By Robbie Broughton
If you’re a keen cyclist, chances are that sooner or later you’re going to have a nasty crash. In fact it’s been said that you can’t call yourself a proper cyclist until you’ve broken your shoulder or at least had a decent dose of road rash. So, given it’s only a matter of time before you do crash, what can you expect?
The top five injuries from crashes (other than bruised bones and pride) are:
1. broken shoulder
2. road rash
3. broken wrist
5. broken ribs
Until recently I’d counted myself lucky when it came to injuries on the bike, only succumbing to a few cuts and bruises on the few occasions I’ve had the misfortune to come off. A little voice at the back of my head had been telling me for some time that things weren’t going to stay that way.
How right that voice was! A few weeks ago when I was taking part in the glorious Mallorca 312 I had my most serious crash to date and picked up a hat trick of the top 5: busted shoulder, road rash and concussion.
Here’s a lowdown of what you can expect in terms of pain, treatment and recovery time for cycling’s top 5 crash injuries.
1. Broken Shoulder
There are 2 types: broken clavicle fractures and clavicle separations.
A clavicle separation or AC separation is where the tendons joining the collarbone and scapula (shoulder blade) become damaged or completely broken, usually caused by direct impact to the top of the shoulder.
There are different grades: grade 1 is damage to the tendon that will heal on its own; grade 2 is where one of the tendons has snapped, which again is a non-operative condition; and grade 3, which is what I had the misfortune to suffer is when both tendons have snapped.
Debate over whether to operate or not, even on grade 3 separations is hot. My Spanish doctor recommended I should go for the op if I wanted to make a complete recovery, including being able to play tennis again. And the thought of having weeks of seeing, hearing and feeling my collar bone continually pop up convinced me to follow his advice.
The procedure involves screwing in a plate to the collar bone which has a hook on the end to keep it in place with the scapula thus allowing the tendons to heal after which (a matter of several months) you have to go back to your friendly knife-wielding surgeon to have the plate taken out.
Pain levels after the crash were pretty bad. I had to wait 4 days before they could operate. Coming round after the op, the pain was excruciating and despite an IV drip with painkillers coursing through me, it was a couple of days before it felt manageable with ibuprofen and paracetemol.
I also had to go back to have the staples removed that they’d used to stitch up the wound. Ouch!
Clavicle fracture: pain level is high and again, opinion on whether to operate or not is split. There are numerous tales of cyclists who’ve suffered for months, waiting for their broken shoulder to heal while their arm dangles in a sling. If you’re a professional you’ll most likely go for the op as you’ll be back on your bike in a matter of weeks rather than months. Surgery involves plating the shoulder blade which will get the airport security scanners beeping.
2. Road Rash
Caused by your body sliding across tarmac, road rash can be a painful injury. The main thing to remember is to make sure that the scrapes are properly cleaned up with surgical spirit afterwards which can be more painful than the initial injury itself. Cleaning up road rash on your legs is a lot easier if you take the precaution of shaving them first! After my crash I had quite a lot of my favourite Rapha jersey embedded into my shoulder and it wasn’t easy picking out the various strands of merino wool meshed into the skin. If you don’t clean up properly, the cuts can become infected. Once cleaned, keep applying vaseline and the scabs will soon drop off, leaving you with a pinkish, sunburnt look. Nice.
3. Broken wrist
The instinctive reaction of a falling rider is to stick out your hand to break the fall (if you have time). Doing so can cause a break in the scaphoid- the bone that joins the wrist and thumb. It’s difficult to pick up in an x-ray. I remain convinced that a crash I had in the UK resulted in a broken wrist but wasn’t picked up at the A&E department at Brighton hospital, who packed me off home with nothing in the way of plaster casts or slings, leaving me to protest the seriousness of my injury to my other half.
Apparently cyclists are treated for concussion more than any other athletes. Thankfully nearly all cyclists wear helmets these days and it’s obligatory on any race or sportive to do so. If I hadn’t had mine, I wouldn’t be here today. If you’ve smashed your helmet with your head inside it against tarmac, manufacturers recommend you buy a new one (helmet, not head). I was sorry to say goodbye to my Kask Mojito -it took quite a bashing and saved my head. The following day I had little memory of the previous evening, a common symptom of concussion. But other effects can include headaches, dizziness, trouble balancing, nausea, fatigue and sensitivity to light and noise. If there are “red-flag” symptoms such as amnesia, loss of vision or consciousness, repeated vomiting, paralysis, seizure, or general unresponsiveness, you may need a CT or MRI scan to check for more serious injuries. There’s also considerable evidence that concussion can lead to mental health problems like depression. Nasty.
5. Broken rib(s)
Another whole world of pain where any kind of movement - turning twisting, bending - can be absolute agony. Also try to avoid sneezing, coughing or laughing. Ribs mend on their own within about three to six weeks so not much you can do other than rest up and take some painkillers.
Coping with an injury that keeps you off the bike can be extremely frustrating and boring as well as painful. Three weeks after my operation I’m still unable to drive, something of a problem living in a remote Mallorcan village with very limited public transport. While I had been looking forward to watching the full Giro d’Italia completely guilt-free and uninterrupted, it’s just my luck that it turns out that the first half of what’s usually my favourite Grand Tour has been a boring procession of pan flat stages. Ho-hum.
General advice is to make sure you rest up. Don’t try mowing the lawn one-handed out of boredom as I did (putting my recovery back by a few days). When you can, try setting up your bike on the turbo to keep fit.
Unfortunately it happens to most of us sooner or later. Luckily, for most of us, it’ll just be a brief hiatus before you’re back on the bike. Wear your battle scars with pride!