Cox had won the event in the previous two Games, but in the final, he faltered early on and crashed on the first corner.
The 33-year-old has had a difficult year dealing with multiple sclerosis and an eating disorder in addition to missing out on athletic competition because of a calf injury.
“I’ve woken up next to a medal in the previous two Paralympics, and I’m thankful it wasn’t a dream! “I feel like I can’t wake up from this nightmare that is today,” Cox posted on Instagram, external.
It’s difficult for me to express my feelings. I believed that this moment would make it all worthwhile after fighting for the past year to recover. When I was pushing to regain the strength to walk, let alone run or cycle, that was all I could think about.