First of all, we're looking for catastrophic or life-threatening injuries, and though such injuries are fortunately not uncommon in professional cycling, they're not uncommon," says Sprouse. "This consists mainly of a visual assessment, which is taught through many years of experience in the fields of cycling, sports medicine and emergency medicine."

This visual assessment involves observing the position of the driver, obvious injury and awareness of the driver, and being conscious when talking and making sense. Normally, the driver has already gotten up when the team car arrives on stage and is gathering. Sprouse needs to figure out what happened and if there are any injuries he needs to worry about.

"Of course, the assessment of possible head injuries is high on the list," says Sprouse. "Our drivers are aware of this priority and can very well participate in a fast roadside screen by answering questions about the current date, the race phase, the racing situation and so on. At the same time we unravel the motorcycles and bring them back to the road if necessary. A quick examination of the helmet is also part of this review.

Normally, the team car is the first to fall in the Tour de France, but if it is a serious crash and several teammates fail, then neutral support could help. Mostly the doctor drives in the team car and helps on the spot. At some stages, the doctor has to watch from the bus because the roads can be narrow and the race is often divided into several groups. In this case, the driver is taken to the bus or picked up at the hospital if necessary.

"There is also an ambulance following the race, if the injury is serious enough and you can not continue, you will be taken to the hospital in the ambulance," Brown adds. He is not seriously injured, looking for his bike, gathers himself and tries to continue driving. If the bike does not work, it waits for the mechanic or the car to arrive to exchange a bike or a whole bike. However, if the team leader crashes, it is the host's job to support the leader.

"If he can go on well, it only depends on when the crash happened. When it's in a very critical moment of the race and he has to get started as fast as possible, you give him everything he needs, "says Brown. "If his bike is broken, you give him your bike, if he needs a new bike, you give him your bike. When it's in a relaxed moment of the race, just wait for the team car to bring him everything he does needs, and then help him to return to the group. "

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How do drivers choose to cancel or not?

There is no consistent decision as to whether a crashed rider should continue or break off the race – the decision to abandon the race depends on the situation. It is usually a group discussion and decision between the team doctor, the sports director and the driver himself. Sometimes it is acceptable to overcome the pain and continue driving, as with Craddock, but the health and safety of the driver comes first.

"Ultimately, a driver can give up at any time, if he considers it necessary. If the doctor thinks that this is medically necessary, it is our decision, even if the driver and the DS [directeur sportif] want it to continue, "says Sprouse. "In such situations, I can honestly say that never before has a DS or team administrator given me a pushback. This is a testament for this team!

Brown repeats the statements of Sprouse. "When it comes to concussion, it's usually the doctor who asks you to stop, sometimes you're trapped at the moment and you do not want to stop, when the doctor sees signs that you've hit your head or concerns about a heavy internal one For most other injuries, it's up to the driver – I know some drivers continue with broken bones. "

Do teams monitor an injured driver?

While all teams have different processes, Sprouse was the team doctor present during last year's tour when Craddock crashed, and after a scan and a series of X-ray and ultrasound scans, the team decided he could continue because he did not have a head injury. "We all saw the iconic images of the blood, that dripped over the face after the stage (an obvious cause of concern), but after 24-hour monitoring, he did not show any concussion symptoms.

"From the musculoskeletal point of view, especially with respect to his shoulder, he worked daily with our entire medical team on the tour," says Sprouse. "Our team chiropractor Matt Rabin was able to do fantastic physical work every day with Lawson. The Soigneurs continued their daily massage, but also focused on the muscles around their shoulders, which would tire after each stage. We have all closely monitored his freedom of movement and the functional limits of the shoulder, as this dictated his ability to handle the bike safely. This was a daily assessment before and after the ride. "

Although not medically necessary, the team Craddocks continued to monitor fractured collarbone with ultrasound. "Although I knew that the fracture was stable and nothing would change its appearance, I think Lawson liked to have a visible confirmation of it. It was understandably reassuring. And since imaging technology is so easily accessible, there was no reason not to look.

When is it a running injury?

With Craddock experiencing visible pain in the rest of the tour, there is a bit of a problem Blurred border between what authorizes a rider to abandon the race and the time when it is acceptable to continue. Both Sprouse and Brown agree: Shocks are reasons for a mission stop.

"It's always a difficult parameter," says Sprouse. "We always pull drivers with a concussion or other serious injury, but in these cases there are generally no arguments or discussions."

"Head injuries are safe," confirms Brown. "For any other injury, it's up to the driver and the doctor to check if the pain is manageable, and usually fractures will not be treated."

How do you manage drivers who want to continue but should not?

It is difficult, as decision-makers influence not only the personal goals of a driver, but also the goals of the entire team. Each driver's contribution is crucial in a 21-stage race like the Tour, but it is crucial to keep the driver's career in context.

"It's hard," says Brown. "You never want to get out of a race. You must remember that stopping a race in the long run could be the best for you.

The recommendation of the doctor probably has the greatest weight if he decides to pull a driver. The doctor travels with the team, stays with the team, and gets to know each driver over the course of a season (and sometimes several seasons, depending on the driver). It is more like a conversation between two colleagues than an external opinion.

"Having built a relationship with the athletes makes this conversation a lot easier," says Sprouse. "I think most riders really understand and appreciate that our top priority is their health and not just their health today or this week! We try to convince them that the goal is to make sure that at the age of 40, 50, 60 they do not regret any health decision they made during the race. We want them to live a long, healthy and active life even after cycling. Knowing this, they seem to respect our contributions in situations in which they prefer to keep running, but we tell them that they should not.

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