Level ground and uphill cycling efficiency in seated and standing positions

PURPOSE: This study was designed to examine the effects of cycling position (seated or standing) during level-ground and uphill cycling on gross external efficiency (GE) and economy (EC). METHODS: Eight well-trained cyclists performed in a randomized order five trials of 6-min duration at 75% of peak power output either on a velodrome or during the ascent of a hill in seated or standing position. GE and EC were calculated by using the mechanical power output that was measured by crankset (SRM) and energy consumption by a portable gas analyzer (Cosmed K4b(2)). In addition, each subject performed three 30-s maximal sprints on a laboratory-based cycle ergometer or in the field either in seated or standing position. RESULTS: GE and EC were, respectively, 22.4 +/- 1.5% (CV = 5.6%) and 4.69 +/- 0.33 kJ x L(-1) (CV = 5.7%) and were not different between level seated, uphill seated, or uphill standing conditions. Heart rate was significantly ( < 0.05) higher in standing position. In the uphill cycling trials, minute ventilation was higher ( < 0.05) in standing than in seated position. The average 30-s power output was higher ( < 0.01) in standing (803 +/- 103 W) than in seated position (635 +/- 123 W) or on the stationary ergometer (603 +/- 81 W). CONCLUSION: Gradient or body position appears to have a negligible effect on external efficiency in field-based high-intensity cycling exercise. Greater short-term power can be produced in standing position, presumably due to a greater force developed per revolution. However, the technical features of the standing position may be one of the most determining factors affecting the metabolic responses.     

Physiology of professional road cycling

Professional road cycling is an extreme endurance sport. Approximately 30000 to 35000 km are cycled each year in training and competition and some races, such as the Tour de France last 21 days (approximately 100 hours of competition) during which professional cyclists (PC) must cover >3500 km. In some phases of such a demanding sport, on the other hand, exercise intensity is surprisingly high, since PC must complete prolonged periods of exercise (i.e. time trials, high mountain ascents) at high percentages (approximately 90%) of maximal oxygen uptake (VO2max) [above the anaerobic threshold (AT)]. Although numerous studies have analysed the physiological responses of elite, amateur level road cyclists during the last 2 decades, their findings might not be directly extrapolated to professional cycling. Several studies have recently shown that PC exhibit some remarkable physiological responses and adaptations such as: an efficient respiratory system (i.e. lack of 'tachypnoeic shift' at high exercise intensities); a considerable reliance on fat metabolism even at high power outputs; or several neuromuscular adaptations (i.e. a great resistance to fatigue of slow motor units). This article extensively reviews the different responses and adaptations (cardiopulmonary system, metabolism, neuromuscular factors or endocrine system) to this sport. A special emphasis is placed on the evaluation of performance both in the laboratory (i.e. the controversial Conconi test, distinction between climbing and time trial ability, etc.) and during actual competitions such as the Tour de France.     

Power output during stage racing in professional road cycling

PURPOSE: The aim of the study was to evaluate the power output during a multistage professional road race using direct power measurements and to compare these results with the performance measurements using competition heart rate recordings. METHODS: Six professional road cyclists performed an incremental cycling test during which peak power output, power output, and heart rate at the lactate threshold (LT) and at a lactate increase of 1 mM above the LT (LT + 1) were assessed. During a six-stage road race competition, power output was measured directly (SRM crankset). To analyze the time spent at different intensities during competition, the amount of competition time spent below LT (zone 1), between the LT and LT + 1 (zone 2), and above LT + 1 (zone 3) determined during laboratory testing were calculated for power output and heart rate. RESULTS: During the five mass start stages, a mean power output of 220 +/- 22 W (3.1 +/- 0.2 W x kg(-1)) with a mean heart rate of 142 +/- 5 bpm was measured. Average power output during an uphill time trial was 392 +/- 60 W (5.5 +/- 0.4 W x kg(-1)) with a mean heart rate of 169 +/- 3 bpm. For the mass start stages, the average distribution of exercise time spent in different intensities calculated for power output and heart rate was 58 versus 38% for zone 1, 14 versus 38% for zone 2, and 28 versus 24% for zone 3. CONCLUSION: Most of the competition time during the mass start stages was spent at intensities near the LT. Compared with power output, heart rate measurement underestimated the time spent at intensity zones 1 and 3, and overestimated the time spent in zone 2.     

Physiological response to professional road cycling: climbers vs. time trialists

The purpose of this study was to identify possible physiological differences between professional cyclists who show best performance in hill climbing ("climbers") and those who excel in time trials ("time trialists"). To this end, professional, top-level climbers (C; n=8; age 26 +/- 1yr; height 176.0 +/- 2.0cm; body mass 63.6 +/- 2.2 kg) and time trialists (TT; n=6; 27 +/- 1yr; height 181.6 +/- 1.7 cm; body mass 72.3 +/- 2.3 kg) were required to perform two laboratory exercise tests on a cycle ergometer: a) a maximal exercise test (ramp protocol) and b) a constant load test of 20-min duration at approximately 80% of VO2max. Capillary blood lactate concentration and several gas exchange variables were measured during the maximal tests while determinations made during the submaximal tests also included: pH and bicarbonate concentration [HCO3-] in venous blood, and electromyographic (EMG) recordings from the vastus lateralis muscle to estimate root mean square voltage (rms-EMG) and mean power frequency (MPF). Both the maximal lactate concentration in capillary blood and VO2max were greater (p<0.05) in C than in TT (6.6 +/- 0.9 mM vs. 5.0 +/- 0.4 mM, respectively, and 78.4 +/- 3.2 ml x kg(-1) x min(-1) vs. 70.5 +/- 2.4 ml x kg(-1) x min(-1), respectively). Higher mean venous blood pH and [HCO3-] (p<0.05), rms-EMG (p<0.01) and MPF (p<0.05 at 10 and 15min of exercise and p < 0.01 at 5 and 20 min) were recorded in C throughout the submaximal tests. Our findings suggest that in top-level professional cyclists, climbing performance is mainly related to physiological factors (VO2max normalized for body mass, anaerobicl buffer capacity, motor unit recruitment) whereas time trialists tend to achieve greater absolute power outputs. It would also seem that other "technical" requirements of the sport (i. e. pedaling efficiency probably related to biomechanical factors etc.) may be associated with successful time trial performance.     

Exercise intensity during competition time trials in professional road cycling

PURPOSE: To estimate, upon competition heart rate (HR), exercise intensity during time trials (TT) in professional road cycling. METHODS: Eighteen world-class cyclists completed an incremental laboratory cycling test to assess maximal power output (Wmax), maximal HR (HRmax), onset of blood lactate accumulation (OBLA), lactate threshold (LT), and a HR-power output relationship. An OBLA(ZONE) (HR(OBLA) +/- 3 beats x min(-1)) and a LT(ZONE) (HR(LT) +/- 3 beats x min(-1)) were described. HR was monitored during 12 prologue (<10 km, PTT), 18 short (<40 km, STT), 19 long (>40 km, LTT), eight uphill (UTT), and seven team (TTT) time trials. A HR-power output relationship was computed to estimate each cyclist's power output during TT racing from competition HR. Competition training impulse (TRIMP) values were estimated from HR and race duration. RESULTS: %HRmax were 89+/-3%, 85+/-5%, 80+/-5%, 78+/-3%, and 82+/-2% in PTT, STT, LTT, UTT, and TTT, respectively. The amount of TRIMP were, respectively, 21+/-3, 77+/-23, 122+/-27, 129+/-14, and 146+/-6. Competition HR values relative to HR(OBLA) and HR(LT) were, respectively, 100+/-3%, 114+/-8% in PTT, 95+/-7%, 108+/-9% in STT, 89+/-5%, 103+/-8% in LTT, 87+/-2%, 101+/-5% in UTT, and 91+/-4%, 105+/-11% in TTT. CONCLUSIONS: %HRmax, TRIMP and time distribution around HR(OBLA) and HR(LT) reflected the physiological demands of different TT categories. HR(OBLA) and HR(LT) were accurate intensity markers in events lasting, respectively, < or =30 (PTT and STT) and > or =30 min (LTT, UTT, TTT).     

Exercise intensity and load during mass-start stage races in professional road cycling

PURPOSE: To evaluate exercise intensity and load during mass-start stages in professional road cycling, using competition heart rate (HR) recordings. METHODS: Seventeen world-class cyclists performed an incremental laboratory test during which maximal power output (Wmax), maximal HR (HRmax), onset of blood lactate accumulation (OBLA), lactate threshold (LT), and a HR-power output relationship were assessed. An OBLAZONE (HROBLA +/- 3 beats.min-1) and an LTZONE (HRLT +/- 3 beats.min-1) were described. HR was monitored during 125 flat (< 13 km uphill, < 800-m altitude change; FLAT), 99 semi-mountainous (13-35 km uphill, 800- to 2000-m altitude change; SEMO), and 86 high-mountain (> 35 km uphill, > 2000-m altitude change; HIMO) stages. Each cyclist's competition power output was estimated from competition HR and individual HR-power output relationships. Competition training impulse (TRIMP) values and time spent at "easy," "moderate," and "hard" zones were estimated from HR and race duration. RESULTS: Average %HRmax were 61 +/- 5%, 58 +/- 6%, and 51 +/- 7% in HIMO, SEMO, and FLAT stages, respectively, and estimated average power outputs were 246 +/- 44, 234 +/- 43, and 192 +/- 45 W. Competition HR values relative to HROBLA and HRLT were, respectively, 69 +/- 6, 79 +/- 9% in HIMO; 65 +/- 7, 74 +/- 11% in SEMO; and 57 +/- 8, 65 +/- 10% in FLAT stages. The amount of TRIMP in HIMO, SEMO, and FLAT stages were, respectively, 215 +/- 38, 172 +/- 31, and 156 +/- 31. Percentage time spent in the "moderate" and "hard" zones was highest in HIMO (22 +/- 14, 5 +/- 6%) followed by SEMO (15 +/- 13, 5 +/- 5%) and FLAT (9 +/- 7, 2 +/- 2%) stages. CONCLUSIONS: %HRmax, time distribution around HROBLA and HRLT, TRIMP, and load zones reflected the physiological demands of different mass-start cycling stage categories. The knowledge of these demands could be useful for planning precompetition training strategies.     

Heart rate response to professional road cycling: the Tour de France.

The aim of the present investigation was to evaluate the heart rate response of 8 professional cyclists (26+/-3 yr; 68.9+/-5.2 kg; V02max: 74.0+/-5.8 ml x kg(-1) x min(-1)) during the 3-week Tour de France as an indicator of exercise intensity. Subjects wore a heart rate telemeter during 22 competition stages and recorded data were analysed using computer software. Two reference heart rates (corresponding to the first and second ventilatory thresholds or VT1 and VT2) were used to establish three levels of exercise intensity defined as phases I (VT2) is substantially lower than that of light, aerobic exercise (相似文献   

Effect of cadence on the economy of uphill cycling.

Competitive cyclists generally climb hills at a low cadence despite the recognized advantage in level cycling of high cadences. To test whether a high cadence is more economical than a low cadence during uphill cycling, nine experienced cyclists performed steady-state bicycling exercise on a treadmill under three randomized trials. Subjects bicycled at 11.3 km.h-1 up a 10% grade while 1) pedalling at 84 rpm in a sitting position-84 Sit, 2) pedalling at 41 rpm in a standing position-41 Stand, and 3) pedalling at 41 rpm in a sitting position-41 Sit. Heart rate (HR), oxygen consumption (VO2), ventilation (VE), and respiratory exchange ratio were measured continuously during 5-min trials and averaged over the last 2 min. Additionally, rating of perceived exertion was recorded during the fifth minute of each trial, and blood lactate concentration was recorded immediately before and after each trial. Significantly lower values for HR, VO2 and VE were recorded during 84 Sit (164 +/- 3 bpm, 51.8 +/- 0.8 ml.min-1 x kg-1, 94 +/- 5 l.min-1) than for either the 41 Stand (171 +/- 2 bpm, 53.1 +/- 0.7 ml.min-1 x kg-1, 105 +/- 6 l.min-1) o 41 Sit (168 +/- 2 bpm, 53.1 +/- 0.8 ml.min-1 x kg-1, 101 +/- 6 l.min-1) trials. No other differences were noted between trials for any of the measured variables. We conclude that uphill cycling is more economical at a high versus a low cadence.     

Preferred pedalling cadence in professional cycling

PURPOSE: The aim of this investigation was to evaluate the preferred cycling cadence of professional riders during competition. METHODS: We measured the cadence of seven professional cyclists (28 +/- 1 yr) during 3-wk road races (Giro d'Italia, Tour de France, and Vuelta a Espa?a) involving three main competition requirements: uphill cycling (high mountain passes of approximately 15 km, or HM); individual time trials of approximately 50 km on level ground (TT); and flat, long ( approximately 190 km) group stages (F). Heart rate (HR) data were also recorded as an indicator of exercise intensity during HM, TT, and F. RESULTS: Mean cadence was significantly lower (P < 0.01) during HM (71.0 +/- 1.4 rpm) than either F and TT (89.3 +/- 1.0 and 92.4 +/- 1.3 rpm, respectively). HR was similar during HM and TT (157 +/- 4 and 158 +/- 3 bpm) and in both cases higher (P < 0.01) than during F (124 +/- 2 bpm). CONCLUSION: During both F and TT, professional riders spontaneously adopt higher cadences (around 90 rpm) than those previously reported in the majority of laboratory studies as being the most economical. In contrast, during HM they seem to adopt a more economical pedalling rate (approximately 70 rpm), possibly as a result of the specific demands of this competition phase.     

The team effect on doping in professional male road cycling (2005‐2016)

This article questions organizations’ (clubs, teams, etc) responsibility in doping use from the case of anti‐doping rules violations (ADRVs) sanctioned by the Union Cycliste Internationale in professional cycling. We built a database with 271 caught riders among 10 551 professional riders employed from 2005 to 2016 in the three first world divisions. We developed a time‐discrete event history model with a multilevel perspective to consider if the ADRV is related to the characteristic of a rider's career path (level 1) and/or the team by which the rider is employed (level 2). Our results confirm two hypotheses: Beginning a career before 2005 or after the age of 22 increased the risk of being caught. Each additional year in the pack increased the risk, despite the fact that a sanctioned rider's career duration average is 7.8 years (3.9 for the others). These caught riders have experienced a more tumultuous career with team changes and an interrupted path. A 2.45 Median Odds Ratio led us to assert a team effect on ADRV. By a team residual effect calculation, we identify 17 teams with a significant effect within the 129 that experienced an ADRV. Our results allow us to emphasize that to understand doping we must take into account work and employment condition, as well as team's organization. This approach completes the dominant “methodological individualism” perspective that considers athletes as analytical units and provides guidelines to the anti‐doping bodies that focus their action on individuals.     

Effects of front and dual suspension mountain bike systems on uphill cycling performance

PURPOSE: The purpose of this study was to evaluate the effects of front suspension (FS) and dual suspension (DS) mountain bike designs on time-trial performance and physiological responses during uphill cycling on a paved- and off-road course. METHODS: Six trained male cyclists (35.6 +/- 9 yr, 76.9 +/- 8.8 kg, VO2 peak 58.4 +/- 5.6 mL x kg(-1) x min-1)) were timed using both suspension systems on an uphill paved course (1.62 km, 183-m elevation gain) and an uphill off-road course (1.38 km, 123-m elevation gain). During the field trials, VO2 was monitored continuously with a KB1-C portable gas analyzer, and power output with an SRM training system. RESULTS: On the paved course, total ride time on FS (10.4 +/- 0.7 min) and DS (10.4 +/- 0.8 min) was not different (P > 0.05). Similarly, total ride time on the off-road course was not significantly different on the FS bike (8.3 +/- 0.7 min) versus the DS bike (8.4 +/- 1.1 min). For each of the course conditions, there was no significant difference between FS and DS in average minute-by-minute VO2, whether expressed in absolute (ABS; L x min(-1)) or relative (REL; mL x [kg body wt +/- kg bike wt(-1)] x min(-1) values. Average power output (W) was significantly lower for ABS FS versus DS (266.1 +/- 61.6 W vs 341.9 +/- 61.1 W, P < 0.001) and REL FS versus DS (2.90 +/- 0.55 W x kg(-1) vs 3.65 +/- 0.53 W x kg(-1), P < 0.001) during the off-road trials. Power output on the paved course was also significantly different for ABS FS versus DS (266.6 +/- 52 W vs 345.4 +/- 53.4 W, P < 0.001) and REL FS versus DS (2.99 +/- 0.55 W x kg(-1) vs 3.84 +/- 0.54 W x kg(-1), P < 0.001). CONCLUSION: We conclude that despite significant differences in power output between FS and DS mountain bike systems during uphill cycling, these differences do not translate into significant differences in oxygen cost or time to complete either a paved- or off-road course.     

Physiological and performance characteristics of male professional road cyclists.

Male professional road cycling competitions last between 1 hour (e.g. the time trial in the World Championships) and 100 hours (e.g. the Tour de France). Although the final overall standings of a race are individual, it is undoubtedly a team sport. Professional road cyclists present with variable anthropometric values, but display impressive aerobic capacities [maximal power output 370 to 570 W, maximal oxygen uptake 4.4 to 6.4 L/min and power output at the onset of blood lactate accumulation (OBLA) 300 to 500 W]. Because of the variable anthropometric characteristics, 'specialists' have evolved within teams whose job is to perform in different terrain and racing conditions. In this respect, power outputs relative to mass exponents of 0.32 and 1 seem to be the best predictors of level ground and uphill cycling ability, respectively. However, time trial specialists have been shown to meet requirements to be top competitors in all terrain (level and uphill) and cycling conditions (individually and in a group). Based on competition heart rate measurements, time trials are raced under steady-state conditions, the shorter time trials being raced at average intensities close to OBLA (approximately 400 to 420 W), with the longer ones close to the individual lactate threshold (LT, approximately 370 to 390 W). Mass-start stages, on the other hand, are raced at low mean intensities (approximately 210 W for the flat stages, approximately 270 W for the high mountain stages), but are characterised by their intermittent nature, with cyclists spending on average 30 to 100 minutes at, and above LT, and 5 to 20 minutes at, and above OBLA.     

Testing of pulmonary function in a professional cycling team

AIM: Asthma affecting elite athletes has been studied mainly in subjects practicing winter sports. The aim of our study was to test the pulmonary function in order to evaluate bronchial hyper-responsiveness prevalence in a team of 25 male professional cyclists (27.9+/-3.9 years old with a VO(2max) equal to 69.9+/-6.6 mL.min(-1) x kg(-1)). METHODS: Using a questionnaire that queried the presence or absence of asthma history or common symptoms of exercise induced bronchospasm, 72% of the subjects had upper airway or bronchial symptoms. Using a pneumotachograph, we recorded a forced flow-volume curve at rest, after a maximal exercise test with ambient air, and after beta2-agonist inhalation, then during a methacholine challenge. RESULTS: In our study, 52% of the subjects showed clinical symptoms associated with bronchial responsiveness during methacholine test, a proportion which is much higher than the average population (3-20%). However, ERS-ATS pulmonary function testing criteria at rest (reduced FEV1, FEV1/FVC, FEF25-75%) were not fulfilled by any of them. In the asthmatic group, O2max was significantly higher (70.5+/-6 vs 68.6+/-8.2 mL.min-1.kg-1, P<0.05). This remained true for submaximal loads suggesting that ventilation energy cost related to bronchial hyper-responsiveness was also higher. CONCLUSIONS: We have reported in this study that professional cyclists have a far higher prevalence of bronchial hyper-responsiveness than the average population, which can be regarded as a real health issue.     

Myocardial stress after competitive exercise in professional road cyclists

PURPOSE: Based on the determination of cardiac troponin (cTnT), brain natriuretic peptide (BNP), and echocardiographic measurements, recent investigations have reported myocardial damage and reversible cardiac dysfunction after prolonged endurance exercise in apparently healthy subjects. In the present study, we investigated the myocardial stress reaction in professional endurance athletes after strenuous competitive physical exercise. METHODS: Eleven highly trained male professional road cyclists (age 27 +/- 4 yr; .VO2peak 67 +/- 5 mL.kg-1.min-1; training workload 34,000 +/- 2,500 km.yr-1) were examined. The following parameters were determined before and after one stage of a 5-d professional cycling race: BNP, cTnT (third-generation assay that shows no cross reactivity with skeletal TnT), creatine kinase (CK), creatine kinase MB (CKMB), myoglobin (Myo), and urea. All participants were submitted to a careful cardiac examination including echocardiography and stress ECG. RESULTS: None of the athletes showed pathological findings in the cardiac examination. CK (P < 0.01), CKMB (P < 0.05), and Myo (P < 0.01) were increased after the race. Normal postexercise cTnT levels indicate that the increase in CK, CKMB, and Myo was of noncardiac origin. In contrast, BNP rose significantly from 47.5 +/- 37.5 to 75.3 +/- 55.3 pg.mL-1 (P < 0.01). Pre- and postexercise values of BNP as well as the individual exercise-induced increase in BNP were significantly correlated with age (R2 = 0.68, R2 = 0.66, and R2 = 0.58, respectively; P < 0.05). CONCLUSION: Strenuous endurance exercise in professional road cyclists does not result in structural myocardial damage. The rise in BNP in older athletes may reflect a reversible, mainly diastolic left ventricular dysfunction. This needs to be confirmed by larger trials including different intensities, sports, and age groups.     

Sports ability after Bankart procedure in professional athletes

Recurrent anterior shoulder instability and the restoration of sports ability after surgery are common problems, especially among professional athletes. The purpose of this study was to evaluate the rate, level and time of returning to sports activity after Bankart procedure in anterior shoulder instability in high level atheletes. From 1992–1994 61 patients suffering from recurrent anterior shoulder instability were operated on open Bankart procedure. 44 out of 61 were professional athletes. There were 7 handball, 7 basketball, 6 football, 2 waterpolo and 1 base-ball player and 4 wrestlers, 2 weightlifters, 2 boxers, 3 bicyclists, 2 motorists, 2 swimmers, 2 sailors, 2 kayakers and 2 skiers. The mean duration of instability was 19.1 months (3–72) before operation. 29 patients had posttraumatic recurrent anterior dislocation and 15 patients had posttraumatic anterior subluxations. The average number of redislocations was 4.4, ranging from 2 to 11. At the follow-up examination the patients were tested clinically for instability using the special score created by Walch and Duplay and the Constant functional score. We measured the strength of the rotator cuff by Kintrex isokinetic device from the 10th postoperative week. 35 out of 44 professional athletes could be fellowed-up. The average follow-up period was 14.2 months, from 6 to 31. 88% of the patients were able to return to sports participation, 66% on the previous levels and 22% on a lower level. 12% of the patients finished their professional sports career. The mean rehabilitation period was 5.8 months, the average period of full restoration of sports ability was 9.3 months. Similar results were documented with the Constant score and the Walch-Duplay test (88% excellent or good, 12% fair). The main reason for the inability to continue sports activity was some pain during extreme abduction and extrnal rotation of the arm and recurrent sensations of subluxation (3 cases). Based on the results of the follow-up examinations an early diagnosis is paramount followed by timely surgical intervention to restore anatomical integrity in proven cases of shoulder instability in professional athletes. The open Bankart procedure is preferred giving excellent functional results and providing good chances for the atheletes to return to their previous sports level.     

Road gradient and cycling power: An observational study in male professional cyclists

ObjectivesTo investigate the influence of road gradient on cycling power output in male professional cyclists, and to determine whether cyclist typology (i.e., flat or climbing specialist) moderates this influence.DesignObservational study.MethodsNinety-eight professional cyclists (27 ± 6 years; 53 flat and 45 climbing specialists). We collected power output data during both training sessions and competitions over 10 years (2013–2022). We determined the maximal mean power values attained for efforts lasting 1, 5, 10 and 20 min, during both level cycling and uphill cycling (average slope< or ≥5 %, respectively), as well as the average road gradients on which cyclists attained their maximal mean power.ResultsMaximal mean power values were higher during uphill cycling than during level cycling for all effort durations (difference ranging between 0.4 and 3.6 %, all p < 0.003). This finding was confirmed for flat and uphill specialists separately (p < 0.003 for both), with a similar increase in maximal mean power values between level cycling and uphill cycling in the two typologies except for longer efforts (≥10 min), in which maximal mean power values tended to increase more in climbers. Participants attained maximal mean power at an average slope of 6.0–7.3 %, with no differences between effort durations or cyclist typologies.ConclusionsProfessional cyclists attain higher maximal mean power values on steep than on level road gradients regardless of their typology, with an average gradient of 6–7 % appearing optimal (or at least the most common) for achieving the highest maximal mean power values.     

Injury and illness among athletes during a multi-day elite cycling road race

Objectives: Although road bicycle races have been held for more than a century, injury and illness patterns during multi-day bicycle events have not been widely studied. The aim of this study was to determine the incidence of injury and illness among riders and describe the medical care interventions provided to participants of cycling road races. Methods: A prospective observational study was conducted on the Presidential Cycling Tour of Turkey, which was held between April 26 and May 3, 2015. The race lasted 8 days and covered 1258 km of road. There were 166 elite cycling athletes representing 21 teams from various countries. Data collected pertaining to incidents involving injury or illness included the following: type of injury; anatomical location of injury; details of the medical encounter; location of the intervention; treatment provided; medication administered and disposition of the rider. An injury was defined as a physical complaint or observable damage to the body produced by the transfer of energy of the rider. An illness was defined as a physical complaint or presentation not related to injury. Results: The overall incidence (injury and illness) was 5.83 per 1000 cycling hours. (Injury incidence was 2.82 vs illness incidence of 3.01 per 1000 hours cycling). A total of 31 incidents occurred. Of these, 15 were injuries, while 16 were complaints of a non-traumatic nature. A total of 43 interventions were made in the 15 cases of injury. The most commonly injured body regions were limbs; the majority of injuries involved the skin and soft tissue. The most common medical intervention was wound care (64% of all interventions). Two riders had to withdraw from the race, and one was hospitalized due to a traumatic pneumothorax. None of the non-traumatic cases resulted in withdrawal from the race. Conclusions: A broad spectrum of illness and injury occurs during elite multi-day road races, ranging from simple skin injuries to serious injuries requiring hospital admission. Most injuries and illnesses are minor; however, medical teams must be prepared to treat life-threatening trauma.