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Chris Carmichael Diary: Proper Treatment of Wounds Keeps You In The Race

I wish I didn’t know as much as I do about road rash. I wish I didn’t still have scars on my hips, knees, arms, and back from the innumerable falls that came with being a professional cyclist. Unfortunately, I know all too well what it’s like to leave a lot of skin on the roads of France, Italy, Belgium, the United States, etc. If you choose to be a cyclist, at any level of the sport, you have to be prepared to sacrifice some skin, and you have to know how to care for your wounds. There were already a lot of riders sporting bandages at the start of Stage 6 this afternoon, and many more will

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By Chris Carmichael

I wish I didn’t know as much as I do about road rash. I wish I didn’t still have scars on my hips, knees, arms, and back from the innumerable falls that came with being a professional cyclist. Unfortunately, I know all too well what it’s like to leave a lot of skin on the roads of France, Italy, Belgium, the United States, etc. If you choose to be a cyclist, at any level of the sport, you have to be prepared to sacrifice some skin, and you have to know how to care for your wounds.

There were already a lot of riders sporting bandages at the start of Stage 6 this afternoon, and many more will be swathed with gauze and netting tomorrow. Following the normal small crashes during the course of a road stage of the Tour de France, the majority of the peloton was involved in a major pileup just inside the final kilometer. It remains to be seen if any riders suffered injuries that will keep them from starting tomorrow, but I can tell you that Lance Armstrong escaped with just some minor cuts and bumps.

Properly treating road rash (abrasions caused from sliding on pavement) plays a large role in a rider’s ability to continue racing. Keeping wounds clean and bandaged prevents infection and accelerates healing. The Tour de France is hard on the immune system, and the added stress of open wounds can spell the beginning of the end by increasing a rider’s susceptibility to a wide range of infections. Tonight, the soigneurs working at the Tour are going to be very busy, both bandaging wounds and working the soreness out of bruised and battered bodies.

Since road rash is a reality all cyclists have to face at some point, you too need to know how to deal with it. Before describing the steps for treating such abrasions, please be aware the recommendations adhere to Red Cross guidelines for treatment of skin abrasions, and I recommend consulting a health care professional for evaluation and treatment after crashes, even seemingly minor ones.

Steps for Treating Road Rash
1. After checking to make sure you aren’t more seriously injured or at risk of being hit by a car or another cyclist, use a water bottle to rinse the affected area. This helps you determine how serious the wound is and reduces the amount of debris stuck to you.

2. When you get home from the ride, or back to your car after a race (you should always carry a first aid kit in your race bag), thoroughly wash the area with soap and water. As much as you don’t want to do this, you are going to have to scrub the wound a bit to get the grit, sand, and debris out of it. If you can do this part within about 15 minutes of the crash, it won’t hurt quite as much. Adrenalin and endorphins, your natural painkillers, are pumped into your bloodstream in response to the trauma of crashing. For a short period of time, you can clean your wounds without as much pain.

3. After you rinse the soap off, inspect the abrasion and look for larger pieces of debris, small stones, glass, etc. It is all right to remove small rocks and debris from the wound, but do not remove any object that has impaled you (sticks, nails, etc.). If you have been impaled, loosely bandage the wound and seek medical attention immediately.

4. It is best to keep abrasions moist throughout the healing process. Scabs are convenient but they lead to increased healing time and scarring. Keeping the wound moist with antibiotic ointments retains the elasticity of your skin as it heals, and thus reduces the stiffness and soreness associated with movement. This is especially true around joints. Apply a thin coat of ointment to a bandage and cover the abrasion.

There are some new products available that help accelerate healing, including Tegaderm® and Duaderm®. These “second skin” products are expensive, but they create a protective seal around the wound that assists your body in the healing process, and they can be a little less messy than dealing with gauze pads.

5. Change your bandages frequently, at least twice a day in the first few days following the crash (Note: “Second skin” products have slightly different directions). Wash the abrasion with soap and water each time you change the bandages and continue using antibiotic ointment. The netting you see holding bandages onto professional cyclists’ legs is available through medical supply houses, and if you have trouble finding it, sections of women’s stockings work well too (and come in more styles and colors).

You will probably notice how much dirt and debris is present the first time you change your bandages. Your body knows the difference between foreign objects and things that are part of you. By keeping the wound moist and bandaging it, you are helping your body push out small foreign objects that could otherwise lead to infections.

Only stop bandaging when there is no longer any seepage from the wound, when new skin has completely formed over the area. This new skin is very susceptible to sunburn, so take special care to generously apply sunscreen to it. If at any time during the healing process, the seepage from the wound is discolored, foul smelling, or chunky, the wound may be infected and you should seek medical attention. Fever and swelling and redness around the edges of the wound are also signs of infection.

If you take the time to properly care for your wounds, you significantly reduce the chances of infection and serious scarring. Contrary to what some people may think, scars aren’t really badges of courage or indicators of character; these days they are more indicative of someone who doesn’t know how to properly treat a wound.