'He couldn’t remember hitting the ground’ - Why Adam Yates’ UAE Tour crash should raise more concern over concussion protocol in pro cycling

The UAE Team Emirates rider continued to ride for 40 kilometres before abandoning the race with concussion symptoms

It’s a well-known fact that the convoy is one of the most hectic places in a bike race. There are team cars, motorbikes and dropped riders weaving their way in and out of fast-moving traffic – having the time and space to think is a rarity. When crashes happen, the chaos of the convoy only goes up a notch as team cars aim to service injured riders by getting spare bikes to those who have suffered mechanicals. Things move fast, and the peloton waits for no one.

It’s for this reason that time is of the essence when it comes to getting riders back in the race after an incident. The reality is that plenty of people involved in professional teams, including the athletes themselves, have a vested interest in riders getting back to the front of a race – especially a stage race. Results and UCI points are on the line, and the more strength in numbers each team has at the pointy end, the better. But at what expense? Is the hurry to get back to the peloton at risk of neglecting proper checks when it comes to a rider’s wellbeing?

Adam Yates’ recent crash at UAE Tour is the latest high-profile example of a rider who has suffered concussion symptoms after hitting the deck, yet continued to race on. The UAE Team Emirates rider fell hard on the hot tarmac roads to Jebel Jais with 47 kilometres of stage three remaining, but continued to ride until the lower slopes of the climb before eventually abandoning with ten kilometres to go. 

When the crash occurred, Yates looked to stand up in a relatively short period of time and speak to a UAE Team Emirates sports director before getting back on his bike. According to the team, the sports directors didn’t see any footage of the crash until far later in the race. By then, Yates was asking the sports directors what had happened in the crash, which triggered them to tell the Englishman to stop riding. Yates abandoned the race quickly and got in the team car. Afterwards, Yates’ teammate and race leader Jay Vine told the media: “He doesn't remember hitting the ground, so our thoughts are with him.”

The UCI’s concussion protocol did not appear to be followed in Yates' case. The protocol came into force in late 2020 and it outlines various guidelines when it comes to treating athletes who look like they could be suffering from concussion after a crash. It first shows a list of red flags to look for during a roadside assessment, such as ‘observable signs of concussion’ such as unconsciousness to a ‘blank or vacant look’. There are then mandatory steps such as a rapid symptom screen of the spine and neck, memory tests and mental examinations. The protocol says that a “delayed recall should be performed after five minutes have elapsed since the end of the Immediate Recall section.”

What was said between Yates, the medical team and UAE Team Emirates’ sports directors at the time of his UAE Tour crash hasn’t been confirmed, but the reality is that the British rider did not appear to be stationary long enough for the concussion protocol to be carried out. The symptoms he exhibited later in the race are a further sign of this.

As mentioned, race convoys are hectic and Yates was back on his bike relatively quickly after the crash. Credit should be given to UAE Team Emirates for ensuring Yates left the race as soon as he told them that he couldn’t remember what had happened in the crash (the team has provided video evidence of this), but the concern is why these symptoms weren’t spotted at the time of the crash. There is also the worry of whether Yates could have done more damage to his condition by continuing to ride after his crash.

The incident, once again, points at flaws in the UCI’s concussion protocol. The rules set out by the UCI don’t take into account that five minutes is a long time for a rider to be stuck at the side of the road, especially if they are then going to be penalised for drafting their team car to regain contact with the peloton – as James Knox was at the 2022 Tour Down Under when he was returning to the race after a crash, for example. The fact that the protocols do not insist that an independent medical professional should carry out these checks is also a problem – as mentioned, team doctors or staff members could have a vested interest in keeping particular riders in a race.

Finding solutions to the current flaws within the concussion protocol is certainly complex, but there appears to be certain steps that the UCI could take in order to avoid more situations like that of Yates' in the future. The first is allowing riders to return to the peloton with assistance of their team cars, which would mean there is less stress to get on the bike quickly and allow time for protocol to be carried out, the second is that the protocols could insist that the medical professional carrying out the checks is entirely independent.

There is also technology that the UCI could adopt to help it become less of a guessing game when it comes to the impact a rider has suffered in a crash. Lidl-Trek professional, Tao Geoghegan-Hart, has been vocal in his support of the company HIT (Head Impact Trauma), which has developed systems to check for concussion symptoms and measure the severity of a head impact in real time. In sports like American football and rugby, Smartfoam helmets exist whereby the foam measures the impact of a hit via electrical signals. The data is collected and sent wirelessly to the tablet or device.

Cycling is a sport which has a history of responding to problems retrospectively, rather than implementing change before it results in serious consequences. Concussion can be life-changing, and it’s something that the UCI should urgently address. Incidents like the one of Yates' today are happening far too often, and although it’s a complicated situation to monitor, there still needs to be more effort from all to do so.

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