Road rash and wound care

by Kristen Legan

“There are two types of cyclists: those who have crashed and those who will” is an old cycling adage.  While we all try our best to avoid collisions and falls, the fact is, crashes are just part of cycling.

Like so many cyclists, my first bike crash happened while racing a crit. One of the racers misjudged a corner and proceeded to take down nearly the entire field. With brakes squealing, bikes crunching, and random water bottles whizzing through the air, we all hit the pavement and slid to a painful stop against a curb.

Luckily, our speed at the time of the crash was relatively slow and nobody was seriously injured. After checking for broken bones and busted bikes, most of us were able to get back on our bikes and limp across the finish line.

Only after crossing the line did I realize that half of my butt cheek was hanging out of my ripped up kit and blood was starting to trickle down my leg. At that moment, the adrenaline from the crash suddenly wore off and my scraped up hip began to scream with pain.

Time to visit the medical tent.

Road rash doesn’t usually require a hospital visit as long as you thoroughly clean the wound and keep it protected from infection. If your crash happens at a race, visit the race medics for help in cleaning and dressing your road rash. They will have all the bandages and ointments to get you home where you can give it a more thorough cleaning.

If you crash while training and don’t have easy access to medical equipment, spray your road rash with water from your bottle and try to remove any large debris from the affected area.

I’ve talked with several wound care specialists and a couple professional cyclists who know a thing or two about road rash. Their expert advice on caring for skin wounds caused from bike crashes can be broken down into three phases:

Phase 1: Initial Cleanup

  • Wash thoroughly – Use soap and clean water to gently wash scrapes and cuts. A shower can be painful when you have road rash but it’s a quick way to fully flush the entire area.
  • Scrub out debris – Gently scrub the wounded areas to clean out dirt and debris. No masochistic scrubbing is necessary! Use a washcloth if possible but a clean tee shirt or towel will work well if you’re not at home.
  • Antibacterial ointment – Apply antibacterial ointment to the wounded skin. This will help prevent infection while your skin heals.

Phase 2: Covering the Wound

There are two options for covering your road rash: hydrocolloid dressing and non-adhesive gauze pads. I personally love hydrocolloid dressing because it keeps everything contained throughout the healing process. Gauze pads are less expensive but you’ll need to replace them on a regular basis.

  • Cover with hydrocolloid dressing – Hydrocolloid dressing is a biodegradable, waterproof, and non-breathable dressing that adheres directly to the skin. This covering keeps the wounded area moist and allows it to heal while protected from outside contaminants.
    • Hydrocolloid dressing will look a tiny bit gross when your wound is still oozing. Keep the dressing on until it falls off on its own or until new pink skin forms on the wounded area.
  • Cover with gauze – Use non-adhesive gauze to cover the wound and tape it to your skin using athletic tape. Frequently replace the gauze pad and continue applying antibiotic cream each time. Continue this process until the road rash scabs fall off and you have new pink skin in that area.

Phase 3: Scar Prevention

  • Allow the scab to fall off – Let the wounded area scab-over and leave it untouched until the scab falls off on its own. Do not pick at the scab or remove it before it has fully healed as this may lead to an infection and scarring.
  • Wear sunscreen – Exposure to UV light can cause discoloration and make scars more visible. Lather on the sunscreen each time you head outside and into the sunshine.
  • Massage – After the scab has fallen off, massage the newly formed skin with lotion for 15-30 seconds several times per day. The circular rubbing motion helps break down collagen bonds and reduces the extent of scarring.

*** While these tips and trick are how I personally take care of my crash wounds, it is always advised to ask your doctor before treating yourself for any injury.

Kristen is an athlete, writer and coach. She raced triathlon professionally from 2009-2013, but has since switched her focus to exclusively racing bikes. In 2012, she was one of six women to complete the entire Tour de France route as part of the Reve Tour. Living, training and working in Boulder, Colorado, Kristen coaches for APEX coaching and has a degree in Molecular Biology & Neurology from the University of Colorado, Boulder.

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