The main purpose of my role is to assess and manage acute injuries ‘on-race’ and to then problem-solve for a solution to keep the riders competing each day. I will also oversee and co-ordinate rehabilitation programmes and ‘Return to Racing’ protocols with practitioners across the globe depending on where the athletes live.
I’ve been with the team since 2014, so have a good knowledge of the operations and challenges that world tour cycling presents. I have worked on all forms of racing from the Grand Tours, Week-long stage races and one-day classics.
I am currently working at the Tour De France 2020!
2020 le Tour De France schedule…
Planning for a race such as the Tour de France starts months before. Every department within the team (medical, nutrition, performance, logistics, clothing) will have their own specific focus in being ready to perform. As part of the medical team, you are making sure the group of riders who are riding the tour are robust, injury-free and ready to perform.
From a physiotherapy perspective we are looking at past medical history, common injuries suffered during a grand tour and then working on an injury prevention programme leading into the race and how they are managing themselves.
As a team we will arrive 4 days before the start of a grand tour to give us plenty of time to settle, prepare and start getting into the team’s ‘working rhythm’.
For me, pre-race will mean functional assessment checks, making sure the rider is symmetrical not only on-bike, but off-bike, as well as ensuring the bike set-up is correct and optimal for that rider.
Pre-race is always long days for everyone in the team as training rides are short, there are media obligations for the riders, meetings for every detail and this year we have COVID, so we have full team testing and new safety protocols to go over. All teams have to have negative tests before travelling to France and then another negative test organised by the race organisers a few days before the race begins, to ensure the race ‘bubble’ is safe.
The closer you get to Grand Depart, nerves start to kick in, so it’s vital for not only me, but all staff to create the right atmosphere and culture around the rider group. This year we have more Spanish-speaking riders, so the focus is on ‘Tranquilo’ and ’Siestas. I am literally dragging some of them to the physio room for a check-up to make sure everything is on track.
This year’s Tour has been delayed as you know, so finally Saturday 29th August comes, The Grand Depart on the Promenade in Nice, and there is a feeling of the unknown for everyone, as usually, a grand depart is chaotic with fans, but this year is a little different with COVID, we don’t know what to expect with fan numbers.
At the hotel before we leave, I make sure I get through all riders to do pre-race checks, this could be for some RockTaping, mobility work or some soft-tissue release. Depending on the individual rider, there will be a different approach and intensity to treatment, but the main focus will be mobility work around the spine, hips and pelvis. A favoured technique of mine pre-stage is Mulligan’s MWM’s using the seat belt, always work well to increase joint range and the riders/athlete almost always feel instant results.
At the start on the bus, I will repeat the same process, if there are any last-minute niggles/aches rather than getting the riders to change in and out of their bib shorts I have started using the Flow Gun, which works really well for all muscle groups, super easy to use. I will combine using this with active and passive movements.
Pre-ride activation on the bus is another part of the process, some riders are regimented and have their own routine, others prefer assistance and variety. I will always put focus on the posterior chain to counter-balance what they are about to do on the bike with their anterior chain. I tend to spend no longer than 5 minutes with each rider. SHORT, SHARP, FAST. It’s a fine balance between activating the muscles to be ready and causing fatigue and soreness.
During the race, my activities will either be travelling on the bus, so I am at the finish waiting or out on the road doing extra feeds, a big performance-focused incentive of the team. The riders and DS group will be plotting various points of the stage where extra fluids and nutrition would be needed. The team have increased this over the last few years, to limit the times the riders need to drop back to the following cars, all aimed at preserving energy for when it matters.
After the stage finishes, the aim is to get back to the hotel as soon as you can. One of the major challenges of a grand tour is transfer times from the finish line back to the hotel, ranging from 20 minutes to sometimes 3 hours!
Recovery will start straight away on the bus; Compression boots and recovery meals are already prepared. There will always be the doctor/physio going back for any acute injury management.
At the hotel, the work starts, already prioritising treatment before all riders are back. Each rider will get a recovery massage from the carer group, and then any specific injuries/concerns will be referred onto myself to take a closer look to assess and treat.
The post-stage treatment toolbox is varied, especially as you will know what approach works better for individuals. The most commonly used methods will be manipulative therapy, IASTM using the rock blades, acupuncture, cupping and electrotherapy. We will always try to monitor rider’s objective measures such as fatigue and muscle soreness, and then track this throughout the race. The emphasis will always be on getting riders to bed as early as possible, but treatment nights can be quite late, usually finishing around 11.00pm! All of this will then be fed into the performance group, which could dictate the next day’s race tactics.
*Rock Blades in action!
Most important thing in my job…
I would say the most important thing is developing trust from the riders when you are on the road to take care of them and problem-solve when you need to, to help them perform. The main thing for any elite athlete is being focused on their performance, and feeling that the environment around them is controlled, stress-free and happy. No elite cyclist wants to abandon a race due to injury. Unlike most sports, we don’t have the luxury of a week in between competition to assess, recover, investigate further etc. One of the reasons a cycling grand tour is one of the hardest events there is, probably all riders will be carrying niggles/injuries, but it’s about how you also manage these through your performance levels over there weeks.
Three tools I can’t do my job without…
First thing I need, regardless of what location we’re at, my portable table. We are not always in 5-star hotels that’s for sure, but if I have the physio table, this keeps a constant variable for the riders.
The second thing is my hands. Being a manual therapy-focused physio, practically everything I do is through experience using my hands, any good therapist will tell you that.
Third thing if I had to pick a single physio tool being on the road with a sports team and looking to get immediate musculoskeletal improvement would be a Mulligan’s Belt, so simple but a great bit of kit.
When not on races/camps with the team as a physio…
Running my own performance physiotherapy business in Cardiff, abloc physiotherapy.
This gives me better balance as a therapist as I then work with athletes from other sports, CrossFit, Powerlifting, Cricket, Boxing, Rugby and MMA. Not only is this then making me think differently for the requirements of their sport, but also co-ordinating rehabilitation plans makes for a better all-round physio in my opinion. I’m very lucky with the setting I am in, probably the best S&C facility around, UFit Fitness Cardiff where I can be as imaginative as I want with rehab programmes and can then work 1:1 with the athletes.
World-Tour level cycling is one of the most unique sports there is. It is renowned for its difficulty, but It has a huge number of factors, some of which you can control and a lot of which you can’t control. This can make the sport very frustrating when certain things go wrong, as there could be mechanical problems or weather factors changing race tactics, but when it all comes together it can also make it one of the most exciting and rewarding sports that I’ve ever worked in. And I think the relationship between equipment `(bike, clothing), physiology and human skill level at its finest makes for an amazing and fascinating sport.