Crashes and Abrasions in Cycling

Introduction

Crashes are as much a part of cycling as mountain stages are to the Tour de France. Whether due to riding errors, technical defects, unfavorable weather conditions, or mass crashes in the peloton - no cyclist remains free from abrasions in the long run. However, proper first aid, professional wound treatment, and preventive measures can accelerate the healing process and prevent serious complications.

Typical Crash Causes in Cycling

Technical Factors

• Tire damage: Burst tires at high speed
• Brake failure: Overheated brakes on long descents
• Material fatigue: Cracks in carbon frames or wheels
• Defective components: Broken chains, fractured pedals

External Influences

• Weather conditions: Wetness, slick surfaces, crosswinds
• Road conditions: Potholes, gravel, cobblestones
• Traffic: Vehicles, spectators on the course
• Mass crashes: Domino effect in dense peloton

Human Errors

• Fatigue: Declining concentration after long stages
• Misjudgment: Excessive cornering speed
• Distraction: Looking at power meter instead of road
• Inexperience: Lack of riding technique on descents

Injury Types and Severity Levels

Commonly Affected Body Parts

Upper extremities (65% of all injuries):

• Palms and wrists (support reflex)
• Elbows and forearms
• Shoulders and collarbone

Lower extremities (25%):

• Hip and thigh
• Knee and shins
• Ankles

Head and torso (10%):

• Face (despite helmet)
• Ribs and chest

Immediate Measures at the Accident Scene

Initial Assessment (Golden Minute)

001. Consciousness check

• Address and touch the fallen person
• If unconscious: Recovery position, call 112

002. ABC Rule

• Airway: Are airways clear?
• Breathing: Is breathing present?
• Circulation: Is circulation stable?

003. Helmet question

• Remove helmet ONLY if unconscious or suspected cervical spine injury
• Otherwise keep on (protection against further injuries)

Bleeding Control

Light bleeding:

• Press clean cloth on wound
• Elevate extremity
• Apply constant pressure for 5-10 minutes

Heavy bleeding:

• Apply pressure bandage
• For arterial bleeding: Tourniquet only as last resort
• Shock position (legs elevated, upper body flat)

Professional Wound Care

Cleaning and Disinfection

Step 1: Rough cleaning

• Lukewarm water or sterile saline solution
• Gently rinse visible contamination
• NOT with high pressure (damages tissue)

Step 2: Fine cleaning

• Remove gravel/asphalt from wound with tweezers
• For deep foreign bodies: Surgical intervention
• Clean wound edges with wound gauze

Step 3: Disinfection

• Apply antiseptic to wound gauze
• Disinfect from inside to outside
• Let work for 1-2 minutes

Modern Wound Treatment (Moist Wound Healing)

Advantages of moist wound healing:

• 50% faster healing
• Less scarring
• Pain reduction
• Lower infection risk

Complications and Warning Signs

Signs of Infection (occurring from day 2-5)

Local symptoms:

• Increasing redness around wound
• Throbbing pain
• Overheating
• Purulent secretion
• Foul odor

Systemic symptoms:

• Fever over 38.5°C
• Chills
• Lymph node swelling
• Fatigue

Action required:

• At first signs: Doctor visit within 24h
• With systemic symptoms: Immediate medical treatment
• Antibiotic therapy often required

Check Tetanus Protection

• Basic immunization present + last booster < 5 years: No action required
• Basic immunization present + last booster 5-10 years: Booster within 72h
• Basic immunization present + last booster > 10 years: Immediate booster
• No basic immunization: Active-passive immunization necessary

Scar Treatment and Prevention

Acute Phase (Week 1-3)

001. Silicone-based scar gels

• Apply thinly twice daily
• Improves skin moisture balance
• Reduces itching

002. UV Protection

• SPF 50+ on healing wounds
• Prevent hyperpigmentation
• Apply consistently for at least 6 months

Long-term Treatment (Month 2-12)

003. Scar massage

• From complete wound closure
• Circular movements with scar oil
• 2x daily 5 minutes
• Improves elasticity and blood circulation

004. Compression therapy

• For hypertrophic scars
• Special compression bandages
• 23 hours daily for 6-12 months

Preventive Protective Measures

Optimize Protective Equipment

Helmet:

• Regular replacement (every 3-5 years)
• Replace after every crash (invisible microcracks)
• Have fit professionally checked

Gloves:

• Padded palms (crash protection)
• Reinforced fingertips
• Breathable material

Protectors:

• Elbow pads for technical trails
• Back protectors for downhill
• Knee pads in mountain biking

Improve Riding Technique

Crash training:

• Practice controlled falling
• Roll instead of bracing
• Body tension in crash moment

Cornering technique:

• Inside pedal up, outside down
• Weight shift outward
• Look in direction of travel (not at obstacle)

Group dynamics:

• Safety distance in peloton
• Anticipatory riding
• Communication with fellow riders

Return to Training After Crash

Physical Criteria

001. Wound healing completed

• Complete closure
• No more wound secretion
• Loadable tissue

002. Pain-free

• During normal movement
• Without pain medication
• Full range of motion

003. No signs of infection

• Normal skin color
• No swelling
• No overheating

Psychological Aspects

Overcoming crash fear:

• Professional support for traumatization
• Gradual exposure (familiar, safe routes)
• Positive self-talk
• Consciously perceive successes

Mental training:

• Visualization of safe descents
• Relaxation techniques
• Building trust in equipment

Special Features of Mass Crashes

Peloton Crashes in Professional Races

Typical scenarios:

• Tight corners in town passages
• Roundabouts
• Final kilometers before sprint finish
• Descents at high speed

Injury patterns:

• Multiple injuries (various body regions)
• Overlap traumas (run over by other riders)
• Psychological stress due to accident severity

Special measures:

• Medical first aid in race doctor vehicle
• Rapid triage (severity assessment)
• Helicopter rescue for severe cases

Care During Competition

Neutralization Rules

• Equipment defect: Neutralization allowed
• Crash of individual riders: No neutralization (exception: race leader)
• Mass crash > 10 riders: Race management can neutralize
• Medical care: Counts as time loss

Mobile Race Doctors

Equipment in Medical Car:

• Sterile wound care
• Pain medication
• Splints/bandages
• Defibrillator

Treatment during ride:

• Superficial wound cleaning
• Provisional bandages
• Pain management
• Decision: Continue or abandon?

Rehabilitation and Scar Prevention

Physiotherapeutic Measures

Lymph drainage:

• Reduces swelling
• Promotes removal of wound secretions
• Possible from day 3 after crash

Scar mobilization:

• Prevents adhesions
• Maintains mobility
• From complete wound closure

Nutritional Optimization for Wound Healing

Psychological Processing

Dealing with Crash Trauma

Symptoms of PTSD after crash:

• Flashbacks and nightmares
• Avoidance behavior
• Hyperarousal and hypervigilance
• Concentration disorders

Seek professional help if:

• Persistent symptoms > 4 weeks
• Impairment in daily life
• Panic attacks while cycling
• Social withdrawal

Sports Psychological Interventions

EMDR (Eye Movement Desensitization and Reprocessing):

• Trauma processing through eye movements
• High success rate in athletes
• 4-8 sessions usually sufficient

Cognitive behavioral therapy:

• Changing dysfunctional thought patterns
• Exposure in sensu and in vivo
• Building positive self-efficacy