Medical Advice

Please read the following advice from Professor Sanjay Sharma carefully – we want you to enjoy your big day safely.

It is YOUR responsibility to be fit and well on the day of the Prudential RideLondon-Surrey 100 in order to enjoy the experience as safely as possible and not put yourself at risk.

Medical Problems

Discuss any medical problems with your general practitioner (GP). The advice here supplements anything he or she says. See your GP if you have a problem that makes it a risk to cycle in a sportive. If you have a serious medical condition and want to consider riding you should get your GP and/or specialist’s agreement.

If this applies to you, please send us details of your condition and treatment along with your rider number. Address the envelope to Medical Director, mark it ‘Confidential’ and send it to: Prudential RideLondon-Surrey 100, PO Box 1234, London SE1 8RZ. We cannot give individual cyclists advice but are happy to advise your GP.

If you have a medical problem that may lead to you having a blackout, such as fits or diabetes, please put a cross on the front of your rider number and write the details, especially your medication, on the reverse of the number. Please carefully read the following useful and comprehensive advice from the Prudential RideLondon-Surrey 100 medical team.

Fit to compete

Cycling is good for the heart but in any strenuous endurance event there are occasionally fatalities from serious heart disease in athletes apparently unaware that they had a problem. Their condition may have been detected if they had had medical advice and the relevant heart tests. A ‘fitness test’ is not sufficient to detect these problems.

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as chest pain or discomfort on exertion, sudden shortness of breath or rapid palpitations, see your GP who will be able to arrange for you to have a proper cardiac assessment.

Such an assessment may not be instantly available, but continuing to ride with these symptoms may shorten your cycling career catastrophically!


If you have ’flu, a feverish cold or a tummy bug, do not train until you have fully recovered, then start gently and build up gradually. Do not attempt to catch up on lost mileage after illness or injury – this may cause further damage or illness. If you have ’flu it can take as much as a month to recover, so consider whether you should take part in the sportive this time.


To reduce injury risk, vary your training rides, the pace and distance. Wear a helmet and be visible – wear bright or reflective clothing.

Muscular aches and pains often occur after an increase in training. Try to gradually increase your training so that you do not suffer prolonged periods of exhaustion. Separate days of heavy mileage with one or two days of lighter training, or rest days so that your body can refuel your muscles with muscle glycogen.

If you cannot ride 50 miles comfortably three weeks before the sportive, you are unlikely to safely manage 100 miles. We do not recommend you ride on this occasion if you have not trained properly.

Think before you drink

You need to replace some of the fluid lost in sweat, otherwise your body becomes dehydrated and less efficient. However, drink when you feel the need and do not drink water excessively before, during or after the sportive as you may develop hyponatraemia.

As with other endurance sports, cyclists who overdrink are at risk of developing hyponatraemia, a serious medical condition where sodium levels in the bloodstream are diluted. Hyponatraemia has resulted in a number of deaths in endurance events over the last few years and is entirely avoidable by not overdrinking.

Drinking in training

Alcoholic drinks, tea and coffee are dehydrating. Take on board plenty of non-alcoholic drinks, especially when training in hot weather.

Drinking on the bike needs practice. Practise drinking during longer training rides and make sure you are used to the drinks available on the day.

Drinking on the day

Make sure your water bottles are full before the sportive. Sip some water or sports drink in the half hour before the start so that you begin the event reasonably hydrated.

Drinks will be available at regular intervals along the route at Hubs and Drinks Stations (there are three Hubs, situated roughly every 25 miles along the route). Do not be greedy when you’re grabbing drinks as you may be depriving slower cyclists behind you of much-needed fluids.

Drink when you feel the need and do not gulp large volumes of fluids before, during or after the sportive. Your needs vary with your build, your speed and, above all, the weather.

After the finish you can only rehydrate (replace lost fluids) gradually over the next 24 to 48 hours. Do not drink large volumes of fluid after finishing: listen to your thirst and drink accordingly.

Eat some salty food as well as spacing out your drinks. This way you will not get hyponatraemia and will still replace the water, salt and glycogen lost in riding the sportive.


Large doses of supplementary vitamins and minerals (such as iron) are not essential and produce no benefit if you are on a good mixed diet, but additional vitamin C in small doses is reasonable when fresh fruit and vegetables are in short supply.

Training (with adequate rest) helps you to sustain a high level of muscle glycogen if you eat enough carbohydrates. If you can, eat within two hours of your long rides. This helps replace muscle glycogen quickly and also speeds recovery.

In the last few days before the sportive, eat more carbohydrates (pasta, bread, potatoes, cereals, rice and sweet things) and less protein (meat) at the same time as tapering or reducing your training. This loads your muscles with glycogen, which will delay, or even prevent, ‘bonking’.

On the day

Wear appropriate clothes for the weather, but be prepared for all conditions.

Do not ride if you feel unwell or have just been unwell, even if you are riding for charity. Most medical emergencies occur in people who have been unwell but do not wish to miss the event. If you feel feverish, have been vomiting, have had severe diarrhoea or any chest pains, or otherwise feel unwell, it is unfair to you, your family and your sponsoring charity to risk serious illness and become a medical emergency. You are unlikely to do yourself justice. There will be many other sportives.


Adequate preparation for a sportive requires appropriate nutrition, hydration and rest. Athletes often consume isotonic, carbohydrate and protein drinks as well as energy gels and bars purchased in sports and health food shops in preparation for the event, which is considered safe practice.

However, over the last two decades there have been an increasing number of commercially available compounds that claim to enhance performance. Some of these have been found to contain substances banned in other countries, and other products (such as steroids) that are banned for use among competitive athletes. Such products are usually purchased via the internet and should not be used by anyone training for a sports event.

Cyclists using performance-enhancing compounds that have not been licensed and regulated properly may experience serious side effects and increase their risk of developing heart disturbances that culminate in sudden death. For example, there have been well-publicised cases of runners inadvertently using compounds in an attempt to help them fight fatigue during endurance events, which have caused detrimental effects on their health, resulting in their death.

In one recent case, toxicology identified traces of DMAA, which is an amphetamine-like substance. Although banned in sport, the product was legally available at the time and advertised as a powerful performance-enhancing agent, and the warnings associated with the potential harmful ingredients were not highlighted on the product. Cyclists should avoid consuming unregulated substances bought over the internet.