How bad is a broken femur and what is the normal recovery time?

When four time Tour de France winner Chris Froome was relegated from pre-Tour form chasing to intensive care in the blink of an eye, cyclists the world over winced at the announcement of a broken femur.

The Team Ineos rider reportedly crashed into a wall at 54 kilometres per hour when a gust of wind grasped his front wheel and brought him to a dead stop.

The 34-year-old's injuries are said to involve fractured ribs and right elbow, pelvis, as well as the thigh bone.

Racing stat Bible, ProCyclingStats.com, has already confirmed that of the 19 riders in its database who fractured a femur after May 15, not one came back to race that season.

The femur is the longest and strongest bone in the human body. Breaking it often requires a fair amount of speed and force, and it's usually an injury associated with motor vehicle collisions. But it's not all bad news.

"If its just a clean break, and you're relatively fit and healthy and have the right physiotherapy, your recovery can be quick," explained former pro and osteopath to UCI WorldTour teams, Alice Monger-Godfrey.

"It will take at least six weeks, though there will be the odd person who gets back quicker. It doesn't have to be the year out that people think. But you need to ensure it's healed properly. You don't want to rush back too soon, as pedalling puts a lot of force through the area.

"However, the length of recovery time depends on where you break the femur," Monger-Godfrey explains.

"When the head of the femur is broken, it's very different to a break half way down the femur. Recovery could be anything from 12 weeks to 12 months."

Femur fracture types range from proximal femur fractures (or hip fractures) involving the hip joint, to femoral shaft fractures, halfway down the bone, or supracondylar femur fractures where the bone is broken just above the knee. 

The hip is rich in blood and nerve supply, but as Monger-Godfrey explains, "if blood supply has been affected it can cause complications and take a lot more time."

Of course, what's most important is Froome's overall health - but there's a nation of cyclists eager to see him ride at the top level. After a successful operation, he's already said to be looking at the rehab ahead - with surgeons quoting six months as a goal. 

"Froome is fit and healthy, at the top of his game, which will speed up recovery. But unless he's completely super-human, that will likely be the end of the season for him. There will be a lot of recovery - a severe amount of pain - and you don't know the extent of swelling, scar tissue, any nerve damage," she explains.

Collarbone breaks are the most common fracture in cycling, with neck and vertebrae cracks not unusual either. Breaking a femur takes quite a bit of work.

"It is definitely a rare injury -  the glutes and surrounding muscle mass mean it's quite a protected joint, and breaking a femur is more often a result of trauma. There's also an element of weight and bone density. If you have low bone density, if you fall, you are more likely to break a bone."

Rare doesn't mean it's not something that affects amateurs. First category rider for TAAP Cervelo, Ryan Visser, broke his greater trochanter - at the top of the femur - in 2017. He was back racing on the road and track in eight weeks.

"I was doing some descending practice in Mallorca - trying to push myself and try a few new things," Visser explains.

"It was a tight hairpin, I just leaned a bit too much and hit some sand. I dropped heavily on to my hip. I got back on my bike, but starting the next ascent, I realised I couldn't put any force through the pedal."

"There's two types of greater trochanter break. You can break the head off, which is basically game over because it's really hard to pin it. Or you can fracture it, which is what I did.

"I was told its six to 10 weeks until you heal. I had six weeks on crutches, and then I could sit on the Wattbike, gently pedalling. I was racing eight weeks after the accident.

"I've crashed before - you usually break a shoulder or a collarbone. You always feel like those are minor and you can bounce back. As soon as I broke my leg, I realised I won't bounce back every time. I've realised I am vulnerable, and that can cause you to lose your edge.

"Another area I was told about afterwards was bone density. I crashed at slow speed but still broke a bone. Since then I've tried to do more jogging, more weights, to try and make my bones stronger.

"I still struggle with walking up the stairs. I push off with my right foot, and the left hip follows - I'm not pushing with my left foot. This is two years after. It's just not quite the same - though I don't notice it on the bike, our team raced the Cicle Classic this year and I'm getting better results than ever on the track."

Visser is keen to highlight that a strong support structure got him back on the bike quickly, with a limited break in the season - and of course, that's something Froome has in abundance.

"Froome will have the best team around him. If its diagnosed quickly and treated correctly, he will be back on track as quickly as possible. I can't imagine his prognosis will be the same as someone not in the same athletic form," Monger-Godfrey confirms.