Know what it is, when to stop and how best to recover from a concussion
Concussion
Cycling isn't usually considered a contact sport. There are no tackles, no collisions built into the rules, no referee watching for a heavy hit. But riders crash. And when they do, the consequences aren't always as obvious as the crash itself.
WHAT TO KNOW:
> A concussion doesn't require a direct blow to the head.
> You don't have to lose consciousness to suffer from concussion.
> Concussion symptoms aren't always immediate.
> If you suspect a concussion, stop riding and get assessed.
To understand what happens after a crash, we spoke to Dr Adrian Rotunno, team doctor at UAE Team Emirates-XRG, for our latest episode of the Helmet Podcast.
Why concussion can be hard to spot
A concussion is a form of traumatic brain injury caused by a forceful movement of the head and brain. That force can come from a direct impact, but also from a sudden movement of the body that causes the head to move rapidly. Unlike a broken helmet or a visible injury, concussion doesn't always leave an obvious mark: headache, dizziness, nausea, visual problems, confusion, unusual fatigue, memory or concentration problems and changes in balance or coordination can all be signs. Sometimes the clearest indication is simply that someone isn't quite themselves.
Cycling makes this particularly complicated. Adrenaline can mask symptoms, while your instinct after a crash is often to pick up the bike and carry on. In a race, there is also the fact that the race doesn't stop. If anything, sometimes it gets even faster.
But the things that make you capable of riding are also the things concussion is going to affect. Your balance, coordination, vision, judgement and reaction time all have to work together to keep you moving safely, often at speed and with very little room for error. You may feel capable of continuing without realising that one or more of those functions has been affected.
Lesson: Being able to ride away from a crash, then, isn't necessarily evidence that you're okay.
What happens to your helmet?
A helmet can't eliminate the risk of concussion, but it does help reduce the risk and severity of a head injury. Understanding what happens during a crash is therefore a big part of developing better protection. At MET, some of that learning comes from the helmets that come back from the WorldTour. One recent example is Tadej Pogačar's helmet from his crash at the Vuelta a España. Rather than simply replacing it and moving on, our engineers can examine the damage in detail: where the helmet was hit, if the structure deformed and what the marks left by the impact can reveal about the crash itself. From there, we can work backwards. What happened? How did the helmet respond? And what could be learned from it? Those real-world crashes become another source of information for helmet development, helping us understand how our helmets behave outside controlled laboratory conditions and where they can be improved.
Listen to the full conversation
There is much more to concussion than can fit into a few paragraphs. In the full podcast, Dr Rotunno and Danni Shrosbree talk through how concussion happens, what to look for after a crash, why adrenaline can make things difficult to assess, and what returning to riding should look like. Lesson: Knowing how to protect your head is one thing, knowing when to stop is another.
Learn from the UCI Concussion Pocket Cards
Dr Rotunno is a strong advocate for following the concussion protocol and recommends that every cyclist – whatever your level – familiarize themselves with the process.
You can download discipline-specific pocket cards here to consult at home.