Egan Bernal’s remarkable recovery from a potentially life-threatening training crash, back to the heights of WorldTour racing, has been studied as part of a newly published medical research paper.

The Ineos Grenadiers climber and 2019 Tour de France winner suffered a horrific crash while training on his Pinarello time trial bike at home in Colombia at the start of 2022. Bernal’s list of injuries was frightening and included fractured vertebrae, a fractured femur, chest trauma and a punctured lung, the then-reigning Giro d’Italia winner having crashed into a parked bus at high speed.

Egan Bernal training crash
Egan Bernal training crash (Image Credit: Mundo Ciclistico/Twitter)

Two weeks later a defiant Bernal was discharged from hospital, acknowledging “he almost died… [but] I’m back! Let’s rock!” His return to racing came eight months later, at the Tour of Denmark, the Colombian having since raced the Tour twice and enjoyed his first post-crash victories as he was, in February of this year, crowned his country’s national champion on the road and in the time trial.

Egan Bernal leaves hospital
Egan Bernal leaves hospital (Image Credit: Clínica Universidad de La Sabana)

It has been an already long road just to return to competition at the highest level of cycling, an extraordinary rehabilitative story considering the injuries Bernal faced and one that has now been recounted in a medical paper in the Journal of Orthopaedic Reports.

Titled ‘Polytrauma in a professional cyclist: A successful case of timely management, rehabilitation, and rapid return to high-level competition’, the paper details the injuries suffered, as well as the treatment and recovery process.

The paper reveals that Bernal was admitted to hospital with an Injury Severity Score (ISS) of 41 points. This is an established medical score which assesses trauma severity out of six across nine body regions. While 54 would therefore be the maximum, a full score of six refers to trauma that is currently untreatable, further emphasising the critical nature of Bernal’s condition upon admission.

The paper continues: “He was managed by a multi-disciplinary team composed of surgical and clinical staff from the institution, emphasising the early initiation of physical rehabilitation as a cornerstone of management and one of the key lessons learnt from the case.

Egan Bernal
Egan Bernal (Image Credit: Egan Bernal/Instagram)

“The importance of effective teamwork, the establishment of rapid response plans for such scenarios, and the timely integration of rehabilitation as a fundamental aspect of care, alongside surgical and medical practices, is highlighted. The result was a successful case, bringing about total physical rehabilitation with no sequelae for the patient, who, furthermore, returned to the highest levels of international competition seven months later.”

The research also outlines Bernal’s case as one of “polytrauma” a term usually meaning: “Injuries suffered from a high-energy trauma which affects two or more organ systems accompanied by an Injury Severity Score (ISS) of more than 16 points, successfully predicting a mortality rate of >10 per cent.”

Bernal is also revealed to have been travelling at approximately 60km/h when his crash occurred, the case having sparked discussion about the safety of using time trial bikes on open roads during training (not least from Chris Froome), although Bernal later downplayed any calls for them to be banned, saying TT bikes are “a part of cycling” and “accidents happen”.

“Vital signs upon arrival were as follows: blood pressure 131/58 mmHg with a mean arterial pressure of 82 mmHg, heart rate of 120 beats per minute, respiratory rate of 35 breaths per minute with a Glasgow Consciousness Score of 15/15,” the paper states. “On primary evaluation, the airway was patent and tenderness along the midline of the cervical spine was noted; a Philadelphia collar was applied.”

Included X-ray images show fractures to one of Bernal’s fingers, his femur, a displaced patella fracture and ribs, with CT scans also showing thoracic spine injuries. He was treated at the intensive care unit and required surgery.

Egan Bernal crash injuries
Egan Bernal crash injuries (Image Credit: Journal of Orthopaedic Reports)

“Cycling injuries can threaten sporting careers, and in most cases, require careful, time-sensitive management and rehabilitation,” the paper’s discussion begins, highlighting specifically the knee injury, femur fracture and spinal injuries as the most likely to impact Bernal’s return to professional cycling.

Egan Bernal crash injuries
Egan Bernal crash injuries (Image Credit: Journal of Orthopaedic Reports)

It concludes: “To the best of our knowledge, this is the first case report to highlight polytrauma management and rehabilitation in a professional cyclist.”

Bernal’s 2025 season began with more injury rehab after he broke his collarbone at Clásica Jaén, although he was spotted back on his bike on Col d’Èze just six days later and last week returned to racing, finishing seventh at Volta a Catalunya. He is expected to target the Giro d’Italia and Vuelta a España this season.