The start in Catholic pilgrimage site Lourdes offered no extra healing for the world champion. But perhaps it helped him survive one of the toughest days of his career to stay in the race and the green jersey until Sunday.
The 200 kilometres and six categorised climbs - including the hors categorie Tourmalet and the Col d’Aubisque - of Stage 19 were almost too much for Sagan's injuries sustained in a crash two days ago on the Col de Val Louron-Azet.
The time cut was just under 46 minutes after the stage winner. The Slovakian made it over the line 38 minutes and 23 seconds behind Primoz Roglic enduring another painful day in the saddle.
"It was probably one of the most painful and difficult days I have ever had in my cycling career," Sagan said.
But never underestimate the motivation of the green jersey and loyal team mates.
"Well I think (the) green jersey and my team mates they help me a lot all the race and I'm very proud of them and we could make it.
"I could be worse."
147 kilometres now lie between Sagan and the green jersey in Paris, including 31 poised in time trial mode on the next stage.
It's all about survival.
