The UCI Introduces a New Concussion Protocol

The Union Cycliste Internationale (UCI) yesterday published a new protocol on Sports-Related Concussion (SRC) that will apply to all cycling disciplines on the UCI international calendar from the 2021 season.

Source: Press Release / Photo credit: UCI / Team Arkéa-Samsic

The protocol is the result of a review and work carried out since 2019 by a group of international experts (doctors, scientists and neurologists) under the supervision of the UCI Medical Director, Professor Xavier Bigard. SRC increases the risk of cognitive impairment (effects on memory, speech and reaction time) which must be recognized and treated quickly.

The protocol is inspired by the 2017 Berlin Consensus Statement on Concussion, a common set of rules that defines a series of measures and tools to quickly identify SRC and manage athletes, and which each sport can adapt to its specificities.

The protocol sets out recommendations adapted to the sport of cycling, where responses to SRC – which, according to research, account for between 1.3% and 9.1% of injuries – vary considerably across the eight disciplines (road cycling, track cycling, mountain biking, BMX Racing, BMX Freestyle, cyclo-cross, trial and indoor cycling).

The main difficulty faced by cycling is the time it takes to reach injured riders and the ability of first responders to remove them from the road or track, confirm the diagnosis and make a quick decision (abandonment or return to competition) in the interests of the rider and other participants. Road cycling, mountain biking (Olympic cross-country and marathon) and track cycling (Omnium) are the disciplines most at risk in this sense – unlike BMX Racing, BMX Freestyle, Trial, Indoor and other track cycling events – where response times are short and doctors have the necessary time to diagnose SRC.

To address this problem, the protocol recommends that professionals (especially coaches, sports directors, mechanics and riders) be trained to recognize the signs of suspected SRC as they are very often the first on the scene after a rider’s fall. The protocol details the signs to look for when assessing the athlete’s condition (feeling dizzy or lightheaded, balance problems, headaches, speech disorders, vision changes) and to make an appropriate decision within an optimal timeframe, either at the roadside or at the edge of the track. Training resources in the form of symptom sheets will be published to help non-medical professionals detect signs of suspected concussion.

If these signs are detected, the diagnosis will have to be confirmed by the race doctor. In the absence of any initial signs indicating SRC, the rider must be monitored by the medical service. A standard examination including, among other things, time and place orientation tests (Maddocks questions) and balance, can be conducted at any time.

In all cases, the rider will have to undergo a more thorough examination after the race using the SCAT5 tool, including a neurocognitive approach. This examination would also be repeated the next day.

The full document is available here