How to Treat Road Rash

My workout for Thursday got cancelled — overnight we had a huge wind storm blow in and I literally thought I was one of the three little pigs with the wolf trying to blow my house down. At one point I did get up to check and see if there was a tornado bearing down on us. The wind was just blowing that hard. I cancelled my ride at 7:00 a.m. because I was worried about cross winds blowing me into traffic. My buddy Wes commented on Facebook that discretion is better part of valor. Indeed.

I thought about riding on the trainer in the basement, but literally the time spent on the trainer is just not that effective. Using my PowerTap, the TSS (or Training Stress Score) for a good hard ride in the basement is about 55 – 60 while riding hard outside for an hour can be close to 100. I would rather extend a ride by 10 to 15 miles tomorrow than ride in the basement at this point. I could always run in the basement, which I may do tonight.

Road Rash Treatement

So if you ride a bike, either on the road or in the mountains, you will eventually crash. Some of us less coordinated folk actually get road rash while running too — but I wouldn’t suspect any of us ever fall while running. :) Everyone has a different way of treating the resulting road rash, and remember that I am not a doctor, but I did eat Wheaties last night before I went to bed. One of my old college roommates is a MD, and I should clear these things with him, but when I talk to him it is more about how the Yankees suck (he now lives in NY) and how he still holds the record for the most times being hit by a pitch in high school baseball locally. I love that guy.

About two months ago I was flying down the road at 19 mph (it was winter, give me a break!) and I came upon a spot where city employees were repairing potholes. Where it actually snows and freezes, we have lots of potholes from the constant freezing and thawing. Apparently there was a large patch where the workers either forgot to stamp down the fresh asphalt or they were hiding in the bushes to see me go down. I hit the loose asphalt and immediately went down. Outside of my pride, my biggest concern was for my new Castelli kit I had just gotten in the mail — I thought for sure it would be shredded and my butt would be hanging out for the entire ride home. To the relief of all the ladies in my town, my shorts were still intact.

I rarely, rarely, rarely wear cycling gloves. I like the feel of the road and staying in touch with the vibe of the ride. When you go down on a bike, that becomes a problem. Here is how my left hand ended up from that fall…it was ugly. I had asphalt ground into my hand and road rash on my shoulder and my butt. I was actually glad that this was all that happened — when I went down last summer I broke my elbow. When I got home I set up a triage center in my bathroom and started to treat my wounds. What you don’t see here is there was a deep puncture wound at the base of my palm. That blood had just trickled up my hand as I was riding home. That patch of skin at the top of my hand is actually from the bottom of my hand — I have no idea how it ended up there. On my right hand there was some real serious road rash, but the main problem is I had a lot of little pieces of asphalt ground into my skin. It would take about a month for them to work their way out. The reason I took this picture is to prove I actually finished the ride. :)

As much as this process hurts, I find that I can get back out on the bike the next day in most cases. I have a low occurance of infection, and these wounds heal up super fast. Here is my process:

  1. I wash the wound with plain soap and water. Like I said, this hurts. Here it is important to pick out any rocks, dirt clumps, grass, or any thing else out of your wound. If you just can’t do it, have someone help you. When I have wounds on my legs, the shower is the easiest place to complete this step. You can use hydrogen peroxide, but I usually don’t find this necessary unless the wound is really deep. And the real reason why I shave my legs (outside of the fact that I have great legs for a woman)? I hate when your leg hair mats itself into your scabs and wounds as they try to heal.
  2. I am allergic to Neosporin for some reason. My body breaks out in serious hives, swells, and pusses up when I use it. Why? No idea. So much doctor gives me a prescription for Clobetasol Propionate, which is theoretically eczema and psoriasis. All I know is it works wonders for my wounds. I swear it works about twice as fast as Neosporin. I put the Clobetasol on liberally. Use whatever type of cream works for you.
  3. Now here is the secret. I buy Tegaderm for my dressing. 3M makes it and you can research it here. I swear it is like a stick Saranwrap. You cut it to the size you need and then peel it off its backing and stick it to the good skin around the wound. It is waterproof and keeps your wound covered and out of the environment. As long as it is properly secured, you can ride with it the next day if you want.
  4. Depending on the size of the wound, I will then use band aids or pre-wrap you can find at any Walgreens to keep the Tegaderm in place. You can research pre-wrap here. It is cheap enough that I keep a roll or two on hand at all times.
  5. I will change the dressing once a day after that. If I am sitting around for an hour or so, I will often take the dressing off and just let the wound breathe. I like to let the wound dry out from time to time, but I have no scientific basis for that.
  6. Depending on how deep the wound is will determine how long it takes to heal up. That hand wound took about two weeks because the puncture was really deep. I am still missing a chunk out of the lower part of my palm and I doubt it will ever grow back.

I know those of you who are medical professionals will have things to add or may yell at me for one thing or another — I do welcome all input. I have refined this process over 11 years of triathlon, cycling, and mountain biking, and it seems to work alright for me. I have been known to use super glue on cuts that were a little deeper than most and I didn’t have access to medical help for stitches. I would suggest you consider heading to a doctor if you can’t get the bleeding to stop or if you think there is damage to connective tissue or bones. Otherwise, good luck and quick healing!

About the Author

I have been participating in running and triathlons for 10 years and love the feeling that training provides. You may not agree with me, but you know you just can't look away...