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Sports-related concussion (SRC) in road cycling: the RoadsIde heaD Injury assEssment (RIDE) for elite road cycling
  1. Neil Heron1,2,
  2. Jonathan Elliott3,
  3. Nigel Jones4,
  4. Mike Loosemore5,
  5. Simon Kemp6
  1. 1 Department of Family Practice, Queen's University, Belfast, UK
  2. 2 Department of Primary Care, Keele University, Keele, UK
  3. 3 Department of Medicine, Queen's University Belfast, Belfast, UK
  4. 4 Medical Department, British Cycling, Manchester, UK
  5. 5 Institute for Sport Exercise and Health, University Collage Hospital London, London, UK
  6. 6 Sports Medicine, Rugby Football Union, London, UK
  1. Correspondence to Dr Neil Heron, Department of Family Practice, Queen's University, Belfast, Antrim, UK; neilheron{at}

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Sports-related concussion in cycling

Sports-related concussion (SRC) is a recognised sport-related injury and a growing global public health concern,1 accounting for between 1.3% and 9.1% of all injuries reported during cycling events.2 Road cycling, however, does not have a sport-specific SRC assessment protocol,3 particularly lacking a roadside screening (‘go/no go’) assessment protocol. We would therefore like to propose the creation of a cycling specific RoadsIde heaD injury assEssment (RIDE) protocol

The solution: RIDE protocol

In order to account for the often transient, evolving or delayed onset of SRC symptoms, serial clinical evaluations should be embedded within a three-stage process to optimise the diagnosis of SRC.4 This RIDE protocol will evolve as epidemiological evidence on SRC in road cycling develops4 5 and feedback is received from interested parties.

The three-stage diagnostic process involves (see figure 1):

Figure 1

Cycling RoadsIde heaD Injury assEssment (RIDE) protocol (adapted from World Rugby HIA protocol).7

1. Initial road-side assessment immediately following head impact event (RIDE 1).

2. Reassessment immediately following completion of the stage on the same day of the injury (RIDE 2).

3. Reassessment the day following the initial injury …

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  • Twitter @neilSportDoc, @drsimonkemp

  • Collaborators Medical department of Team Ineos professional cycling team.

  • Contributors All named authors contributed to the writing of the article and reviewing various drafts of the manuscripts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests NH is a team physician at Team Ineos, the professional road cycling team, whilst NJ is chief medical officer for British Cycling, ML works within boxing as a doctor and SK the head of medicine for the RFU. ML and SK have both been involved in developing the SCAT5 tool.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.