(Originally published in my Self-Propelled column in the sports page section of the November 6-12, 2011 issue of the Baguio Chronicle --- a weekly newspaper based in Baguio City, Philippines.)
WHAT goes up must come down. Falls, spills, and crashes are facts in biking. Even the most experienced riders and the world’s best professional riders go down.
Usually the damage is not so bad but you will almost always have to deal with some level of road rash from the friction of your skin sliding along pavement, crushed stone, or even a mountain bike trail.
Recognizing the 3 degrees of road rash.
1st Degree: Reddened surface only, unbroken skin layer.
2nd Degree: Surface of skin is broken but with a good amount of healthy tissue under and surrounding the wound. This will allow the skin cells to regenerate and the wound to eventually heal.
3rd Degree: Skin is entirely removed and possibly exposing underlying tissue such as bone, underlying fat, tendons, etc.
*CAUTION: ALWAYS seek immediate medical attention for 3rd degree road rash or if ever you are in doubt about any of your wounds or your ability to properly look after them on your own. DO NOT attempt to treat yourself.
Here are my suggestions for a simple, safe, and effective method of treatment for basic 1st and 2nd degree road rash:
STAGE 1: Initial Cleaning (usually performed at the scene of the accident)
Spray or squirt saline solution or clean water all over the wound and pat dry with a gauze (you can rub a little but not vigorously or you may cause more damage)
Hydrogen peroxide, alcohol, and iodine Not only add unnecessary sting but they can cause cellular damage that delays healing or leaves additional scarring.
Remove only the very loose debris such as rocks, glass, wood splinters, etc. Save the rest of the cleaning for the shower or bath as soon as you can get to one. Sooner is definitely better.
Dab on a topical antibiotic cream like Polysporin, Neosporin, or Fucidin and cover with a sterile dressing until you can get home (or to the hospital emergency if required) for further treatment.
STAGE 2: Comprehensive Cleaning (usually at home in the bath or shower)
Get in the shower or bath, soak the wounds with warm water (not hot, unnecessary pain), and rub gently with a soft soapy cloth or just your hands. Repeat this until the wound looks mostly clean and free of debris.
Pat dry with a clean towel or gauze.
(If there is still some small debris that appears stuck like rocks or large grains of sand, and you can get an edge of it, you can try removing these one by one with sterilized tweezers.)
Spray or squirt saline solution on wounds again and dab dry, always with sterile pads or gauze.
Apply antibiotic cream and cover with sterile bandage. Note: In place of traditional sterile wound dressings, there are some breathable dressings on the market made by 3M, Smith & Nephew, and some others. Consult your doctor or pharmacist for proper use of these alternative dressings.
Repeat Stage 2 steps at least twice daily for a few days and then at least once a day for another week or so.
Keep the wound as clean as possible and always covered, especially when outdoors to prevent exposure to the sun in order to minimize scarring and skin discoloration. Always monitor yourself for any signs of infection. The wound may be infected if it is red, hot, swollen, and unusually painful, smells bad or has pus.
Signs of a systemic infection can be serious and you should seek immediate medical attention if you develop fever, change in appetite, red streaks/lines radiating out in any direction from any wound site, lymph nodes become swollen or tender, and if for any reason you are in doubt or generally do not feel well.
After doctoring yourself, check your bike before riding away from the scene of the accident. Even if everything looks intact after a crash, you might still be a catastrophe waiting to happen. A hairline crack can grow, a dent can buckle, and a bend can break and the only way to ride safely again is to do a thorough post-crash inspection.
INSTRUCTIONS:
• Lift the front end of your bike and spin the front wheel. Look to see that the wheel has no wobble and is not rubbing against your brakes. Lift the back of the bike and spin the rear wheel to check for similar signs.
• Check that you didn't bend your handlebar. Make sure your handlebars have not repositioned themselves in the fall. If they are twisted, use an Allen wrench on the headset to reset them.
• Squeeze the front brake and rock the bike fore and aft to feel for play in the headset. On a mountain bike, check for looseness where the fork sliders enter the lowers. If anything is amiss, steering and balance will be out of line.
• Check spokes to be sure that none has de-tensioned.
• Squeeze both brake levers to ensure that the pads are centered on and still contacting the rim. Adjust the brakes if the wheel is slightly out of tune and get the wheel fixed when you get home.
• Check that your chain is still on the front and back chain rings. If it has slipped off, grab the chain and place it back on a chain ring.
• Look to see if both tires are full of air.
• Re-adjust your bike seat if it is askew.
• Ride your bike slowly at first, listening and feeling for any out of tune parts.
• Always have a qualified mechanic check out your bike after a crash. He will be able to spot problems you may not have noticed.
• Do not try to ride a damaged bicycle. It may be unsafe.
While helmets can do amazing things to protect you from head injuries, they are not rated to withstand a crash after being damaged. If your helmet is damaged in a crash, it is important that you replace it immediately.
If you aren’t sure if your helmet has been damaged, some companies (like Giro) offer free inspection of your helmet, and will recommend whether or not it should be replaced. If your helmet’s company does not offer this service, it is a good rule of thumb to replace the helmet if you have any doubts about whether or not it is damaged. Most companies recommend replacing your helmet every two to three years even if you haven’t crashed, because the materials helmets are made of will eventually break down, and helmets often suffer wear and tear from being banged around or dropped in everyday use.
Until then and have a safe ride all the time. The best way to void crashes is not to ride beyond your limits. Put on that cycling helmet each time you get on your bike. Remember: YOU CAN BEAT THE EGG WITHOUT BREAKING THE SHELL.* (SP24)
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