Cyclists hiding concussion symptoms to stay in races as awareness grows

“I could have become incapacitated, or worse,” Sarreau told RMC Sport, highlighting concerns that were once taboo within the professional peloton. His testimony comes as other riders, including Nacer Bouhanni, begin to speak openly about mismanaged head injuries.

Bouhanni described racing through a serious concussion. “My first concussion came from a crash at the Tour of Yorkshire. My optic nerve was affected, it was very serious. Yet I still rode the Tour de France two months later. My vision was off, sometimes even double depending on the angle. I went back to racing without seeing clearly. It was total nonsense.”

Former team manager Yvon Sanquer later admitted to “bad choices” in handling such cases. “It was complicated because there’s a level of responsibility as a team manager, and even for partners,” he said. “It’s true that today, with all the medical protocols in place, I don’t think it would have happened in the same way.”

The challenge for medical staff lies in assessing riders who are determined to continue. Dr. Samuel Maraffi of Total Energies Pro Cycling Team explained that although awareness around concussions has improved over the past decade, on-the-spot diagnosis remains difficult.

“When we ask if they have a headache, they say no, even if they probably do, just to keep racing,” Maraffi said. “Cycling is a special sport because of its nature. In rugby, if there is a suspicion, you take the player off the field, evaluate him and then decide. In cycling, you cannot do that.”

The UCI has implemented concussion protocols, but the sport’s format creates unique challenges. Unlike rugby, where players can be temporarily substituted for assessment, cycling races continue without pause.

“The athlete falls, and sometimes there is no camera. We do not see him fall. When the team car or the doctor arrives, the rider is already standing next to his bike,” Maraffi said. “The health issue is right there. You have to detect symptoms in that moment and decide he must not continue.”

Sports doctor Jean-Jacques Menuet points to several factors increasing concussion risk in modern cycling. “Speed leads to harder braking, especially with disc brakes. The earpiece is another distraction that can cause crashes. Caffeine and sleeping pills, combined with severe falls and brain injuries, seem to me even more dangerous than doping.”

The long-term effects of repeated concussions can include serious neurological conditions such as Alzheimer’s and Parkinson’s disease, yet awareness of these dangers has come late to the peloton.