UCI announces new concussion protocols
The UCI has announced all cycling disciplines will integrate new concussion protocols in 2021. These new protocols were specifically created for fast-paced sport and sports-related concussions, or SRC, to be formally added to the UCI Medical Rules at the Cyclocross World Championships in January 2021.
New protocols include expanded protocols for on-course and post-race assessments, as well as guidelines for returning to racing after a concussion.
The new framework takes into account one of the major issues faced when determining whether or not a cyclist has a concussion: The time it takes to account for signs of a SRC can make or break the race for that athlete, meaning riders are not likely to stop and assess their mental state before jumping back into the race. A good example of this is Romain Bardet’s crash in the 2020 Tour de France. Viewers watching the crash at home noticed symptoms of a SRC from Bardet, but without a doctor present immediately after the incident, Bardet was put back on his bike and allowed to race the final 90 km of stage 13.
If Bardet had waited for the race doctor to assess the situation that doctor might not have allowed the French rider to continue, as cycling stands now, it would be hard to ask a rider to stand on the roadside and wait for a doctor to clear them to continue the race. After the race, his team announced Bardet had been diagnosed with a hemorrhage in his brain and he did not start stage 14.
These new protocols suggest non-health professionals who are close to the events receive training to recognize the symptoms of an SRC on course. The general idea being that the first person on the scene would be able to recognize if the athlete in question is presenting signs of a SRC before the race doctor is present. Non-healthcare professionals include directors, mechanics, coaches, and the riders themselves. Immediate signs of a SRC include dizziness, trouble with balance, changes in vision, and slurred speech.
If signs of a SRC are present the rider must then wait for the race doctor to confirm the diagnosis. After the race is over the rider must be assessed again, using the SCAT5 neurocognitive test. The SCAT5 tool is the 5th edition of a sports concussion assessment test designed for licensed healthcare professionals and takes a minimum of 10 minutes to perform.
Crucially, the new protocols have also outlined the post-SRC actions. All sports-related concussions are to be reported to the UCI Medical Director. As for the riders return to competition, the UCI has suggested 24 to 48 hours of rest and a week off from competition. For junior riders, they have extended the downtime to two weeks.
Concussions have become more of a concern in the last handful of years as more research detailing the long-term effects is released. Cycling in particular has struggled to implement concussion protocols due to the fast-paced nature of the sport. Riders and fans alike have been calling on the UCI and the men’s riders union, the CPA, to implement on the ground concussion protocols for the safety of the riders.
“The issue of sports-related concussion was one of my priorities, along with the misuse of tramadol, when I arrived at the UCI in 2018,” the UCI Medical Director Professor Xavier Bigard said in a statement by the UCI. “Cycling now has guidelines that set out the various phases involved in dealing with SRC (initial assessment, diagnosis, recovery, and return to competition). This protocol applies to all disciplines while taking their specific characteristics into consideration. It will make it easier to trace individual SRC cases and better understand their place in cycling traumatology.”
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