- Dr. Denis Jacob oversees medical imaging inside the Tour's rolling hospital truck. Photo: Dan Seaton | VeloNews.com
- Although Tour doctors couldn't disclose the subject of this image, Jean-Christophe Peraud had a fractured right collarbone diagnosed in the Tour's mobile medical center the day VeloNews obtained this photo. Photo: VeloNews.com
PARIS (VN) — It’s a long and perilous road from the Grand Depart to the Champs-Élysées in Paris, and the accidents that inevitably thin the 198-strong peloton along the way are nothing new.
But the past 10 years have brought with them a host of new treatments and diagnostic technologies that help team medical staff assess and treat injuries and, more importantly, decide who can continue and for whom the damage is simply too severe.
Until this year, apparently serious injuries could only be evaluated off-site. Find yourself on the ground with a suspected broken bone or serious soft tissue injury and the only option is to pack yourself into a team car and drive to the hospital.
But hospitals are often far from the race, and hospital trips can bring with them the same attendant waits and delays familiar to anyone who has spent six hours waiting for a doctor in the emergency room. Instead, this year, the Tour unveiled a new 500,000 Euro mobile medical center, packed with equipment to diagnose and treat many injuries on-site at the finish of every stage.
The center carries a lead-lined room with X-ray equipment to check riders for broken bones, a sonogram machine capable of imaging deep injuries to muscles, tendons, and ligaments, and space for injured riders to shower, clean, and treat the kind of cuts and abrasions that are the hallmarks of falls from a bicycle.
“This is the first time we have had this trailer at the Tour,” said Denis Jacob, a radiologist from Dijon who was manning the medical center at the finish of last week’s time trial in Chorges. “This is a very quick diagnostic. In a half hour we can get the diagnostic, so you win time. And all the radiologists are specialists in sport. We understand the problems [riders can have].”
Having facilities on-site, Jacob said, can reduce the time to diagnose injuries from hours to minutes, meaning riders who escape serious injuries can immediately turn to rehab and recovery instead of sitting in a hospital room, waiting for treatment. Riders with injuries to the head or spine, which are serious medical emergencies compared to the fractures, bruises, and dislocations they more commonly see at the Tour, still require hospital care. But nearly everything else can be handled on-site, working in consultation with team doctors.
VeloNews confirmed that the availability of on-site X-ray imaging was a factor in Jean-Christophe Peraud’s decision to race this Tour’s second time trial, despite having fractured his collarbone in a fall during a pre-ride of the course. The decision proved disastrous when he crashed again during his race, falling heavily on his injured shoulder. Had he avoided the second fall, however, the ability to diagnose the extent of his earlier injuries quickly, and without a trip to the hospital, may have saved his top-10 ride at the Tour.
Though most riders escape from race accidents with relatively minor injuries — road rash, bruises, and sprains — more serious injuries are inevitable in the busy, high-speed racing at the Tour. Tour medical staff said they had seen scores of riders, but only a few with injuries that forced them out of the Tour.
The Tour’s leap into the 21st century follows a similar move in a number of other high-risk sports run by the Tour’s promoter, the Amaury Sports Organization. Though it made its first appearance at the Tour this year, the trailer has been used for years in motocross and the Dakar rally, a series of grueling, off-road motorsports contests also promoted by ASO.
“This is the first time for the truck [at the Tour],” said Jacob. “But I’m every year on the Dakar rally. I have twelve Dakars. This year we are also doing BMX, motocross, and the world championships of motocross.”
Not a cyclist himself, Jacob’s experience at the Dakar may leave him more accustomed to seeing the kinds of catastrophic injuries that can result from accidents in motorsports, contested at higher speeds and with heavier equipment than bicycle racing. Nonetheless, he told VeloNews that all of the doctors along for their first Tour de France had little difficulty shifting to the fractured collarbones and cracked ribs that often result from crashes at the Tour.
“Trauma is trauma,” he said.