Kissena Forum Archive

Injury: Sprains, Strains, Breaks & Insurance

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Working with a PT makes a lot of sense and may be covered by your insurance 
Working with a PT makes a lot of sense and may be covered by your insurance 
The right one, though.  THe PT place I'm going seems to be at their limit with helping me increase my range of motion.  At the start, when it was just about moving my arm, they seemed to be fine.  FWIW, I'm looking for another place/person.  But it needs to be geographically proximate and covered by insurance.  
@GregHoge Yea definitely would like to find someone with a sport background.

I have heard good things about ACME but man are they pricey! Maybe thats just the cost these days, but $500 seems steep
Max, if your issue is a simple one to spot you can go to any experienced fitter. If your issue is complicated or really subtle it may be worth the extra money to go with ACME as they are probably the most experienced in the NY area. 

Years ago I think Jules went to see Andy Pruitt in Colorado. Maybe that’s an option for you when you visit family?
Yes, back when I was a rich banker I once panicked at some knee pain I'd picked up after a week of hard training in LA. Flew to Boulder and had Pruitt fit me. He's since retired but his clinic is still going strong.
There's another guy to check out.  Happy Freedman.  He's probably more expensive than ACME.  But he has a real following.  

https://www.happyfreedman.com/

He was at HSS.  But he's been a solo act since Covid.  
Has anyone ever dealt with Achilles tendinitis before? I got it from running a few weeks ago and it's been really frustrating to come back to cycling (esp. in increasing volume and intensity). I've been doing some PT exercises but wondering how long I can expect this recovery process to take so I can train in earnest and prepare for some races.
Eric it's going to suck but you have to rest it. I screwed up my Achilles 2 years ago and it took a solid 4 wks of doing "nothing" before it felt mostly normal and didn't affect pedaling.

Obviously seek professional medical care but I suspect a big part of the prescription will be rest.
Soft tissue is 80% healed after 6 weeks.
In the past few days I've had some knee pain that has gotten progressively worse.  Specifically on the outside of my right knee, and it only hurts when riding (walking is fine).  I haven't made any changes to my position as of late so a bit confused as to what it might be.  It did start after the bear ride, so I think some if it could just be overuse, but took a few days and some light riding and it doesn't seem to be getting any better.

Any ideas or suggestions are appreciated.
So this has still not resolved for me unfortunately, good amount of stretching, strength work, some





 position tinkering and an AI fit that showed nothing was super out of whack.  

I've been off the bike for 2.5 weeks while I was in Colorado.  Figured skiing would make it worse but turned out to be completely fine, even under a lot of stress/pressure in the race course and in the bumps.  Now back home and the pain is acting up after one 45 minute ride.  Next step is finally going to a proper doctor.  I have some heel wedges I'd like to try as well- but will likely try to do a professional fit assessment, any recommendations on good spots are welcome.
I had my bike fitted at Acme by James Martin, who races for TBD. He's a super nice guy, and his fee is $330 since he's an apprentice. He did a great job on my Roubaix, so I recommend going for it.
@EricMa I've had achilles tendonitis flare ups twice in the past from running and backpacking.  Like Dave said, really the only thing that helped for me was giving it good solid rest.  Mine got pretty bad to the point that even walking was really difficult, I want to say about 3 weeks of total rest got me to a place where I could slowly re introduce activity.  I didn't do much PT, just foam rolling, but I was also 18 so mileage may vary
I had some Achilles tendinitis a few summers ago. Took about 4 weeks of minimal to no usage and changing my cleat position slightly to get back to pain free riding/living
I ended up scheduling a fit at ACME and just had it earlier today.  Couldn't get a time in with Jonathan, ended up with their other guy Greg.  He was awesome, seemed very knowledgable and was really attentive throughout the whole fitting which ended up being around 3 hours.

Time will tell if the changes we made work to fix some of my problems, but on the whole it was a really informative and positive experience.
Any tips for dealing with saddle sores( Kind of pimple / cyst type), Ive started using benzoyle peroxide in the shower and detsatin( diaper cream ) 
Trying to avoid the best treatment ( Not Riding)
Hydrocolloid bandages.  Specifically bandaid brand's Advanced Healing Hydro Seal that are made for blisters.  They are thicker than normal hydrocolloids, so it provides some cushion.

I've struggled with saddle sores pretty much the whole time I've been riding and those bandages make it so I can more comfortably ride with a mild sore.

One downside is that they can start to peel off on longer/sweaty rides and get some adhesive on your chamios.  It comes off with some scrubbing but still annoying.

Longer term, checking saddle height and making sure your hamstrings arent super tight.
I sadly have some experience with saddle sores. Beyond getting your fit right, and the stretching, some other things to do that I'm aware of:
• Use chamois cream when riding
• After every ride, get out of the bibs as soon as you can, clean yourself well, and keep it dry and aired out afterwards. Go commando, wear boxers, etc. 
• If you do get a sore anyway (I usually do at least once a year), and it's small enough to still ride, I've used a product called 'Boil Ease'. It works great. I couldn't find it in CVS when I was visiting stateside the other month. But it's really helped me in the past. Now I use an antibiotic powder from the local pharmacy that seems to help. Next time I visit the good ol' USA I'll order some Boil Ease from Amazon. https://www.amazon.com/Boil-Ease-Relieving-Ointment-Ounce/dp/B00412QET4

Good luck. Saddle sores are no joke. Races have been lost thanks to them, including the famous LeMond/Fignon TDF time trial. Apparently Fignon had a bad saddle sore, and that (along with a flopping pony tail and no aero bars) contributed to his loss. And if you don't know about the '89 TDF, then look it up. One of the best Tours ever. You can watch it while airing out your taint. 

Echoing Nate’s great points, here are a few off the bike tips that help me prevent saddle sores, and manage them when they show up:

  • Change immediately after your ride. Don’t linger in kit. If you drove, bring clean underwear and pants and change before you even rack your bike. Riding from home? Change before making that recovery drink, etc...

  • Shower with Hibiclens (the soap surgeons use). A small dab is enough to clean the area. A bottle lasts forever.

  • Keep Preparation H, Neosporin, and Cortisone ointment on hand. At the first sign of trouble, use whichever fits: Prep H for sores or inflammations, Cortisone for rash, Neosporin for cuts. I'd bet "Boil Ease' is similar. 

  • A drop of soap directly into the chamois when washing your kit.

Hope that helps. Good luck!

Found a super old article from Dave Zabriskie, from 2007..., before even DZ-Nutz existed:

MAIN-TAINT-ANCE by Dave Zabriskie

An often overlooked part of being a healthy and fast cyclist is the taint. The taint is the part of your body that contacts your saddle. I believe the name was derived from the taint not being the parts that are well know by name: as in it taint that and it sure taint those! If you can't comfortably sit on the saddle you taint gonna be able to ride your bike very far. This can negativly effect training and racing, so one must keep this area well main-taint-ed.

There are three simple concepts to accept and follow: Cleanliness, Lubrication and Dryness. Trust me all of this was learned by experience! Here are the steps to follow:

-. Begin with a clean taint and chamois (if you are a hairy beast like me you may want to shave the area--USE CAUTION!)

1. Generously apply chamois cream
2. Ride, Train, Do what you do
3. Dismount bike (Follow the next steps immediately and without fail)
i. Remove chamois
ii. Shower
iii. Use a truly antibacterial soap like Hibiclens

4. Exit Shower
i. Dry taint with towel
ii. Dry taint with air

-. Either remain naked while making your after ride meal or use hair dryer

-. Antique yourself ala Jackass with a handful of Baby Powder

Why do we do this?

The chamois cream, helps reduce chafing that occurs while riding. There are a number of products out there and here are a few that I know work well:

Noxema
Butt Butter
Bag Balm
Assos Chamois cream
Sixtufit

Try them to determine what works best for you. Often when things are getting a bit raw I mix a few to exploit the full potential of each. Do yourself and your training partners a favor by not using too much. I have been known to have a little seep out of my shorts and it never fails to gain the attention of those behind me. Make sure your chamois is in good shape. Don't use one that is old and worn out. After the ride get out of your shorts ASAP, you don't wanna start growing mushrooms down there. Get into the shower and wash up, if you are having "problems" use Hibiclens, it is a surgical scrub and very powerful. I take it to races because each hotel has different soaps and who knows which could cause an irritation. After the shower make sure the area is dry either walk around naked for a while and let it air out or use a hairdryer. The final dose of goodness comes from a little shot of baby powder to the taint. By following these steps you should be main-taint-ing fairly well. If you are experiencing some saddle sores sometimes the only way to get rid of them is to stop riding for a couple of days. If it's really bad you might have to see a doctor. I am sort of an expert so if you want you can send pictures and I'll give you my opinion on the best way to proceed. PLEASE DON'T!

Oh yeah one more thing I think that can help is to shave all of that "bum fluff" down. It can be tricky, use electric clippers and be careful, I recommend a mirror.

-DZ
I remember when Zabriskie published that. True words of wisdom. Can’t get better advice than that. 
One thing to note: if it’s a real bad sore, you should probably take a short break from cycling and clean and dry it every day morning and night until it’s better, or at least good enough to ride. One good thing about Boil Ease is that it has a little bit of painkiller to ease the discomfort. But I’d do that only when it’s small. A big one needs greater attention. 
"I have been known to have a little seep out of my shorts and it never fails to gain the attention of those behind me."--DZ

Well before then, I heard stories about this.  He once stayed at a friend's home.  DZ apparently traveled with baby wipes, which he used instead of toilet paper.  It was a chronic issue, which is possibly 
attributable to saddle position?

When I have a pimple down there, I sometimes try a hot towel to open it up, then dry, then wipe with a benzoil peroxide pad (a benefit of having teens at home).  Seems to work some of the time, though can't say why (maybe luck).  Part of me wonders if I'm opening up the pores, medicating them, and sealing them.  After that dries, I apply either chamois creme and vaseline imprenated with cocoa butter (this is a recent experiment).   

Since they are au courant, I'm wondering if a bidet does a better job of cleaning than paper.

And thanks for the Hiblcens tip.  gotta look into that.  When I was younger, I tried Dr. Bronners soap when I had saddle sores.  The topical counter-irritant was irritating.  Not sure it did anything.  
Xeroform is a (hospital grade) gauze that can be used on practically any damaged skin and works miracles. I’ve used on burns and road rash, highly recommend. They use this all the time in ER’s.

Shout out to Hibiclens also which actually does wonders for strong BO incase anyone wondered…. There’s a whole subreddit on it.
Thanks for tips 
Never had a pimple before , very annoying 

As some of you know, @KevinWomack crashed yesterday during the final lap of the L&C race, heading up the GAP climb to the finish.

He spent the night at the hospital and may need to stay again tonight as a precaution, since a few fractured ribs could affect his breathing. He’s chilling and recovering at new NewYork-Presbyterian Brooklyn Methodist in Park Slope.

I’ll let Kevin share more details if he wants, but he’s in good spirits, albeit maybe a bit bored, as he rests and recovers.

If you have a moment to send a message or say hi, I’m sure he’d appreciate it.

Oof. @KevinWomack  Hope you're not in too much pain or getting the sponge baths from Borat... unless you're into it, in which case... WINNING!

Seriously though get well soon. Crashing blows.
Hope you heal fast @KevinWomack and get back out there soon!
(also obligatory X-ray post is missing ;))
Hi everyone, thanks for all the messages! So it’s a fractured clavicle, 4-5 fractured ribs and a punctured lung, lots of pain and all the opioids! I have no memory from the moment I went over till when I got to hospital, wild.

Spent the day forensically reviewing some YouTube footage and it looks like 593 passes me on the right and moves in front of me, probably 1” too soon, it sends me 90 degrees right and heading direct into a light pole. Not sure if it’s bc the ground was wet n dirty bc of the storm but I think I tried to turn, bike slipped right, I faceplanted left. No time to even put my hands out as my knuckles and helmet can now attest.





Footage here: 1:09:10 is when I go down on the right.

https://youtu.be/vtrCuGHx3uE?si=3H9NxaGs65s0bCpP

Another vid showing the guy moving in front of me.52:40: https://youtu.be/0lPvX7m-KhY?si=nY1TKkaw9UWiG2-n

Looks like I was in around 20-25th place ant the time, I remember still feeling pretty good at this point.

Shout out to @David Yang and @eloy for taking me and staying at the hospital. They had to put up with my screams of “please stop!” when they were inserting the tubes, seriously the most pain I’d ever felt. I should be getting discharged later tomorrow or early Tuesday. Pretty annoying in the fact we have this wee man I won’t be able to help much with…

Here’s some highlights of my stay so far.








Not sure how long I’ll be off the bike but hoping it’s not too long. Already being questioned by the wife on if I should be doing more of these races in the future…… 👀
@KevinWomack

oof.  that sucks.  We were hoping you'd score some cheddar at the race and take us out for donuts.  

Pushing on broken ribs to fit in the chest tube is one of the most painful things I've had done to me.  

FWIW, since I left my phone at home, it started blowing up with messages at 8:03am.  My wife, who was just stirring, saw the texts and had no idea if it was me or someone else.  She called Dave to clear it up.  When I got home, she said to me, 'funny thing...'  Think I might have to turn off the phone next time.  

Any surgery planned?  Both ribs and clavicles can go either way.  

Keep us posted.  
Oh shit! All the best Kevin, looks like a gnarly crash. Hope they send you home soon so that you won’t have to eat much more of the hospital food. The pictures with the little one are great though. 

By now, Dave must’ve seen the medical procedures for a punctured lung enough times to fix it himself next time.
Oh shit! All the best Kevin, looks like a gnarly crash. Hope they send you home soon so that you won’t have to eat much more of the hospital food.
I briefly thought they served him mystery meat and ice cream.  
Random notables:

It never gets easier seeing friends and teammates in this situation.

Adrenaline is a helluva drug and will mask pain and injuries in the first few minutes. Always get checked out by medical professionals and err generously on the side of caution after a crash.

Kevin's roommate in the ER room, partitioned off by a thin curtain - was sedated and asleep and the entire time, snoring loudly. It added some levity to the seriousness of the situation: while Kevin was getting a tube shoved into his chest cavity and screaming in pain, his buddy next door sounded like an ogre having the worst (best?) night of sleep, snoring away without a care in the world.

At one point before the tube was inserted the entire ER crew - admins, RNs, doctors, technicians, etc. - was in Kevin's room and they were fawning over him. Nurses who didn't need to be in there were just hanging out until they were called elsewhere. Everyone loves a scotsman!

At the ER, after Kevin was stabilized and things were ok in the most basic sense, I joked that they should dedicate the room as the "KCC ER Bed" or sponsor us - When Max went down last year it was the same major injury on the same hill on the same last lap, treated at the same hospital, same ER room, and at least one of the same doctors who treated Max last year... who was wearing the same Blundstone boots that I commented on (looking a little more worn)!

After the procedures were done and we all breathed a sigh of relief, I flagged that same doctor coming out of the room in the hallway and he recognized me (obviously because I was in sweaty post-race cycling kit) and he asked how our friend [Max] was doing. I told the doc that Max recovered fully and just came back from the Tour de France - and then realizing how that sounded, quickly added, "As a spectator, not to race!" The young doctor laughed and said you guys have to really stop coming here. I agreed.

Eloy providing a needed distraction by streaming the final decisive climb of TdFF on his phone while we waited for the doctors to do their thing.

Good luck Kevin, we'll have a recovery pint when you're out and draw up a plan to get you in the grey jersey next year.
Treat that concussion seriously; there are some unexpected things about the recovery; emotional volatility being one of them.

Otherwise, if you were just trying to get out of helping with the little one I could have given you the tip to just break the tip of your thumb ;)

Glad they're feeding you in 1960's Kodachrome color...