Know How To Treat Bumps And Bruises From Mountain Biking

IMBA Trail News
Volume 11, Number 2
May-June 1998

by Jon Alegranti

Mountain bike riders enjoy facing the challenges of momentum, gravity, variable terrain, and obstacles, and occasional biffs are part of the game. Whether deep in the backcountry or in an urban park, being prepared to care for yourself or others in the event of an accident is an important part of outdoor recreation. Self-sufficiency and responsibility for one's welfare are as much a part of mountain biking as fat tires and straight handle-bars. Always remember IMBA's sixth Rule of the Trail: "Plan ahead."

Avoiding accidents is the first rule of first aid. Hone your technical riding skills on gentler terrain, ride smart, and wearing a brain-bucket. But sometimes accidents happen.

First aid training is valuable, but basic courses have limitations. Conventional first aid teaches you to maintain the victim until help arrives. In the backcountry help may be hours away, at best. Steve Endres of Wilderness Medical Associates in Maine points out that mountain biking injuries often take place far from civilization and conventional medical help. Endres emphasizes that even if you can send for medical help, prolonged transportation time, limited medical equipment and a potentially severe environment requires changes in first aid protocol. Outdoor oriented medical training such as that taught by WMA operates on the basis that YOU are the medical help.

Although wilderness oriented medical training is ideal, standard first aid and CPR courses like those taught by the American Red Cross and numerous other instructors provide good basic training. Such courses are taught regularly, are relatively inexpensive, and don't take a lot of time.

Craig Loomis of Aurora, Colorado, is a professional Emergency Medical Technician, instructor for Medic First Aid, an avid mountain biker, and member of two volunteer mountain bike patrols. "I've had a lot of training and experience, but it's the basic skills that are important," Loomis noted.

Loomis has put those basic first aid skills to use on Moab's famous Slickrock trail. "I was volunteer patrolling Slickrock for the BLM and Moab patrol and I got a call for a man down on the practice loop. I found him bleeding heavily from a compound fracture to the arm. He was also in shock. I dressed the wound and applied a pressure dressing to stop the bleeding. When the Grand County Sheriff arrived, we put on a splint and gave him oxygen until the Search and Rescue people arrived."

Nearer to home, Loomis is a volunteer mountain bike patroller with the Front Range Mountain Bike Patrol. While riding the Buffalo Creek Trail system in the Pike National Forest, just west of Denver, Loomis found himself responding to another call for help. "I was informed of a biker who had injured his back after an endo. He had been down one and a half hours when I got to him. He was cold, in shock, and extreme pain. I called for help on the radio, tried to warm him as best I could, checked his vitals and got a medical history."

Said Loomis, "Even with 30 years of experience as a professional EMS provider and thousands of hours of training, I didn't do anything to these patients that the average citizen couldn't do with a minimum of training and a basic first aid kit."

The good news

Most mountain bike injuries aren't severe. According to a report published in the Fall 1997 edition of Wilderness Medicine Letter, 70-80 percent of injuries are minor, consisting of abrasions (50%), lacerations (15%), and contusions (bruises) (10%). Between 80 and 90 percent of injuries involve extremities.

The most common significant injuries are fractures involving the upper extremity. Injuries to shoulders, clavicles (collarbones), elbows and wrists head the list. Other fractures sometimes seen include the ribs, pelvis and vertebrae.

The really good news

Head trauma is relatively uncommon (five to 10 percent of injuries). This is attributed largely to the use of helmets by more than 85 percent of riders. To date, there are few documented cases of death from closed-head injury in off-road biking.

Common injuries and first aid treatment

The following is good advice every mountain biker should know about common off-road riding injuries and first aid, both for yourself and for others. Any injury more serious than a minor scrape, cut or bruise should be examined and treated by a doctor or other medical professional.

Abrasions: Road rash, scrapes and scratches the identifying marks of a cyclist.

Treatment: Clean out the wound, apply antiseptic, cover with a clean bandage.

Lacerations: Cuts.

Treatment: Stop bleeding (with direct pressure or pressure points if necessary), clean out the wound, apply antiseptic, cover with a clean bandage.

Contusions: Bumps and bruises.

Treatment: Apply ice to minimize swelling and reduce pain.

Broken collarbone: Skiers tear ACL's, cyclists break collarbones.

Treatment: Immobilize and support the arm with a sling if possible or by holding the arm close to your chest. Use a second sling, Ace bandage, or bike tube to "splint" the arm to the body for further immobilization. A spare bike tube is also handy as a makeshift "figure eight" sling.

Broken Shoulder

Treatment: Immobilize the arm.

Broken/sprained wrist

Treatment: Use a splint to immobilize the wrist. As with any joint injury, immobilize the bone above and below the joint.

Broken ribs

Treatment: Wrap the ribs to keep them from moving.

Fractured vertebrae: Spine injury

Treatment: This one is serious. If there is any question of neck or back injury, the victim should be immobilized and evacuated by professionals.

Lightning Strikes

Lightning is responsible for about 200 deaths each year in the U.S. alone and more than 1,000 people are injured annually. The highest-risk areas are the Southern states and the Rocky Mountain states. Colorado leads the nation in lightning deaths per capita.

Effects: Cardiac arrest, burns.

Treatment: CPR is critical if pulse and respiration is absent.

Like any other injury, using common sense goes a long way toward avoiding injury. In case of approaching thunderstorms, avoid high terrain and being the tallest object in an open area. Distance yourself from your bike, particularly if it's a steel frame. Crouch down in a low spot with feet and legs pressed together. And of course stay out of water during electrical storms.

Special thanks to Steve Endres, Operations Manager, WMA, Inc., Bryant Pond, ME. 1-888-WILDMED, and Craig Loomis, Instructor, Medic First Aid, EMP America, Inc., Eugene, OR, 800-800-7099 for their contributions to this article.