Brain breakage
March 1, 2016 § 36 Comments
When you get hit by a car you get hurt. The easiest injuries to take account of are physical. Broken bones, contusions, blood, and lots of pain let you know when you’ve injured your body.
But whether you get hit by a car or fall down in the middle of a crit, you almost always wind up with another kind of injury that is much harder to evaluate, diagnose, and treat. It’s the mental trauma that accompanies the physical injury.
Formally recognized as post traumatic stress disorder, as cyclists we’re all familiar with it in different guises. Here are a few:
–Fear of descending after a downhill spill.
–Fear of riding near others after you’ve fallen in a group.
–Anxiety about the proximity of cars after you’ve been hit by an auto.
–Anxiety about your tires/wheels/frame after you’ve fallen because of an equipment failure.
For many cyclists, these fears can be much more debilitating than the bones and torn skin that eventually heal. The joy and freedom of cycling, for many riders, vanishes forever after they’ve been clocked by a car and carted off to the ER in an ambulance.
I was so terrified the first time I descended the road on which I’d cracked my pelvis that I shook. That’s a road I’ve descended hundreds of times, but the first time after my fall it was a fearful new world.
One friend who took a nasty spill found her heart racing at 172bpm seven months after the injury … as she drove to the shop to get her bike repaired.
Whether you got hit by a car or slid out in a turn, these anxieties can completely ruin cycling for you. Along with that, you can lose much more than fitness. When the healthy lifestyle that often accompanies cycling is replaced by sedentary behavior, it can have a ripple affect that upsets work, family relationships, and the fundamental building block of your existence, your health.
From a legal perspective, this type of injury is compensable. A cager who whacks you and breaks your leg and bike is also on the hook for the resulting fear and anxiety that he has now brought into your life, especially when your PTSD wreaks havoc in your home and with your work.
But whether your trauma was caused by a motorist or your own bad judgment, your behavior should be the same. Fear and anxiety about riding should be treated by a licensed healthcare professional. “Get back on the horse” is the ultimate goal, but there are therapeutic ways to get there that are safe, healthy, and effective.
So if you find yourself unable to pedal after your physical injuries have healed due to anxiety or fear, get help.
END
Cycling in the South Bay 
Wish I had this advice some years ago after a broken collarbone. On descents I had done many, many times before, I couldn’t lose the fear. I would cry just trying to get down a hill. While I don’t cry anymore, I still can’t just “let it rip.”
I am cautious now and don’t see that changing.
Good advice, Seth! Thanks for speaking up about it.
Welcome!
Wise words.
Born of a dumb move.
Thanks Seth. I still remember the first time back on the track after major stackage on said track. It took quite awhile to be comfortable again
One friend said that it’s distinctly different whether you’ve fallen due to equipment failure. He replaced his entire bike after a wheel failure.
i loved racing crits, bumping shoulders, pulling off the front and all that until my great crit crash of 2015. Someone clipped their pedal on a turn and I couldn’t help but crash into them smashing my face into the pavement. Now I am terrified of crits!
Thanks for letting us know we aren’t the only one’s suffering!
You’re bulletproof until you get hit by a bullet. Lots of people go through this and some don’t ever get better.
Start back slowly, time heals the jitters. But more cautious now on descending turns and hyper aware of front tire pressure. And my (pre-crash) switchback descent PR is from another era, and that’s just fine by me.
It goes from “Who cares?” to “I care.”
First time back on NPR after my crash barfed a little 🤑 Took a friend to get me there!
Yep!!
About 5 years ago I got really lucky, when a car pulled out and hit my bike tacoing the rear wheel, I managed to get my leg out of the pedal and on the ground and did a nice pirouette. Still took me a good 6 Months to get over the whole are you going to pull out on me every time I approached a junction. I suspect with advancing age it would take even longer today. Thanks for being serious about a real problem.
You’re welcome. I hope you’ve added a super bright, $250+ head light with powerful strobe for your daylight riding. I use the Diablo.
The first time I went for a ride alone after being hit by an asshat and sidelined for the better part of last year, I was riding up Silverado trail (wine country) which has a huge shoulder. A car decided to pass from the other lane and so, it was oncoming to me. It passed without incident, but my heart was through the roof. I kept pedaling, and calmed myself down by telling myself, “that was normal car behavior, nothing unusual, and that’s not what happened to me”. Serious self talk. It worked and helped change my visceral response over time. Also because I was last in our line of five, and first hit, for a long time, I would do anything I could to make sure I wasn’t last in line. I would sprint off the front to make sure I was towards the front of the pack, or middle. I didn’t even realize I was doing this, a close riding buddy noticed it and called me out on it.
That’s what friends are for. One thing that has helped me is to remind Mr. Davidson that the things he faces aren’t unique to Mr. Davidson. Everyone has the same challenge, so Mr. Davidson is advised often and repeatedly to stop acting like he’s something special. Since he has an awful propensity to believe in the philosophy of Mr. Davidson Exceptionalism, this is hard to swallow but, like bad tasting yet effective medicine, it is good once you get it down.
It’s a dangerous world and cycling, especially racing, is a dangerous activity. Maybe part of the attraction is the feeling that we’re beating the odds and somehow blessed w/ magic luck and ability. A crash forces us to face reality and the resulting cognitive dissonance – This is exhilarating/This is effin’ DANGEROUS! – might just be a survival mechanism. This is all theory because I NEVER crash!
“It’s a dangerous world” is pretty much all you need to know, in addition to the great Waylon Jennings song, “You’re Still Gonna Die.” Which I add here for your listening pleasure.
Well crap, oat bran won’t save us after all.
But you will well crap.
Thanks for this It is a great post and really helpful to read.
You’re welcome!
My last crash was 2009. It was during the Solvang Century. I didn’t do a century for months, and when I started riding them again, I rode them on our tandem bike with my husband. When I ride my road bike I use a flashing red light on my saddleback and a solid white light on the front. I signal my turns, etc. My goal is to be predictable, visible and safe. And I race pretty much just time trials now, as a way to manage risk. But that PTSD is insidious, isn’t it, no matter what precautions you take.
It never really goes away. Now imagine what it’s like being shot at, over and over again, right?
So true. I’ve written about my own fear of getting the death wobble while descending (never on the mtb, though, just the road bike). People would respond that it was just the bike, but I have always known deep down that it was ptsd-related. Mostly I have worked through it and can get down a mountain, but well behind everyone else.
They can collect the $10k descending bonus. Oh, wait. THERE ISN’T ONE.
I think it helps to ACCEPT that if you’re a cyclist who races and likes to “mix it up” in the bunch it’s just a matter of time before your luck/skill runs out and sometimes “shit happens” which is totally out of your control and you’re gonna end up eating the tarmac. It’ll hurt, there will be consequences bodily/mentally/financially but it’s a part of the game. ACCEPT IT. Often there is NOTHING YOU could have done differently (other than stay on the couch) to change it. There is NOTHING TO LEARN from it, you didn’t create it and couldn’t change it, it happens…ACCEPT IT and get back into it. If you go back to racing it WILL happen again. Maybe not this race or next race or even next season season but sooner or later you’ll get hurt again. ACCEPT IT and race anyway.
This is similar to how they tried and failed to treat “shell shock” in WWI and WWII.
Don’t underestimate the PTSD of your loved ones. If you have a bad crash they are the ones with all the worries, seeing you suffering and in pain, possibly close to dying. Then you decide to climb back on the bike and they have to live with that, waiting for that next phone call.
True.
I can relate Dr. Feelgood. And by “Horse” you mean “Heroine” I presume?
If you get back on the heroine wear a condom.
I was rear-ended by a car last year. I was told that I landed on the hood before hitting the ground, bouncing a bit and cracking my helmet. Luckily, mostly bruises that healed within a month. Someone asked me after it happened if I was spooked, and said that I didn’t think so. However, I found that I was not riding over in that area of town for over 3 months.
When I finally forced myself to go over, a guy I don’t know got on my wheel. Normally, I wouldn’t mind, but I had to ask him to move away as I was not comfortable. I get visions of cars slamming into me very violently. This happened last August. I have mostly been riding in the Velodrome since then, but that’s primarily due to asthma and cold weather, However, like Seth says, these scars might fade, but they will never go away.
Yep.