Tour de France Concussions Raise Concerns Over Roadside Diagnosis Limits

Crashes during the Tour de France’s opening week have reignited debates about the challenges of diagnosing concussions in a high-speed race where time is critical. Three riders who abandoned the event since its July 4 start in Barcelona—Clement Berthet of Groupama-FDJ United, Alex Molenaar of Caja Rural-Seguros RGA, and Norway’s Torstein Traeen of Uno-X Mobility—all suffered concussions after crashes, retiring later that day once symptoms were confirmed.

All three cases followed a similar pattern: the riders crashed during stages, resumed competition, and were later withdrawn during evening hours after medical assessments. Berthet crashed during the opening team time trial, Molenaar fell five kilometers from stage five’s finish line, and Traeen collided with the ground on the descent of the Col du Tourmalet while wearing the yellow jersey.

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The leading medical director of the International Cycling Union (UCI), Xavier Bigard, acknowledged the limitations of roadside evaluations. He noted that the association introduced a concussion protocol in 2021, a year after French rider Romain Bardet rode over 90km following a high-speed crash without immediate diagnosis.

“We’ve made progress,” Bigard stated in an interview with Reuters. “But the roadside protocol is brief and conducted under intense pressure. A full concussion assessment requires 10–15 minutes with multiple tests, which is not feasible on the course.”

Groupama-FDJ’s medical director, Mathieu Le Strat, highlighted the difficulty of pressuring riders to stop when they are eager to continue. “Competitors are often desperate to get back on their bikes,” he said. “A thorough evaluation simply isn’t possible there.”

Tour medical chief Florence Pommerie emphasized the subtle and intermittent nature of concussion symptoms. “There’s no single red flag; it’s a constellation of signs that may fade over time,” she said. “Symptoms can disappear temporarily or emerge later, complicating diagnosis.”

Bigard and others reiterated that cycling’s broader culture still prioritizes performance. Pascal Chanteur, vice president of the CPA riders’ union, noted growing awareness of the issue but stress that “the urgency of finishing a three-week race remains a major obstacle.”

“Our goal is to make the protocol as secure as possible, even if it’s not perfect,” Bigard concluded. “But education and systemic change take time,” he added, underscoring the ongoing struggle to balance athlete safety with competitive demands.

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