Hmmm...do we know anything about the source of the photo? I agree that some of the elements (the bike mid-air and the person cringing at the left) see to pop out a bit too much, but I could accept the photo as real if the photographer could vouch for it. We've all seen some AMAZING shots. (Those pix which lead in to each issue of Sports Illustrated are usually great.)
I guess what I find REALLY hard to accept is that a photographer was there at exactly the right moment to capture all these elements in play...and didn't jerk the camera or stop shooting. Yeah, I know hardcore photogs who cover action sports or wars are hardened, but here we have a bike spinning through the air, a person about to get wiped out, (is that a jacket flailing around behind her?), a rider on the ground about to get mushed, and this cold-hearted bastard keeps snapping away.
Overall, there's just too much hyper-reality going on *all at the same time* for me to accept it without more info.
I'd kinda like it to be real, in that all that and only one significant injury!
EDIT: I finally see that what I saw as a person cringing to the left is a person flying through the air. Optical illusion or bad eyesight? You be the judge!