On The Road
by: Bill Oetinger 12/1/2005
Falling Down
Clavicles or collarbones: call them what you will, these fragile little buttresses between shoulder and neck are the weak link in the cyclist's orthopedic chain. Probably it has something to do with the fact that we humans were never really meant to be standing up on our hind legs, and as a result, we still fall down a lot. Either we land smack on one shoulder or the other or we break our fall with extended arms, in which case either the arm breaks or the shock is transmitted up the arm to the shoulder and thence to the collarbone.
A moderately fit adult can usually fall from a standing position without much trauma. But for cyclists, add a little more height from the perch on the bike; add whatever awkwardness ensues from being tangled up with the bike frame (still clipped in, for instance); and most importantly, add a lot of speed. Put all that together and you ratchet up the odds of injury considerably.
Cyclists by the thousands break their clavicles. My entirely subjective guess is that half of all "serious" cyclists have broken one clavicle or the other at least once. Sean Kelly, that tough old road warrior, is said to have broken his clavicles at least 15 times. Bobby Walthour, the legendary six-day racer from the early 20th Century, broke his left collarbone 18 times and his right one 28 times (not to mention 32 fractured ribs). Tyler Hamilton famously broke his right collarbone on the first stage of the 2003 Tour de France and rode through the pain, all the way to Paris, picking up an astonishing stage win along the way and fourth overall.
Now, thanks to some jackass riding, you can add me to the ranks of the broken collarbone brigade. I crashed on a club ride on October 30. Any cause or fault for the crash is entirely down to me. I can't blame road conditions or traffic or weather or other riders. Operator Error, plain and simple. We were in the run-up to a county line sign with a tight, right-hand corner not too far in advance of the sign. I was leading the pack, and I wanted to hammer the turn hard to hold my place coming out of the corner. I thought I had a good line and a good lean angle. I know I had a little more speed than prudence might have dictated, but I thought it was all under control.
I'm still not certain what happened. I'm pretty sure I did not brake. My best guess is that I started my sprint while still at too great a lean angle and clipped a pedal on the pavement. (There is a fresh scrape on the pedal to support this theory.) Clipping the inside pedal under hard cornering causes the rear wheel to lift off the road and hop sideways, with the bike pivoting on the front wheel. When the rear hits the road again, it bites hard, the bike stops suddenly, and the physics take over: the rider launches over the top and off the outside.
I've been thinking about crashes a lot since that moment. It may be a bit simplistic, but I think there are three basic scenarios that can play out when you overcook a corner.
1. You plot a tangent off the arc of the corner. That is, you keep on riding off the road and deal with whatever lies in wait along that path: guard rails, curbs, ditches, trees, brambles, boulders, cliffs. This is really a game of Russian roulette. You may hit something nasty or you may get lucky and just roll out into a relatively benign patch of meadow or road shoulder. I had a miracle escape of this sort last spring. I was cornering hard on a fast descent when I crossed a small slick of water and the rear wheel slid out. I managed to save the skid, but by the time I had made the neccesary course corrections, I was headed off the road at 30+, straight for a 20'-deep rocky gorge. The miracle was that, just at the place where I plotted my tangent, there happened to be a nice, paved driveway bridging the gorge and then heading uphill on the other side. I shot over the bridge and rolled up the one-lane road, much as a truck might use a runaway ramp. Had I had my little moment ten feet earlier or later, I would have flown off into space and down into the rocky gorge.
2. You lay it down. If one or both wheels go and you don't save it, you slide, like a feet-first slide into second base. If you don't hit anything, and if your contact with the pavement is at enough of an oblique angle, the worst you'll get out of your adventure is some road rash. This often looks horrific and can be quite literally a pain in the ass for healing. But overall, it's better than the other options. A joker in the deck in all of these scenarios is oncoming traffic. If your crash is in a right-hander, your momentum will almost always carry you into the other lane, and if there is traffic there... I once laid it down and slid across the road, ending up lying on my back looking up at the front bumper of a FedEx truck, whose driver had just managed to screech to a halt before I went under the wheels. Some days you're the windshield; some days you're the bug.
3. You high-side it. For some reason(s), the bike stops but stays upright and you go over the top, off the outside. This is what I did in the latest crash. All else being equal, I think these must be the most violent and potentially catastrophic incidents.
I did a fancy front sommersault with a half twist. My form wasn't great, but the degree of difficulty was quite high, so the judges awarded me high marks overall. In fact, the riders right on my tail--the other goofballs contesting the county line sign--said it looked really spectacular and terrifying. They thought I would turn out to be much more badly injured than I was. (They all managed to avoid running over the top of me, thank you very much.)
I landed hard on the pavement on the outside point of my left shoulder--compressing the clavicle--then slammed down all along my left side. The big knot of my left elbow joint was pinned between the pavement and my ribcage, and so it hammered into my ribs, fracturing two of them and dislocating one. The clavicle broke into five pieces.
On the bright side, I picked up only a modest amount of road rash, spread in small patches over a wide area...shoulder, forearm, hip, calf. In spite of my rather splashy injuries, my clothes and bike escaped almost unscathed, and I was able to get my jersey and favorite undershirt off without having to have them cut off of me. How one can pick up road rash without shredding the clothes is a mystery of modern fibers. As for the bike, I assumed it would be trashed, as the crash felt extremely violent (to my poor old body). I have been in much less violent crashes where wheels were tacoed or bars or brake pods or forks were destroyed. In my only other front sommersault, I walked away with only minor scrapes, but the bike was totaled. This time, I took the abuse but the bike was fine. I give high marks to those fancy-pants, 16-spoke Bontrager wheels. I thought they looked kind of effete and stupid-lite, but the sales people assured me they were tough suckers. Maybe they were right. As for the rest of the bike, it's all carbon, and if carbon doesn't shatter, not much else can happen to it. It certainly won't bend.
Since the crash, I have heard more clavicle stories than I ever would have thought possible (leading to my estimate about half of all cyclists having had such a break). And not just cyclists: my mother broke her collarbone skiing; my friend Deb broke hers falling down the back porch stairs. I have come to understand that clavicle breaks take many forms, from modest to massive, and that recovery time and experience of pain vary considerably. There are the “micro-fractures†or hairline breaks. There are the AC-separations, where the clavicle gets knocked out of the little spoon-shaped depression that passes for its socket. Then there are the ugly ones, with multiple fractures and torn tissue and maybe even breaks in the skin. I heard one guy say he was back on the bike in two weeks (this was a seriously committed racer). Others talked about three or more months off, with surgeries needed, plates or pins installed, and even ligaments replaced (from a donor cadaver).
As for the pain, who can say? These are my first broken bones, so I don't have much to which I can compare this. One person I talked to said their orthopedist told them that clavicle breaks are among the most painful injuries we can sustain. Based on my own experience, I find that a bit of a stretch. I've seen strong men screaming--howling--in agony with blown knees, and I can easily imagine that any number of other horrors--from severe burns to box jellyfish stings--could be off-the-chart painful. My pain was bad, but I never felt like screaming, with or without the Vicodin they prescribed for me. The ribs were probably worse than the clavicle, but both were more inconvenient than brutal. I will say this though: I wouldn't have wanted to get back on my bike and continue riding. After I had taken an inventory of my hurts and decided the clavicle was the worst of my problems, I had considered doing so. I was about 15 miles and three small climbs (and descents) from home. I probably could have done it, but it would have been a grim ride. And while I was thinking about it, my friends flagged down a CHP cruiser, and he gave me a lift.
I know of at least two lunatics who have crashed in the Terrible Two about 25 miles from the finish (on the tricky descent into Cazadero). Both broke their collarbones and both finished. Both looked like death warmed over when they got in. Full marks to these hard boys for guts, but not a lot for common sense. Most especially, my hat is off to Tyler Hamilton for his TdF performance with a broken clavicle. As I recall, his break was closer to a clean, hairline break, so maybe the pain wasn't all that bad. With all due respect to his toughness and his willingness to withstand a painful pounding, I seriously doubt he could have continued with a break as messy as mine. And the fact that he pulled out the following year with fractured ribs indicates that he is after all human. But if the pain from his collarbone break was even a fraction of what I was feeling, then he was in a world of hurt, day after day.
The emergency room physician in my case said that while it wasn't the worst looking clavicle break he'd ever seen, it probably made his short list of ugly ones. In spite of that, no surgery was indicated. Just a figure-8 brace to pull back the shoulders and stabilize the region so the bits of bone could settle back into a semblance of their former order. And that they have done, more or less. The assorted chunks still look a little gnarly in the follow-up x-rays, but they're knitting back together in a satisfactory manner.
Meanwhile, I'm off the bike. I wrote an essay a few months back about other riders being off the bike for extended periods, either due to burnout or physical breakdown. (Stress-related breakdowns, not idiot-induced accidents.) I allowed as how this wouldn't happen to me, or at any rate that I couldn't imagine it happening to me and didn't want it to happen to me. Well. Here I am, off the bike and out of the routine of riding that has been the theme song of my life for many, many years.
I live in a land of moderate climate that allows for year-'round riding, and I have a flexible, self-managed work schedule. So I am free to ride pretty much whenever I want, which for the past 15 years has been holding steady at three times a week--typically two weekday trainers and one weekend whopper--plus a week or three of cycle-tour vacations every year with rides every day. I do sometimes take non-cycling vacations, but they're rare. I don't think I've been off the bike for more than a week at a stretch more than once every couple of years for many years. Plus, until now, I had been very fortunate in the bike-crash department. I have stacked it a few times, often in spectacular fashion, but before this latest booboo, I had never been badly hurt...nothing that kept me off the bike for more than a week. Now I'm off for at least six weeks.
I suppose if one must forego cycling for a few weeks, mid-winter is a good time to do it. We have had our first rainy days of the year, and I don't mind missing rides on those days at all. But we have also had some exquisite days of perfect Indian Summer, with the vineyards almost incandescent in their brilliant reds and yellows, and then the urge to be on two wheels and out in the fresh air is a powerful, painful tug. But I find I don't miss the riding as acutely as I imagined I would. I see other cyclists out there, toiling away, and I don't pine to be with them. I just feel kind of dull and empty. Not quite dead, but not quite alive. And while I don't really miss riding in the cold and wet, I do miss being in touch with the rhythms of the seasons and the vagaries of weather.
On November 26, I was scheduled to lead the club's weekend ride, something of a late-autum tradition for us: over the ridge into Knights Valley and the Mayacama Mountains, up the winding climb on Ida Clayton Road along the shoulder of our highest local peak, Mt. St. Helena. It's a favorite ride of mine, especially in the fall, when the leaves are turning and the broadleaf woods manage a passable imitation of a New England autumn. I wasn't anything like close enough to healed to take on this ride, so I drove out to the summit of Ida Clayton with a car full of munchies and water and wine and set up a little rest stop for the folks on the ride. It was nice to see everyone and partake of that easy chatter that links a group of riders on a nice day in the middle of a loop through a sunny but rather nippy paradise.
While it would have been much, much better to be on the bike, I enjoyed my car trip. (If life has handed me a lemon, I am determined to make lemonade with it.) The day was picture-postcard perfect, so I stopped several times coming and going. Got out and did short walks along the side of the quiet road. Got to check out some vistas in slow-time detail that I never would do if I were moving it along to stay with the group on a ride. But jeez, the car--even a nimble little Honda--felt so clumsy and heavy on the narrow, twisting mountain track. I've written before on more than one occasion about the difference between car touring and cycle touring. No point in belaboring the comparison now. But it's real, and the car takes hind teat every time, in my book (as long as the weather is nice, anyway). By the time you read this, I hope the bike will be my main ride again, even if I'm just working back into shape.
Bill can be reached at srccride@sonic.net