Doctor Advises Caution about Any Premature Return for Pogačar

Tadej Pogačar suffered a non-displaced fractured C7 vertebra in his neck in Saturday’s crash at the Vuelta a España, but his agent is floating the possibility of him being back in action in four week’s time.

That’s when the world road race championships takes place, with Pogačar the winner of the past two editions.

“Between tomorrow and the day after, ‘Pogi’ will be taken to Barcelona and operated on there,” Alex Carera told Quibicisport on Friday evening. “Therefore, only after the surgery is complete will we know exactly how long he’ll be recovering from and, therefore, whether he’ll be able to make it to the World Cup [championships – ed.] or not.”

Pogačar set the worlds as one of his top season goals, and was also intending on chasing victory in the following week’s European championships, and then Il Lombardia.

He is also the defending champion for both of those races.

Fans of the rider will take encouragement from Carera’s statement which suggests it is still a possibility that his star rider could be in action again this season.

“If we get encouraging news from Barcelona and from the surgery to which Pogi will be subjected, his presence in a competition between the worlds, the Europeans or Lombardy might not be compromised,” he said. “In short, we cross our fingers and wait for the next updates.”

However a medical expert is warning that things could go seriously wrong for the rider if he returns too soon.

‘You could risk being paralyzed’

Tom Teulingkx is a Belgian sports doctor who has worked with elite athletes and Olympic teams. He worked at the mountain bike world championships this weekend and has considerable experience of sport and the injuries related to it.

Speaking to HLN, he commented on Pogačar’s crash and specifically about the neck fracture that he suffered.

He formed his opinion based on the medical update the UAE Emirates-XRG team doctor released on Saturday evening.

“The vertebral body C7 is just below the neck,” he explained. “It consists of a piece of bone with a hole through which a nerve bundle runs, but there are many protrusions to protect the neck vertebra in a fall. If such a protrusion breaks down, it is less severe than if the vertebra itself breaks completely.

“Falling is never fun, but it can always be worse. Pogačar wouldn’t be the first athlete to suffer permanent damage to a cervical vertebra and a complete spinal cord injury from a very stupid and maybe even less serious fall. Then that bundle of nerves is cut, and you’re paralyzed in a wheelchair for the rest of your life. [Triathlete] Marc Herremans is one of the most well-known athletes to have experienced that.”

While Pogačar avoided such an outcome, Teulingkx is clear that a premature return to competition carries with it very large risks.

“That cervical vertebra fracture really needs to heal properly before he can get back in action,” he said. “I think caution is warranted. If you fall again on a damaged vertebra, those protective projections could break and you could risk being paralyzed for the rest of your life.

“It would be a shame if a rider is maybe rushed back too soon and then can’t really play sports for the rest of his career.”

Other factors to bear in mind

The fracture to his C7 vertebra wasn’t the only injury Pogačar suffered in his fall.

He also hit his head, suffering concussion, and fractured his collarbone.

That further complicates things and Teulingkx points out that these factors must be considered and respected.

“The recovery period also depends on the other injuries. A collarbone fracture can be surgically fixed, but it takes a few weeks,” he said. “And there’s a concussion. Apparently he wasn’t unconscious and got into the ambulance on his own. So that might be okay.

“But even with a concussion, you have to be very careful not to return to sports too early, or it can cause problems for a long time.”

Athletes are very driven people. They often push things in terms of trying to return to training and racing as soon as possible after illness or injury.

Pogačar wants to defend his worlds, Europeans and Il Lombardia titles, while those around him also want him to succeed.

However Teulingkx and others will hope that such motivations will be counterbalanced by caution. Even if he gets to a point where he can ride again soon, what would happen if he fell again?

The first of those targets is the worlds in four weeks’ time. Teulingkx points out that the kind of neck fracture Pogačar suffered takes between three and six weeks to heal, with that time influenced by the severity of the injury.

“All these injuries make it very difficult to do sports over the next three to four weeks, let alone at a high level. It’s the end of August. The season is almost over. I wouldn’t be surprised if Pogacar doesn’t compete again this year. But a lot depends on his medical report and recovery, the details of which we don’t know at the moment.”

He will hope that caution is shown and that that undue risks are avoided.

“We need to have more respect for such incidents and give elite athletes time to recover mentally and physically,” he said.