While the riders of a WorldTour Team are always in the spotlight, the big successes are also determined by the people who work behind the scenes. We spoke to Anthony Pauwels, physiotherapist and osteopath at the Quick-Step Floors Cycling Team. He talks about his role in the team, massaging, taking care of injuries, mental coaching, the purpose of ice baths and supplying nutrients during a race. All this is explained in the article!

What is his role within the team?

Anthony is a physiotherapist and osteopath and works for team Quick-Step Floors Cycling Team as well as for the national cycling team of Belgium. Within the pro team, he works together with two other physiotherapists, and one of them must be present at each WordTour race. Because many extra races were added to the WorldTour calendar since last year, it’s a fulltime job now for the three of them. This year, Anthony was present at the Tour de France, the European Championships and he’s currently working at the Vuelta in Spain.

“My added value comes especially after big crashes because of my knowledge of osteopathy and physiotherapy,” says Anthony. “Furthermore, I also have a preventive role. Riders demand a lot from their body during races and with the help of certain techniques, I can help a body to relax more and bring it to a recovery mode.”

Besides his expertise, Anthony also assist the soigneurs of the team. “The agreement with the team is that I give support where needed. With multi-stage bicycle races, I always do one massage a day to spare the masseurs. This is quite time consuming because it takes up to 50 to 60 minutes per rider. When I’m done, I visit the riders in their rooms to check if there are any problems. I always do this in consultation with the doctor, because sometimes some cases have to be reviewed again. After a day with crashes, my colleagues will obviously take over the massage because I’m needed more to do my specific job. That’s how we do this day by day: we try to get as many riders at the finish in a healthy condition.”

Depending on the length of the race and the numbers of riders that take part, there are three or four soigneurs besides the physiotherapist. In a big multi-stage bicycle race like the Tour de France, there are always four soigneurs. In the past it was even five, but that was when teams were allowed to start with nine riders. Since they can only start with eight riders, four soigneurs is sufficient.

Big crashes

Caring for injuries is something specifically for the doctor, but all soigneurs are educated to take care of wounds. Anthony’s role is more structural, more physical. “Osteopathy comes with a lot of manipulations. After a crash you see a lot of blocked and twisted vertebrae. It’s my job to limit complications as much as possible. It may sound crazy, but I have to give the complications back to the body. Because before a rider starts to feel the pain, aside from the bruising and abrasions, the body tries to compensate as much as possible to protect certain zones. You try to bring the balance back in the body to prevent more problems in the coming days. But you can’t stop everything and sometimes a body just needs some rest to recover. Unfortunately, you can’t perform miracles.”

Niki Terpstra fell hard on his back during the Tour de France in the stage to Roubaix, but he could continue to ride on in the next stages. This was a typical case for the expertise of Anthony. “I put a lot of time in this. Sometimes I treated him twice a night. It just happened the day before the first rest day and I treated him twice that day to reduce the injury as much as possible. He suffered a lot in the first stage in the Alps. He was about to quit the Tour de France, but we pulled him through physically and mentally. The result of this was that he relatively had a good last week! But it took me some days to make this work. He had to climb on his bike every day, of course, and had to burden his back again every day. See it like this: when a normal workman has such a crash, the doctor will prescribe him three to four days’ rest. In this world, it’s not possible. So, you try to stimulate the body of a rider as much as possible to recover by itself.”

Another example is the horrific crash of Philippe Gilbert. The Belgian rider misjudged a corner while descending, hit the low stone border and fell over the edge of a cliff. Luckily, he survived the accident and could continue the stage. Afterwards, he had to leave the Tour de France with a fractured left kneecap. “That was more a case for the doctors, I couldn’t do anything about it anymore. But I was incredibly amazed. It’s almost unbelievable that he made it to the finish with a broken kneecap! He was lucky that it was broken and didn’t move. In this respect, the body doesn’t do a lot about it because the adrenaline is so high. This brings the body in a phase where it can perform superhuman efforts. When I saw his knee that night, after some hours of rest, it didn’t look healthy. It was twice as thick! From that point, the best a rider can do is take some rest.”

Mental coaching

Besides the physical aspect, the mental aspect is also very important in professional cycling. That’s why mental coaching is a part of Anthony’s job. “When you spend a lot of time with a certain rider who regularly visits your treatment table, it creates a bond. I work a lot with Bob Jungels. Some days in the Tour de France were somewhat disappointing for him. At those moments, you try to focus on the positive moments of those days. He had to let go of some of the riders in the Tour, but he mustn’t reflect himself on them.”

But he admits that sometimes keeping silent is also an option. Just offer the riders some rest. During a big multi-stage bicycle race, especially during the Tour, these riders are really lived . When they lay on his table for an hour and only speak for five minutes, then that’s fine for him, of course.

Anthony also senses when a rider is in a good shape “Well, you can see this in the appearance of a rider. When they radiate total comfort, then you know that he is confident and knows he has done everything he could. When you work a lot with the same riders, you know if someone is recovered or not in the long run. You know if he has the good legs, as they say.” But that’s just a part of the total package, according to Anthony. “We always have two cooks with us who provide the nutrition for the boys. That’s their fuel and if you don’t have good fuel, you’re nowhere even if you have the good legs. It’s all about the whole package. Also, you need a good strategy and a good team spirit. It’s everything added together.”

Ice bath

During every big multi-stage bicycle race, the Quick-Step Floors Cycling Team brings a camper with them with built-in ice baths. When it’s very hot, the riders love to cool their body down in it after a race before they go to the hotel. Some also use it to lower their body temperature before they go to sleep. They take an ice bath for about 10 to 15 minutes. Sometimes they can go twice in a row to create the effect of a contrast bath, like in a sauna. Then they have to take a break in between for about 10 to 15 minutes.

Other than the name suggests, an ice bath isn’t filled with ice. The water is about 14 degrees Celsius. This doesn’t seem so cold, but the temperature of tap water is about 17 to 18 degrees. And too cold isn’t good for you. If you used ice water, which is about 4 to 6 degrees, this wouldn’t be healthy. Capillaries can necrose and you have to watch out for freeze wounds.

About four years ago, these ice baths were a hype and every team wanted to use them. Science is a bit divided about the effect of an ice bath and not as positive anymore as they were in the beginning. But Anthony thinks they are useful anyway: “Just like a massage, it brings a bit of ‘feel good’ for the riders. So, the psychological effect is sometimes more than the physical effect.”

So what does an ice bath do physically with a rider? “When you look at it purely scientifically, the cold water has an anti-inflammatory effect. After a training, the recovery of the muscle tissue goes through a form of inflammation. This is part of the recovery process. To make sure the inflammation phase doesn’t get out of control, you can reduce this somewhat with cold.

Furthermore, vasoconstriction – where the blood vessels constrict because of the cold – is followed by vasodilatation. The blood vessels widen when body temperature rises again. This fluctuation ensures an enormous blood flow that accelerates the recovery. However, it’s hard to prove this scientifically.”

Some riders prefer to take an ice bath right after a race when they arrive at the hotel. So, this is about an hour after a race, before the massage. Anthony says it’s better to give a massage after an ice bath when the body is back to its normal temperature. “Muscles always react with cold and become a bit more stiff and rigid. So, I prefer to give them a massage more than half an hour after an ice bath. Others prefer to take an ice bath before they go to bed to start their sleep with a cooled body. I think that’s better sometimes.”

During races

Anthony is always present at the start of a race because some riders want to get taped at the last moment or want to run through some techniques, like certain breathing techniques for the aperture. To kill time during the races, he tries to assist the team and soigneurs as much as possible. “Now during the Vuelta, I will drive ahead of the riders. In this job I’ll do the course exploration , inform the sports directors of certain important points, but also pass on the wind direction and weather conditions. With this information, we can adjust our tactics a bit if necessary and give the right information to the boys. The nice thing is that you also see parts of Spain where you would otherwise never be.”

Furthermore, he’s always willing to join the soigneurs at the provisioning. There are fixed points that the organization has pointed out for the supply. It’s important that they can get there on time, because that is often the difficulty. The amount of provisioning depends on the heaviness of the race and the weather conditions. If it is really hot, the teams will try to hand out bottles at as many points as possible. In this way, the riders don’t have to get back to the team car for drinks as often.

In the bags they hand out to the riders, there are always two drink bottles: one filled with water, the other one with an isotonic drink. Depending on the length of the race, they also put some bars and gels in it. “Sometimes we put a small coke in it because it’s a sugar bomb and it contains caffeine. We sometimes even put some rice cakes or small pastries in it. But that depends on the weather. If it’s cold they tend to eat more than when it’s hot.”

Sometimes it can get a bit chaotic at the provisioning points, but that’s mainly due to the inexperience of some soigneurs. “You do notice if someone does this on a regularly base, like those who work in the World Tour. During national competitions, especially with some team members of countries that aren’t experienced with this, you see that they run along with the riders. That’s very annoying for the other soigneurs who are standing over there. So, during European Championships and World Championships you see some accidents happen sometimes. People walk into each other or stumble. You want to prevent that. I always try to find the best place to stand and stand near others I know who I can trust.”

Not all riders grab a bag during a race and some will let it pass by or get something from the team car later on. According to Anthony, this depends on the situation: “If they are really racing, they don’t have time to grab a bag. And you don’t want to take the risk that they miss a change in the race situation or miss the escape because of the extra ballast.”

What to do when the season comes to an end?

Within the team, Anthony works as an independent employee. This applies for all the medical and paramedical staff. The soigneurs and mechanics are in permanent employment and have some spare time when the season ends in October. But at the warehouse, where all bikes and vehicles are stored, there is always some work to do. “In my case, I don’t have to be there. I have enough work to do with the national track cycling team. So, when the road season is over, I change my focus to the track. So, for me there’s no standing still, certainly not.”