The pain comes suddenly, and with it the tears: anyone who has ever fallen off their bike knows how much abrasions hurt. Why is that the case? Even a minor fall damages the upper layer of skin, the epidermis. This damages many small nerves lying directly under the skin, which trigger the pain. As long as only the top layer of skin is affected, the abrasion does not even bleed, as there are no blood vessels in the epidermis. Only when the underlying dermis is injured does the abrasion bleed. The body then tries to stop the bleeding and activates blood clotting: the injured vessels should be sealed as quickly as possible to prevent pathogens and germs from entering the wound. To do this, the body produces more of the protein fibrin, which acts like glue on the wound. With these reactions, the body tries to rule out the greatest danger with an abrasion: an infection.
What you need to properly treat a graze wound
- Sterile, damp cloth to clean the wound, tweezers if necessary
- Disinfectant spray (e.g. Octenisept or alcohol solution) and saline solution
- Wound ointment if the wound has dried out
- Dressing material (ideally plus net dressing) for smaller wounds, plasters or tapes are sufficient to secure the dressing
Wound cleansing
- First you must clean the wound mechanically: Foreign bodies, such as rolling stones, must be removed.
- Then clean and disinfect the wound. Use a sterile saline solution, disinfectant spray or an alcohol solution (see interviews)
- If you only have a minor scrape, a spray bandage or a simple plaster will suffice. For more severe wounds, you should apply a sterile dressing and have the injury assessed by a doctor.
Abrasions heal within ten days
Especially if you have suffered a deep abrasion in typical cycling areas such as the elbow or knee, this will take time to heal. Do not allow any water to come into contact with the wound for the first few days and make sure that the injured area is always clean. The first phase of wound healing takes about four days. The body produces granulation tissue to close the wound on its own. In the second phase, additional collagen fibres are built up, which reduce the wound area and bring the wound edges closer together. In the final regeneration phase, the collagen fibres are stabilised; the wound closes completely and a new layer of skin has already formed. The healing process takes around ten days in total. At the latest then you can start cycling again.
If you want to avoid such a long break, it's best to do like ex-pro Erik Zabel: "My recipe against grazes? I make sure I don't get any in the first place!"
Interview with emergency doctor Sebastian Zimatschek: "Don't put any ointment on the wound!"
Sebastian Zimatschek is an anaesthetist and emergency doctor. He has led the medical team since the first edition of the TOUR-Transalp and has a lot of experience with cyclist injuries
TOUR: Where do cyclists most often dig themselves up?
Zimatschek: The elbows, buttocks and knees are the typical areas.
What is the correct initial treatment for an abrasion?
This depends on the severity of the wound. All wounds should ideally be thoroughly cleaned with sterile water and then disinfected. We use sterile saline solution for cleaning and a less irritating alcohol solution. We do not use solutions containing iodine, as some people are allergic to it. Superficial abrasions are sterilely covered and bandaged by us. In the case of deeper wounds, a pressure bandage may be necessary and, in individual cases, the wound may need to be dressed with tape or sutures. As a general rule, cyclists should always have adequate tetanus protection and have this refreshed if necessary.
What do you think of the professional method of brushing the wound open in the evening and then dressing it fresh?
We do not consider brushing to be a sensible option. If a wound has been cleaned well after the injury, this would only disrupt the healing process. Regular wound checks followed by dressing changes seem more appropriate. If purulent wound secretions form, a doctor should urgently check this. They can remove any remaining dirt and wound secretions and the wound can heal better. But I wouldn't advise any amateur rider to use a root brush at home - that's a matter for a doctor!
Do you have to take a break with a severe abrasion?
As a rule, yes. Particularly in the case of wounds in the joint area, i.e. on the knees or elbows, the chafed area cannot heal at rest due to the constant strain. This can lead to wound infections, which in the worst case can also affect the affected joints.
What are the most common mistakes cyclists make when they get grazes?
Apply ointment to fresh, bleeding wounds. No ointment should be applied to open wounds! They should be treated with a sterile dressing, especially if they are bleeding.
How long does it take for an abrasion to heal?
This varies from person to person, usually seven to ten days. You should not start cycling again until a firm scab has formed. In the joint area, this can take several days.
How professionals treat abrasions: Three questions for former team doctor Claudio Sprenger
TOUR: During the race, there is often no time for extensive wound care for minor injuries - how do you treat the riders on the road?
Sprenger: If the wound is not bleeding very heavily, it is first treated with a disinfectant spray. This also seals the wound a little, so the rider makes it to the finish without too many problems.
What happens to the wound after the race?
It is thoroughly cleaned - sometimes you have to use the unloved hand brush. It hurts, but it has to be done. The area is disinfected again; the most important thing is to prevent inflammation.
Are the drivers usually fit for work again the next day?
If the wounds are not too deep, yes. You then wear special mesh bandages that do not slip but restrict your movements on the bike as little as possible. Nevertheless, abrasions will still hurt for a few days and need to be treated every evening.
