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November 24, 2017
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  • ebbe

    Some interesting thoughts here, Neal. There might simply be no a good solution for these sorts of circumstances: I wonder how people would have responded had the mechanic flat out refused to give Skujins his bike back when Skujins asked for it. I’m pretty sure there would have been mass outrage as well, along the lines of: “He’s not trained as a medic”, “He’s influencing the race”, “He’s stealing the bike”, etc.

    The only way to really tackle this would be to write some sort of rule mandating a medical check, by a trained medic, after every crash. Rugby inspired perhaps. It might even be possible to make that check international, with standard questions/answers that the riders can memorise up front. A fully conscious rider would be able to recant the standard answers, a confused rider won’t. But then there’s the inevitable down side… of course the time that check takes could mean a rider who’s perfectly fine will at some point lose a race (or even misses the time limit and be eliminated from a race) as a result of that check. There are no time outs in cycling.

    Maybe the most important lesson here is for cycling fans and media to have a look in the mirror and to stop celebrating athletes who get back on a bike after a crash as “hard as nails”, “warriors”, etc. Maybe we should start celebrating sanity over (extraordinary accomplishments paired with) foolish risk taking. Top tube descending comes to mind, but there are various other examples of course. Such a shift in mindset might do something to help with the doping problem (in various sports) also, specifically the use of pain killers.

    Another contribution (but would not have helped in this specific case) would be to allow substitutes in stage races, as is normal in most other team sports. That would reduce the need for hurt riders to continu when they shouldn’t. Of course a substitute would be ineligible for any classification or jersey, but they could take the place of a colleague who’d be better of resting or taken to a hospital.

    • Neal Rogers

      Thanks Ebbe

    • Mike Williams

      How stupid do you have to be to give a cyclist back his bike after he had staggered into the racing line to pick up some piece of crap that fell out of his pocket?

      • Rahsaan Bahati

        He wasn’t stupid! He is trained to do one thing and thats fix the bike and get the rider back on the road. Sitting on the coach watching the tube, we’re lucky enough to have a low heart rate. When the Sram guys encounter a situation their adrenaline sky rockets, and back to my first point, they want to fix the problem and get the rider back on the bike. There are so many different elements that went into the Sram guy hopping off his moto and going to the rider which are to many to list here however I would say, instead of calling someone stupid, which totally negates the narrative in this article, how about NOT be stupid and offer suggestions and resolutions. Here is one I would add:
        Perhaps the driver and or passenger on the moto should have some sort of entry level Medical EMT training. More times than none they are the first to an accident and see the aftermath seconds after a bad crash. Thats just one suggestion which I have many.

    • DaveRides

      The controversy over a neutral mechanic making those decisions would be averted by giving them two clear ‘screening’ rules which could be implemented without them requiring any medical training:
      1. Require they check that the helmet hasn’t taken a hit. Helmet damaged = wait for the race doctor.
      2. Allow them to only fix the bike, not help the rider remount the bike. Can’t remount unaided = medical disqualification.

      Allowing an injury substitute is way overdue in 2017. To prevent teams from abusing the rule to swap in a rider with fresh legs, the substitute riders for a WorldTour or HC race could be provided by the host nation’s U23 national team rather than the team’s normal roster.

      In addition to an injury substitute, a medical disqualification rule would be more likely to be accepted if a ‘false positive’ (i.e. checked out at the hospital and fully cleared) could have the medical disqualification lifted and the rider allowed to resume the following day. They could be given the time of the last-placed rider from the group they were with at the time of crashing for the incomplete stage.

      • ebbe

        I do like your ideas Dave, however I’d predict is that there will be many false positives and riders will not be happy about that. I regularly see riders posting pictures of cracked helmets, accompanied by “the helmet saved my life” or some variation. 99% of the time they are indeed fine, and just want to continue asap (with a new helmet of course). So there needs to be some sort of agreement that riders will submit to these kinds of checks (either a quick helmet check, or a concussion protocol, etc) otherwise we’ll end up with yet another never ending saga over something that is supposed to be an improvement being rejected.

      • John Murphy

        In the heat of the moment where seconds mean everything, it’s hard to tell a scuff from a crack and how do you draw the line in a concrete sense?

        They have enough on their plate trying to restore a damaged bike.

  • cthenn

    Impossible to implement any kind of effective protocol. Bike racing is too dynamic, too spread out. It’s not like the NFL where everyone is confined and if a player is injured on the field, all attention can be given to him. What can you do in a bike race? You can’t have a doctor with every rider, or every group. A crash can occur anywhere along a line of riders spread out over 20 minutes or even more. Impossible. In this case, it was as clear as it could be that Skujins should never have been able to remount, but what is a neutral support mechanic supposed to do? And again, there could be instances where no one even sees what happens, no cameras, no motos, no nothing. What if cameras didn’t catch Skujins stumbling around and bouncing off the curb?
    If he is “forced” to retire, there would be outrage on the other side, saying that it’s up to the rider and team if they should abandon. Unfortunately there really is nothing that can be done. Only in circumstances where a rider crashes near a race doctor, or team car can these decisions be made on the spot. But we don’t need any kind of rules or protocol for this, it would already be clear to those around.

    • Mike Williams

      You fall, then you have to wait to be cleared by one of the doctors before you can re-mount…pretty simple and no more disruptive than a mechanical.

      • Michele

        What constitutes a fall? Do they need clearance every time they hit the tarmac?

        ‘No more disruptive’ … I’m pretty sure they are more team cars / individuals providing assistance for mechanicals than there are doctors in the peloton.

        It would be significantly more disruptive.

        It’s not ‘pretty simple’.

        • Mike Williams

          Your bike hits the deck, you wait for a doctor to give you the OK…it would incentivize the USI to put more Doctors in the convoy.

          • John Murphy

            That would change bike racing as any crash will effectively end your race.

            Froome crashed at last year’s Tour de France, if he had to wait he’d of lost. He was fine.

      • Nick Clark

        It would be massively more disruptive, and definitely not simple…

        What happens when a group of riders come down together (as per the other day at the Giro)? Does everyone who hit the deck have to be checked? If so, checked by who? Who decides the order that people are checked in? If there’s 30 riders on the deck, do the first checked get to continue riding straight away? If not, is the race neutralised? If so, what happens to the breakaway? Etc. etc…

        Assuming that any solution to an issue like this is going to be ‘pretty simple’ effectively guarantees you’re not going to find a solution…

        • Mike Williams

          Just how many of these do you think happen in a stage? If (the likely majority of them) they come down within 3km of the finish, then its a non-issue. If its what happened to Thomas at the Giro, then the convoy is right behind the peleton so it would take the doctor less time than their team car (even at the Amgen they claim the doctor was there within 2 minutes). The doctor(s) could simple reverse triage the riders: send the obviously non-injured on their way first.

          You can’t trust the judgement of the rider, the team, and based on the comments from the UCI and SRAM in this case the support personnel. So you make it automatic…much simpler.

          And I will also refer you to a race a few weeks back where the doctor had to argue (for a few minutes) with a clearly concussed rider that he could not continue the race. In my system, the team has to take the bike away…they have nothing to ride…end of discussion.

  • Greg Keller

    “Most teams in the race also have a team doctor, who often rides in the second follow car, behind the peloton, essentially in a sweeper role. On Monday, Cannondale-Drapac medical staff was at the finish, in San Jose.”
    Did Cannondale say why? (Not casting aspersions, just curious.)

  • takethattakethat

    How many cyclist are going to have to die before something is done about how unsafe professional cycling is? Its 2017 not 1965 this is fucking shameful.

    • Superpilot

      But what? Take out every potential for a crash? No descents, group sprints, cobbles, wet riding? Even riding piano you can touch wheels and crash. It’s a person riding a bicycle, there is not so much you can do directly with its inherent dangers, more around what support you can put around the peloton, and removing dangers around them.

      • Luke Harvey-Palmer

        No, just apply a simple culture of care and concern for the athletes. This is not a job, nor does it need to appear in a job description. If everyone’s prime responsibility was the welfare of the riders – and their ‘job’ their secondary focus, then things would change for certain. If I am walking to work, and see someone wandering the streets in front of cars, dazed and confused – do I help them, or just get to work and when I learn of someone people seriously injured or killed in a later report, do I just shrug my shoulders and say, I was just on my way to work to do my job. Come on, common sense, and cultural change around the sport is required. It doesn’t make it a less excitng or dangerous sport, it would have the opposite effect, because when I do risk all, and have a mishap, I will be comfortable knowing that at least people are looking out for my welfare, and I am looking out for theirs (which would ultimately stop me from doing anything too risky in the first place).

  • the_NEW_contender

    If the crashed rider can not remount, neutral service should not assist the rider in that foolish endeavor. Neutral service should focus on the equipment (is it mechanically sound and operational?) and not participate in helping crashed riders remount.

    • MTZ

      what it the peloton have hit the rider?

    • John Murphy

      That wouldn’t really make things less dangerous, perhaps even more so.

      A concussed rider flailing around trying to get on his bike unassisted is more of a danger to himself and others.

      Heck, mounting a bike perfectly clear headed isn’t the easiest thing to do.

  • jon

    From the perspective of equipment, perhaps this is where disc brake and tires greater than 25mm shine; better brake modulation during descending, and wider tire for larger contact surface, which in turn would provide greater traction. I’m sure many would disagree, but personal experience tells me that a steep, technical descend, is better engaged with wider contact surface and better brake modulation. The argument of added weight will dissipate and fizzle into nothing with the slow and yet steady progression of technology and engineering. American motorcycle legend, Wayne Rainey, broke his back at Misano in 1993 while racing in the two-stroke 500GP class, as sad as the incident was, the silver lining was the invention of spine protection system that motorcyclists could don for racing or casual riding, and since then spinal injury from racing has drastically reduced.

    Onto a darker note. Sport in many ways are very much like war, at least in the ultra competitive sense. Like war where there will be fatalities whether we like it or not, cycling will have its fair share of crashes. This is the risk that one takes, if you can’t stomach it, then perhaps this isn’t for you, and it is the same reason why UFC isn’t my cup of tea; I don’t understand the idea of getting the crap beat out of someone and at the end the looser has to show sporting spirit and hug/ shake hand with the winner. As much as it is cliche, “no guts no glory” or “fortune favors the bold”; many will take great risks in the heat of the moment. Young riders will do everything in their power to shine and make their mark in the pro rank; this is especially true, considering that two years ago Skujin was the victor riding into San Jose, on that day, he nearly crash on descending as well. Skujin’s crash while very unfortunate it is also fortunate that it didn’t result in fatality. When Jorge Lorenzo first entered the MotoGP class with Yamaha, he would crash in FP1, FP2, maybe even during warm up, and then come out destroy his rivals on Sunday. Again, I don’t get how someone can push their body so hard day in day out all the while risking death, perhaps the same is true for Isle of Man TT, someone will die there each year. And this to me is true in every bit. I met skateboard legend Steve Caballero many years ago, he can barely walk then, is he well known in skateboarding? you bet! but at what cost? BMX Legend Dave Mirra also paid the ultimate price.

    Fundamentally, injury and death will happen in sport, but instead of assigning blame, it would be more constructive to simply update protocols and equipment to let the competitiveness fulfill itself to the fullest extent.

    • Superpilot

      The riders would just use better equipment to go even faster though. then if something outside the equipment leads to a traction failure (gravel on the road, overflowing drain on a dry day, wet road, user error) then the speed and impact is even worse.

      • jon

        Sure, though, it is the nature of progression I’d argue. At the end of the day, we’re our own limitation and guardian, we decide when we would tap the brake to reduce speed and we would push to the max. A perfect example I’d cite is an interview with Emma Pooley in Cycling Sports several years ago. This is right after she was crowned world champ in TT. She talked openly about how she is not as good at descending as others, so she would repeatedly practice descending the same section until she is comfortable with speed.

  • I wonder what the TV moto pair were thinking while filming/watching the entire situation. They were the only ones that were there that watched the entire thing go down. The neutral support guy was busy running through checklists and making sure equipment was correct.

    Something should be done about this but it is an extremely tough situation since there is a subjective side to this. Experience and education can help but it is still extremely difficult for neutral moto to make a medical decision and possibly cost a rider the race.

    • Anon N + 1

      You make a good point. I suppose the camera operator or the pilot of the camera moto could have called/radioed the race commissars and requested urgent medical attention for the rider.

  • Alan

    “The good news, of course, is that Skujins was not seriously injured” — pretty sure he was!!

    • CuttingRemarks

      I also found that line incredibly misguided – a poor choice of words at the least. Not even a week ago Cycling Tips ran an article specifically addressing the underestimated and under-discussed issues around concussions (https://cyclingtips.com/2017/05/no-things-just-concussion/). It seems Neal missed it. Otherwise a nuanced, thoughtful piece.

    • Neal Rogers

      It’s a bit subjective, but “serious bodily injury” is defined as “Bodily injury that involves a substantial risk of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or protracted loss or impairment of the function of a bodily member, organ, or mental faculty.” Skujins could be back in the peloton in a month. That’s not a serious injury.

      • Nifty N

        Great article Neal, thanks.

        I might add it could also take him months to fully recover, with the potential list of on going symptoms being rather extensive – physical, cognitive and emotional. Not to mention the risk of Second Impact Syndrome. Maybe on this point we’re arguing semantics, but the CT article made the valid point that it is never “just a concussion”. Even in the midst of a solid piece journalism this can lead the reader think, “Oh, he’s alright then.”.

        Hopefully, however, in the aftermath of these events and after the discussion that surrounds them, there is a trickle down affect into the lower levels of the sport in terms of awareness and treatment of concussion and head injuries.

  • oitotheworld23

    I’ve gotta say, I wasn’t always a Neal Rogers fan (he even blocked me on twitter years ago.. likely for good reason), but he has been putting out some good stuff lately (this and the Travis McCabe article). Keep up the good work.

  • zosim

    ANYONE who has dealt with a concussion in cycling needs to take control. I have walked several friends to ambulances rather than letting them ride against their protestations that they are fine.

    • Superpilot

      I also found a chap once sprawled on the pavement with an obvious concussion. He instisted he was fine to ride back home. I rode him slowly to safety, then he thankfully remembered his partners phone number and I had to talk her into taking him to emergency dept for assessment. But it stuck with me that he could barely stand, yet was insisting he could ride. Would have been so dangerous if he had of ridden on the road again!

  • Joelbass79

    Good article… but what about helmet inspections? I don’t know if Toms’s helmet was damaged, but the impact certainly looked like it should’ve taken a beating. Checking helmet integrity is certainly not perfect, but it’s a more objective point of inspection that could fall within UCI rules when it comes to proper equipment. If the helmet is damaged–cracked shell or compressed/damaged foam–they have to wait for a new one, and with the new one comes a concussion check. Obviously there will be missed concussions, because not all concussion causing impacts will damage the helmet, but there’s got to be something neutral support or mechanics can do to help prevent situations like this that can be done quickly and fairly objectively.

  • lpto

    Forget concussion-detection training for everyone. CPR should already be trained for everyone in my opinion. However it’s year 2017 and it would be pretty easy for the cycling community to come up with a product that would live stream multiple data streams from a cyclist to the race commissaries, this could include accelerometer data from the helmet or head. All the technology pretty much is already out there.

    Personally I’d lower the bike weight limit by 1kg and make it mandatory for all riders to carry gear with necessary sensors to record the multitude of data including “concussion sensors” and live transmit it for the race lead. Take example from Formula 1 for example with their standardized car-electronics and transmission equipment. Also virtual safety car is a great idea.

    Just make the riders carry a LED-display, in which every LED would contain a different set of instruction. Even a LCD-screen could work. Taking it further the system that would decide on concussions could be even automatised. This way there would be no guesswork included.

  • Al Budynski

    Helmets that “bleed” marking paint, say purple so that it’s not actually confused with real blood, would indicate concussion level forces were sustained. This way, even mechanics can tell when the rider needs a medical checkup. This technology already exists. It would need some development for this application but this is not asking a lot. Also, communication. Why doesn’t the race doctor have live video feed in their car??????? This and the ability to communicate w the neutral mechanic at the scene would have prevented Tom from mounting the bike.

  • Superpilot

    What if the neutral support had evaluated and decided to pull a rider from a race, when the subsequent evaluation shows that they are fine. How happy would the riders and teams be?

    Short of removing any rider who has had an accident from the race immediately, there is no clear objective method to evaluate 100% accurately how significant a head impact has been, and its effects. There are plenty of anectodal cases where a significant head impact has not lead to a concussion, but correspondingly where a seemingly minor impact has lead to massive life changing continual side effects.

    Grey matter is a very grey area.

    I’m of the opinion the neutral support did as he was asked. He probably didn’t even see the initial impact as he was on the back of the bike? If there are to be changes, they have to be given the power to make an evaluation and to have that be followed without the fear of repercussions from the rider, teams or organisers. Personally I think there are too many vested interests for that power to go so far down the chain though.

    As some have said, even a pitch side evaluation of concussion is very subjective and that is by a designated medical specialist. Now add that on the shoulders of an dude that probably works a a bike mechanic most of his life, wants to do his job description because he wants to keep his job, adrenaline fuelled because he is looking at blood and tattered clothes on a banged up rider, thinking about fixing his bike, cars and riders are whizzing past, the rider is losing time, and he has to remember and calmly evaluate someones medical state?

    Hmm…

    Don’t get me wrong, something should be done, I’m just saying that in this instance I don’t blame anyone or think the neutral rider or organisers are culpable. They did what every race organisation has done for a very long time, and it is unfortunately part of cycling as it stands today.

    I was thinking, compared even to in the early 2000’s or 1990’s, he probably got far better attention and care. How many of our past heroes have done the same, and then ridden through to the stage end, then ridden the rest of the tour? Not saying todays care can’t improve, just how bad it was previous..

    Changes may need to be made, but from this point forward.

  • Luke Harvey-Palmer

    Lot’s to be said here, and plenty of divided opinion, but I am pretty sure in most workplaces, and in most professional sports the #1 concern and obligation of all participants (riders, soigneurs, mechanics, managers, support) is the safety and welfare of the athletes. Simple.

    SRAM hiding behind protocols and saying ‘he only did his job, he is not a trained medic’ is PR bull#$%^. I understand why they have to make this statement, but someone also needs to call foul on this and take responsibility for the welfare of the rider. That situation was unsafe for several people. Period. You did not need to be a trained medic to recognise that and act with care and concern.

  • Scotttropical

    Well said Luke, I’m tired of all the “what ifs”, “he’s just doing his job”, “its a grey area”, and all the other lame excuses. It’s only a bike race versus someones life. A Bartender can get sued for just doing his job, serving drinks to an obviously drunk person. He has an obligation to cut off the booze. By saying the SRAM support was just doing his job is so wrong. OK maybe he is not trained to spot a concussion but IN THIS CASE it was so blatant that something was wrong. So what if Toms get mad, what is he going to do? Could you imagine the uproar if rode into another rider or a race vehicle and died? I was screaming at my laptop not to put him back on his bike. If I was standing on the road and saw that happen I would stopped him from getting on his bike. All at the risk of being yelled at or sued.

    • Nick Clark

      The bartender analogy doesn’t work… Identifying someone who’s drunk too much is part of RSA training which is required to work a bar, and it’s illegal for a bartender to serve drinks to a drunk. So no, a bartender can’t get sued for ‘just doing their job’, they can get sued for not doing their job…

      A neutral service mechanic is NOT trained in identifying a concussion, and it is NOT part of their job.

      Also, there’s a bloody big difference between watching something like this unfold from the side of the road (as an uninvolved onlooker) and choosing to act, and being directly involved (as the mechanic) in a very tense, fast moving situation and have the awareness to notice what’s going on, and then the judgement to make the right call.

  • David

    It was obvious he was badly concussed, even a race mechanic could see that. Letting him back on his bike was irresponsible.

  • Stuttgart5

    In the future riders will wear more protective gear, covering at least the shoulders and hips. The question is when,not if. And they will look back at history in horror. Every rider crashes multiple times per year.

  • Simon Van Rysewyk

    Hi Neal,
    Great introduction to the complex issues bedevilling pro cycling-related concussion/brain injury. I am the Communications Manager at Brain Injury Australia. A couple of quick observations:

    (1) Sports-related concussion (SRC) is among the most complex injuries in sports medicine to diagnose, assess and manage. Currently, there is no perfect diagnostic test that can be used to immediately diagnose SRC.

    Importantly, delayed-onset symptoms of SRC are real and there is a need to consider follow-up evaluation after a suspected SRC, irrespective of a negative sideline/roadside screening test.

    Ben King: “I mean, you have to know the baseline as well.”
    Baseline testing may be useful, but is not necessary for understanding post-injury scores. If baseline testing is used, clinicians need to replicate baseline testing conditions.

    Current evidence does not support the use of impact sensor systems (e.g., in helmets) for real-time SRC rapid screening/assessment.

    As a suggestion, a trained medical officer could ride with the neutral support mechanic, or immediately following, on a separate motorbike?

    (2) Sport Concussion Assessment Tool (SCAT) 5 is now available, and should soon replace the use of SCAT3 in pro/amateur adult/child sport (http://bjsm.bmj.com/content/early/2017/04/28/bjsports-2017-097506.long). SCAT5 includes the Maddocks’ questions and the Standardised Assessment of Concussion (SAC).

    It is important to know that orientation questions (eg, time, place, person) are unreliable in the sporting situation compared with memory assessment.

    (3) The Consensus Statement on Concussion in Sport, based on the 5th International Conference on Concussion in Sport (Berlin, October 2016) is now available (http://www.braininjuryaustralia.org.au/wp-content/uploads/Concussion-Consensus-Statement_Berlin.pdf), and is good background reading.

    • Neal Rogers

      Appreciate all this, thanks Simon

      • Simon Van Rysewyk

        :-)

  • badhombrebigdo

    I saw that crash live. Letting Skujins re-mount and continue to ride was supremely reckless and shouldn’t of happened… that said Cannondale staff reeled him in later and he got to show just how much of a brave ass hard man that he is.. respect to him, but honestly, him displaying he’s got the stones to ride through a catastrophic crash on a descent isn’t necessary. Not for him or anyone.

    • Samaway

      Agreed. Such is the hyper-masculinity of cycling (and sport), unfortunately.

  • Cruz er

    Blaming neutral support is nonsense. This is really disturbing but it’s not the fault of neutral support. Those guys are hyper focused on trying to get the bike going. So many times riders are frustrated by a less than quick wheel change, and those support guys are just doing their best.
    He was so focused on the bike, he wasn’t even paying attention to the rider’s condition in the heat of the moment.
    It’s easy to judge, looking at a video from arms length, in the comfort of an armchair but this kind of blame assigning is nonsense.

    I really think Neal wrote a balanced article here and people should take the time to objectively read it.

    If it went the other way, people would be blaming neutral support for holding up a healthy rider and that he is not a medical professional, and what right does he have to do that?
    They can’t win.

    • Scotttropical

      Again with the what ifs. This was not a case of simply sliding out on a corner, he slammed his head on the pavement and was clearly unstable. Who can honestly say he was fit to get back on that bike after seeing him slam his face on the tarmac and stagger around like a drunk. If his arm had a compound fracture should that have kept him off the bike?

      • Cruz er

        It’s easy to be an armchair quarterback and start the blame game. It’s more difficult to look at the circumstances and what the situation was at the moment. Again, read the article. The rider is fine, and recovering. No one was killed. This is what one would call a “teachable moment”, if the UCI cares to learn from it.

        The only “what if” is to those blaming neutral support, because with that train of logic, no one will ever be in the right.

      • ebbe

        You’re now assuming neutral support guy watched the whole thing in slowmotion as we did on TV, including the crash, Skujins hitting his head on the asphalt, him staggering, etc… It’s more likely neutral support guy came from behind a corner or a group of riders, pulled up when saw a bike and rider lying there, then devoted his attention to securing and checking the bike.

        I do like how you’re accusing Cruz er of using “what ifs” and then ending your own comment with a “what if” ;-)

        • Scotttropical

          It is not a what if, it is a question. If his arm had bones sticking through the skin should he get back on his bike? Yes or no?
          Of all the people watching, 2 moto drivers, camera man and numerous bystanders nobody stepped in. So what if the SRAM moto didn’t see the crash many others did. The video was not in slow motion.

          • ebbe

            “What if…” IS a question, by definition! ;-)

            So to answer your question: What if (yet another what if) the neutral support guy didn’t see the crash (because he wasn’t there yet) and what ensued (because he was working on the bike)? That makes a HUGE difference. Your argument was (I quote) “he slammed his head on the pavement and was clearly unstable”. How can you hold anything against somebody who didn’t even see that because he was doing his job mending the bike? Should neutral mechanics or cameramen (they were the only ones there) make the call to pull a rider out of a race? You can be pretty sure that would be deemed unacceptable by riders and teams in 99% of cases.

    • Samaway

      As the article states, “From the SRAM perspective, and more specifically, from the neutral race perspective, his job is to protect the rider from other riders and race traffic, and to get him back on a safe machine. He is not there to make medical assessments of the rider.” If this is a correct summary of their duties, then the neutral mechanic sure as hell failed. Skujins could hardly stand, and had staggered into the middle of the road in front of a chase group. The mechanic did nothing to “protect” him. It was a truly shocking moment, and we’re lucky the road was wide enough for the group to go around Skujins.

  • Bakers Dozen

    Neal, it looked like Tom crashed on the edge of a sunken underground utility repair trench. Has anyone reported that to the roadway authority to get it fixed before another person riding a bicycle crashes there? I’m also curious about the cone on the right of the road. Was that a half-baked attempt to ‘mark’ the (known?) hazard? Race courses and roads generally need to be reasonably safe. A number of people have roles in that.

    • anonyfool

      I don’t know about that particular cone, but there was an extended period of rain in California this past winter/spring and there are many roads with similar marking/cones in all the mountainous areas I frequent near San Jose for erosion of the shoulder/road edge and I assume it’s state wide. Since they are still fixing major problems like impassable lanes still, these *minor* issues that permit car traffic are still around. It’s been about four weeks since it stopped raining and several roads and fire roads/trails near me are still closed with no estimated date for re-opening, in several cases the entire hill side supporting the road has slipped away for hundreds of yards.

  • David Bonnett

    Neal – thanks for a well thought out article on a tough topic. As one of the many watching the live stream who was saying “Don’t let him back on his bike!” as it happened, in retrospect I do think that what sounds great in principle (stopping this from occurring in the future) is much harder in practice – the first time a race doctor holds up a rider post-crash who could have been in contention, expect screams of outrage. Don’t forget that Toms had crashed *on the same descent” (different spot) in 2015 and remounted to win the stage.

  • Luke Bartlett

    It’s essentially impossible to have a blanket rule for head injuries. So it doesn’t make much sense to try to enforce a blanket rule ie. Post-crash you must be diagnosed before taking further part in riding. Accelerometers even won’t work very well, considering the fact that how the acc. is applied and who its applied to makes a huge difference (ie. “glass jaw”). Maybe the UCI say that for every crash where there is obvious damage to the helmet, it must be replaced. Even in a case as seemingly obvious as this, you can’t expect someone who is, at every other crash, completely under the pump to ensure rider safety after the remount (by way of checking the bike) to be responsible also for diagnosing traumatic brain injuries by monitoring the rider when they’re also monitoring traffic/the bike/fidgeting with wheels.

    It was sickening to see him remount like that, and maybe we simply need the race director to make a call to pull him out via race radio based on images alone. What about when the crash/post crash isn’t televised?

    So there’s a situation that a rider isn’t willing to pull himself out/doesn’t feel he has to, a mechanic doing his job focusing on the bike, the race is all over the road so resources are spread out, it’s just a shit situation.

    Does the UCI make a concession for riders with a head injury? something like a time bonus applied at the end of the stage which would seek to compensate a rider waiting on the road to get checked out? does the UCI make a concession that after a head injury the rider can simply dismount and be ruled out of GC and can get on the next day? That probably wont help since if a rider stops it is most likely a bad injury and they wont take any further part in the coming days. We saw with Rohan Dennis that even after feeling symptoms of concussion after a rest day he tried to push on, which IMO is utterly stupid since the only real recovery for a head injury is darkness and rest (ie. not racing a bike at 50km/h).

    Sports need to invest in studying brain injury like they do with soft tissue injuries.

    tl;dr
    -theres no simple solution
    -you can’t assign blame to any one person
    -invest more in the mechanisms involved to make more informed regulations

  • BobG

    Replace one photo Moto with a medic that always follows a break. The issue here was that the cars following the break were waved ahead and the rest of the cars were following the peleton. The break was isolated on a fast and technical decent except for a few motos. One of which could be a medic.

  • De Mac

    Great article, which yet again highlights some of the dynamic situations that influence cycling. Whilst many have criticised the SRAM neutral service bloke, the reality is that he had a specific mandate and had he not limited himself to that, it would’ve brought plenty of criticism. Toms was in no way, shape, or form in a position to keep riding – as evidenced by him falling over on two further occasions and almost hitting the kerb, after he re-mounted. The race organisers ought to have had someone there to determine the extent of the injury and act appropriately – the amount of motos and cars in the race, yet no medical assistance was available to the lead bunch of riders, on what was roundly described as a very dangerous descent??? I’m glad the bloke is alright, but the incident certainly turned the stomach at the time…

  • That was disturbing to watch the footage of Skujins try to get back on his bike. It’s hard to imagine how these things fall through the cracks, but interesting to understand the complications. Thanks Neal.

  • ?A basic sensor in the helmet could indicate if the helmet has had excessive force and could be the first indicator before medical care ?arrives.

    • Nick Clark

      Worth reading the response from Simon Van Rysewyk above – “Current evidence does not support the use of impact sensor systems (e.g., in helmets) for real-time SRC rapid screening/assessment.”

      • Thanks for that @disqus_tkYXS1xCah:disqus. Some very interesting points. Also Interesting comments @simonvanrysewyk:disqus, specifically around devices. I would have guessed that this would be not be an issue these days with miniaturisation and accelerometers. Hasn’t ICEDot started something? https://cyclingtips.com/2013/12/icedot-crash-sensor-review/

  • Pavel Volkov

    Chief medical officer or his assitant based on the live video feed (he can monitor a number of feeds but the main broadcasting TV feed was enough in this case) would pass radio instruction to hold off the rider via the main or medical radio channel. This is how this crash would be dealt with in motorbike road racing events.

  • Barnsy

    It’s simple really. Damage your helmet and your not allowed to ride until accessed by a doctor. I’m not sure of the rules elsewhere, but if you crash and damage a helmet in the state of NSW, Australia. You serve a mandatory week off and need a doctors clearance before resuming racing. Twice in the last two years I’ve had crashes at the vellodrome and broken my helmet. The first time I felt fine and was back racing after a week. The second time the commissars pulled me from racing for the day even though I wanted to keep going. I failed the concussion test when I went to my doctor the next day. They made the right decision, a secondary head trauma could have been fatal.

  • Scott Doherty

    crazy crazy crazy. that could’ve ended so badly. I wish someone on the scene, neutral motos, cameramen had had the nutz to refuse him his bike or had done a bit more. yeah yeah they’re doing their job but surely their should be a blanket rule if something looks really dangerous, dodgy etc anyone involved in the race should have some level of authority or discretion over a situation like that.

  • Scotttropical

    To all you people with some excuse for letting Toms back on his bike let me ask this. If you were there and saw it happen what would you do? I know what I would’ve done. And if I ever crash like that I hope it is witnessed by the people posting sensible and compassionate replies.

  • charlesojones

    The bigger issue is a complicated one that you’ve outlined well. In this particular incident however the immediate reactions from virtually everyone were similar – “why is he helping him get back on the bike?” I don’t think medical training was necessary to recognize that Toms was in trouble. I fully realize that a mechanic is not expected to be a medical expert. And as always, hindsight is 20/20, but again, virtually everyone’s initial thought was: Why is he doing that? I think the mechanic could’ve made a much better judgment under these particular circumstances.

    It’s all water under the bridge at this point. But for the future, the entire race caravan and the public in general would benefit from greater awareness regarding head injuries.

  • winkybiker

    The whole issue of riders remounting after crashing seems overblown. How many riders have suffered additional injury because they continued riding after a crash? Sure it COULD happen, but it isn’t really the issue here.

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