MOUNT VESUVIUS, Italy -- Lance Armstrong is getting back in shape after 3½ years of retirement. Staying on his bike is another matter.
The seven-time Tour de France winner fell again at the Giro d'Italia on Friday after bumping wheels with the rider in front of him.
His tumble came on a day when Spain's Carlos Sastre captured the 19th stage and Russia's Denis Menchov all but wrapped up the Giro title as riders headed up the Mount Vesuvius volcano. The race ends Sunday in Rome.
Unlike his crash in March at a race in Spain, Armstrong avoided serious injury this time.
"Just a little stiffness in the hip and knee," Armstrong said, according to Astana team spokesman Philippe Maertens. "Was glad to not end up in another ambulance."
The Texan also crashed at the Tour of California in February, becoming entangled with his personal photographer's motorcycle. After the March 23 crash in Spain, a stainless steel plate and 12 screws were inserted into Armstrong's right collarbone.
The latest crash occurred as the main pack negotiated a hairpin curve on the scenic Amalfi coast. Armstrong hit the pavement on his left side -- the opposite side from his crash in Spain. He got right back up, changed his rear wheel -- which had a few broken spokes -- and rejoined the group.
Armstrong finished 16th -- 1 minute, 42 seconds after Sastre -- and remained 12th overall, 13:29 behind Menchov.
Sastre, the defending Tour de France champion, won the stage with a solo attack up the volcanic slopes. He was timed in 4 hours, 33 minutes, 23 seconds over the 102-mile course, which began in Avellino. The Spaniard also won the race's most grueling stage up Monte Petrano on Monday.
"It was two nice victories," Sastre said.
Franco Pellizotti of Italy finished second, 21 seconds behind. Danilo Di Luca was third, 30 seconds back.
Menchov crossed fourth with the same time as Di Luca and kept an 18-second lead over the Italian in the overall standings. Pellizotti remained third, 1:39 back, while Sastre moved up from fifth to fourth.
Di Luca gained an eight-second bonus for third place but needed to gain much more time on Menchov to set up a decent chance of holding off the Russian in the short individual time trial that concludes the race.
"We're almost there, but tomorrow I've got to be attentive," Menchov said. "We've got to wait until the final finish line in Rome."
Di Luca could go for another time bonus in Saturday's mostly flat 126-mile leg from Naples to Anagni, which features a short uphill finish.
"I'm going to try to win the stage or be there in the sprint," Di Luca said. "The finish suits my characteristics."
The serpentine Vesuvius climb covered eight miles. Vesuvius is best known for its eruption in A.D. 79 that buried the ancient city of Pompeii. The stage took riders past breathtaking seaside views, with the island of Capri and the Bay of Naples within clear sight.
Two riders -- Yuriy Krivtsov of Ukraine and Mauro Facci of Italy -- attacked 10 miles into the stage and gained a lead of seven minutes on the peloton at one point. The duo was caught by the pink jersey group at the base of Vesuvius.
Ivan Basso and Stefano Garzelli were the first highly placed riders to attack on the climb, and Sastre quickly launched an attack of his own and joined Basso in the lead after Garzelli fell back.
Sastre and Basso rode together in front for about a mile before Sastre accelerated and left Basso behind with about three miles to go.
A bit further down the road, Di Luca tried to leave Menchov behind, but the Russian shadowed Di Luca every time the Italian accelerated.
"I was at my limit and so was Menchov, so we were even," Di Luca said.
Armstrong lost contact with the pink jersey group on the second half of the climb, but teammate Levi Leipheimer had a solid day. He came in sixth, 53 seconds after Sastre, and remained sixth overall.