Bruised v. Broken Kneecap

French rider Philippe Gilbert had to withdraw from the Tour de France after a crash that left him with a broken patella. But before he withdrew, he finished the stage, some 60km from the point where he went over a low stone wall on a fast downhill just after a brutal bend in the road. This was roughly the same spot where Italian rider Fabio Casartelli was killed in 1995 crashing into a similar stone wall head first. The Tour de France race route is very challenging, and these riders don’t mess around by putting on the brakes very often.

Regular readers of the blog know that a little more than two weeks ago, I fell hard on a steep part of Queen Anne hill, crashing my knees on the hard sidewalk. After an X-ray of my right knee, I am nursing a bad bruise, not a break. But the knee was very sore and swollen for several days, bad enough to interrupt my sleep. I can’t imagine riding a bike 60km on a bruised knee, much less a broken one.

If you’re wondering about the medical judgment of letting Gilbert ride with a broken patella, race doctors generally defer to the rider if he can get back on the bike and go. A more thorough assessment comes after the race stage is done. No team wants a rider — a valuable asset into which they’ve invested a lot of money — to cause himself permanent injury by riding when he shouldn’t. But that judgment isn’t made until after the race stage, unless the rider has a head injury and is clearly unable to make a lucid decision at the point of the accident. Lawson Craddock, a young American rider who fractured his scapula during the first stage, is still riding — although he ‘s dead last. He’s finishing within the time limit outside of which riders are disqualified, and that’s saying a lot with such a painful injury.

Professional athletes deal with injuries all the time, but I can’t imagine a sport in which the competitors are tougher than at the Tour. If you’ve ever had a bone break, or even a bad bruise, imagine getting on a bike and riding up a mountain like the Alps. The Tour de France is the crowning event of the professional cycling year, and competitors in the race unlucky enough to suffer accidents do it all the time.

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