Annemiek van Vleuten fractured her elbow in her heavy crash during the mixed relay team time trial at the World Championships in Wollongong.
The 39-year-old fell off her bike seconds after setting off from the start ramp for her leg of the TTT, seemingly losing control, veering to the left and sliding out.
She visited a local hospital in New South Wales, Australia for checks after the incident, which later revealed a fracture in her right elbow, the Dutch cycling federation confirmed to Cyclingnews later on Wednesday.
It has raised fears that Van Vleuten might not be able to take part, or be at her best, in the elite road race on Saturday, which she was an overwhelming favourite for.
“Annemiek is allowed to cycle with this stable fracture, but the question is of course with how much pain that will be,” national coach Loes Gunnewijk said. “We will see that in the coming days. We hope that Annemiek can still start, but that has to be justified.”
Van Vleuten's crash left the Dutch with two riders, Riejanne Markus and Ellen van Dijk, to complete the female leg of the relay, which saw them finish in fifth. Switzerland won the race.
The Dutchwoman, who has twice won the ITT rainbow bands and once the World Championships road race, posted on social media that she was "worried" about her right arm after the crash. She was able to walk to an ambulance after the incident, but was not OK, clearly.
"On my way to the hospital for x rays of my right side," she wrote on Twitter. "All bruised and especially worried about my right elbow/arm. My front tire exploded and I crashed."
She followed that up by saying that the tyre exploded after she hit the side of the road, so this did not cause the crash.
"Don't know what happened but looks the tire exploded after I did hit the side of the road," Van Vleuten tweeted. "So that was not the problem. Something caused I got out of balance, but what ever caused it: it will not help or change my situation. Now in the hospital."
“I'm just in pain and it doesn't feel right. I haven't recovered from it anyway. I can't believe what happened,” she told Dutch broadcaster Nos.
Van Vleuten was due to lead a strong Netherlands squad in Saturday's elite road race, which contains Demi Vollering and Marianne Vos as well.
The Dutchwoman has had a record-breaking season, winning the Giro d'Italia Donne, the Tour de France Femmes, and the Ceratizit Challenge by La Vuelta, an unprecedented triple. However, it could end quietly if the fracture affects her ability to ride.
The Netherlands' attempt at the mixed relay TTT had already been affected by a mechanical for the men, as Bauke Mollema's chain dropped off during the male trio's attempt. With Van Vleuten also suffering misfortune, the Dutch squad could only manage fifth.
