Sepp Kuss, who dropped from 10th to 12th overall in the Tour de France, suffered a painful fall early in the mountain stage to Le Marckstein and bravely rode through stage 20 with bandages over his left eye and ear.

The American was also a key domestique of Jonas Vingegaard and Jumbo Visma in this year's Tour de France, but had to switch to survival mode due to his injuries.

Cousse crashed with Carlos Rodriguez of Ineos Grenadier on the steep descent of the Baron d'Alsace just 25km into the 133.5km stage. Both riders apparently slipped on a fast curve and suffered injuries to their faces and bodies. Both riders were treated by race doctors and allowed to continue the race.

Rodriguez managed to make it back to the peloton, where he was attacked on the final climb by Simon Yates (Jayco Alura) and lost contact. Rodriguez lost 52 seconds, dropping him from fourth to fifth overall at 13:17. He also received a 20-second penalty for a long slipstream tow from a team car.

Kuss started the stage in ninth place. However, he suffered pain in the crash and lost contact with the GC riders, finishing in 83rd place with a time of 20:39, dropping him to 12th overall.

Former teammate and now TV personality Tom Dumoulin went to check on Sepp Kuss, who finished bloody and bandaged.

"He looked terrible. But he was smiling, as always, and he asked me right away how I was doing. He's a really great guy," Dumoulin said.

Jumbo Bisma praised Kus for completing the stage.

"This man is a warrior. We love you, sep!" and the team posted images of his blood and bandages on social media.

Kus was taken to a mobile x-ray van after the stage. No broken bones were found, but the wound was sutured.

Grischa Niermann, Jumbo Visma's sport director, told Wieler Fritz about Kuss's crash.

"A crash like that could have happened at any time. If it had been Jonas, it could have ruined everything. I was pretty stressed in the car until the bottom of the last climb," Niermann said.

"Kuss went the distance right after the crash and suffered serious eye and face injuries. He had a tough day."