The Jonas Vingegaard incident proves cycling still has a concussion problem

In truth, it seemed like quite an innocuous crash. Jonas Vingegaard tumbled off his bike with 84km to go on stage five of Paris-Nice earlier this month, cutting his upper lip, and appearing to hurt his wrist. At the time, he was leading the race, and not willing to cede much time, the Visma-Lease a Bike rider jumped back on his bike, as riders normally do. There was no immediate cause for concern, although after the stage, the Dane was shown in discomfort, holding his wrist as he was examined by a team doctor.

However, later, his teammate Victor Campenaerts said Vingegaard told him he was experiencing "dizziness" during the stage. "Given the circumstances, it's very impressive that he finished this stage. I didn't get the impression that he was very lucid," Campenaerts told Sporza.

That sounds like concussion, a diagnosis the rider himself confirmed. "After the crash I was dizzy, and after the stage, I got very nauseous and was incredibly tired, which continued for the next several days," Vingegaard told B.T.. "I'm happy to be back on the bike, even though it took a little longer than hoped due to my concussion, which required a lot of rest.”

Adam Becket

News editor at Cycling Weekly, Adam brings his weekly opinion on the goings on at the upper echelons of our sport. This piece is part of The Leadout, a newsletter series from Cycling Weekly and Cyclingnews. To get this in your inbox, subscribe here. As ever, email adam.becket@futurenet.com - should you wish to add anything, or suggest a topic.

The 28-year-old’s injuries forced him out of Paris-Nice, which was won by his teammate Matteo Jorgenson, and also the Volta a Catalunya, which is currently running. It means that the Dane isn’t set to race until the Critérium du Dauphiné in June, although that could change.

More than anything else, though, what this highlights is that cycling is still yet to tackle the concussion problem. If Vingegaard seemed dizzy during the stage - as Campenaerts said - then why was he still riding?

The UCI has a concussion protocol, which is an initial assessment immediately after a crash, a post-race follow-up and another on the day following the incident. In the initial assessment, riders are asked if they have a headache, nausea, dizziness or double vision, followed by some test questions. It’s understood this was followed in Vingegaard’s case, and he passed the initial test, and so kept riding.

Regardless of the intricacies of this particular incident, it is a reminder that cycling has not solved its relationship with concussion.

The problem with a bike race, as opposed to almost any other sport in which concussion is a possibility, is that it’s on the move. In rugby, the directive is “if in doubt, sit them out”. This works fine within a sport which takes place in a stadium, where substitutes are available too. Tests can be taken by a neutral doctor, away from the action, and then a decision can be made.

In cycling, this would take place at the side of the road. Cycling is also the sport of the tough, the valiant. Where does not bouncing back sit in this?

Two years ago, at the Tour Down Under, Soudal Quick-Step’s James Knox was stopped for a concussion test after a crash, but then ended up being disqualified after he was deemed to have drafted cars in an effort to get back to the bunch. Knox did not have concussion, but that is moot - the concussion test took him out of the race.

There is no easy solution to all of this. Immediate concussion tests after every crash would disrupt races entirely, but riders - and sometimes their teams - cannot be relied on to always make the best decision in the moment that the action is disappearing up the road. Riders undergoing tests could be towed back to the bunch, but this would simply increase the grey areas - what if the incident happened at the end of a race - and it could also open the door for abuse. Perhaps riders undergoing concussion tests in stage races might be allowed to finish without losing any time, but this could be deeply unfair on a mountain stage, and provides no solution in a one-day event.

Ultimately, though, cycling needs to do more about concussion. Vingegaard initially rode on at Paris-Nice, before pulling out, but it was a tough decision to make. Broken bones are much easier to diagnose and then do something about - a broken collarbone is obvious, for example - while invisible injuries are an absolute minefield.

The alternative is the situation we have at the moment, where we have protocols which are difficult to enforce fully, and brain injuries remain a constant threat. They should not be underestimated. If in doubt, we really should sit them out.

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