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  1. #1
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    Tree meet face, major facial trauma, time off bike??

    Well, I've joined the broken riders club, very reluctantly and before what was supposed to be my first endurance event. I always thought I'd break a collarbone, but never something this serious.

    I went off the side of the trail and met a tree going pretty fast, 18mph according to Strava, but fast enough to break my nose, have several facial fractures, break my eyesocket, and crack the lining between my skull and nose (or sinus)? I was in trauma care overnight and sent home, the most concerning thing being an air pocket my brain from where the ER nurse allowed me to blow my nose to get blood out, apparently it blew air into my brain. They said it was small enough to be reabsorbed but I would require surgery to relieve pressure on my brain if it grew. Risk of infection exists until the lining heals, especially if bacteria is blown into the fracture. I also needed over 50 stitches to my forehead.

    Fortunately, no concussion, no brain bleeding, etc. Biggest neurology issue could be infection and a potential CSF leak, but the latter wasn't on my paperwork and was only mentioned in passing. We're basically just waiting and trying to prevent an infection at this point.

    This was all three days ago, I was home on day two and on antibiotics and painkillers. Trying not to focus on the risks.

    My neurologist said that I'd be off the bike for up to 6 months, but that it was up to the facial folks since there was no real neurological issue at that point. I thought that seemed...long. My facial surgeon said 2 weeks back to low impact activity and 8-10 weeks back to riding on the bike again. Both docs said I could be back on the stationary in a week or two, so that is a relief at least.

    I was wondering, people that had similar injuries, what was your recovery time? When were you able to get riding again? I can handle 8-10 weeks, even a bit more, but 6 months seems really long. I will obviously take my doctors word for it, because injuries can vary so much, but I'm interested in what other people went through.

  2. #2
    Raleigh
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    Dude, I'm glad you're alive - I wish you well, man!

    Btw - which Pisgah trail?
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  3. #3
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    Quote Originally Posted by woodchips View Post
    Dude, I'm glad you're alive - I wish you well, man!

    Btw - which Pisgah trail?
    Thanks.

    Embarrassingly enough, Lower Black...

  4. #4
    Raleigh
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    Quote Originally Posted by Adodero View Post
    Thanks.

    Embarrassingly enough, Lower Black...
    Well, at least you can say it was Pisgah, and not DuPont...

    *edit - regardless of where you're at, we all know it only takes one small thing to happen to get everything unsettled.

    Lower B is fun and fast, and it's too easy to get caught up in the fun of it all!
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  5. #5
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    Quote Originally Posted by woodchips View Post
    Well, at least you can say it was Pisgah, and not DuPont...

    *edit - regardless of where you're at, we all know it only takes one small thing to happen to get everything unsettled.

    Lower B is fun and fast, and it's too easy to get caught up in the fun of it all!
    Hah, very true! It never seems to be the slow tech that gets people, it's always the faster ones.

    that's more or less what happened, I got a bit caught up in it all, I sent one of the little rock kickers near the bottom but was not focused on where I needed to be going, landed off the side of the trail and couldn't recover before hitting the tree.

  6. #6
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    July 4th: Mistake on Big Rock, DuPont: Hit tree with face & first ER said my injury was above their pay grade-thankfully. Next ER, facial trauma surgeon "I can fix that." Through and through cut on lower lip with 35 stitches inside & outside to close. Kind of shocking to see one's teeth with the mouth closed. No painkiller & antibiotics as prophylaxis-no infection. Back on bike 2 days later in full skittish mode. About 4 months later scar is not too bad, daily lip massage to break up scar tissue. Lip alignment is about as good as I could ask for. Bill from first ER was about $1,000- hope you have good insurance. I don't think I'd ride again without it. I think you took a much harder hit than I did & I am not sure what I am waiting on to get a full face helmet. Best wishes for a full & speedy recovery.

  7. #7
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    Quote Originally Posted by Slowdownhill View Post
    July 4th: Mistake on Big Rock, DuPont: Hit tree with face & first ER said my injury was above their pay grade-thankfully. Next ER, facial trauma surgeon "I can fix that." Through and through cut on lower lip with 35 stitches inside & outside to close. Kind of shocking to see one's teeth with the mouth closed. No painkiller & antibiotics as prophylaxis-no infection. Back on bike 2 days later in full skittish mode. About 4 months later scar is not too bad, daily lip massage to break up scar tissue. Lip alignment is about as good as I could ask for. Bill from first ER was about $1,000- hope you have good insurance. I don't think I'd ride again without it. I think you took a much harder hit than I did & I am not sure what I am waiting on to get a full face helmet. Best wishes for a full & speedy recovery.
    Ouch. Were you at Transylvania Regional? They more or less did the same thing, booted me to Mission HQ, "mothership" as they called it.

  8. #8
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    I did end up at Mission but not from Transylvania. Violated Carlos' first rule: "Don't do stupid s***." It will get better.

  9. #9
    Pinehurst NC
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    A few of us health care professionals wear full face helmets because most self-insured hospitals have very poor maxillofacial coverage in their policies, and the insured gets stuck with the bill. Hope your recovery goes well!
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  10. #10
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    Coincidentally, almost this exact injury happened to me on Oct 13th. Snagged my bars on a branch and careened into a tree face first. I was going pretty slowly, less than 8mph according to my Garmin, on an easy trail I've ridden close to 200 times.

    I also avoided a concussion, but received a Le forte III fracture, fractured sinus, and a huge laceration through my eyebrow that perfectly matched the outline of my sunglasses. Also some stupendous black eyes and swelling a few days later. Thankfully no eye injuries or anything really "permanent."

    There was enough displacement that I had maxillofacial surgery a week later. Luckily the surgeon was able to go through my mouth and use the existing lacerations, so I didn't need the "full face" surgery. Went home with some sweet titanium hardware.

    The downside is that I'm now on week 2 of 4 of having my jaw wired shut. Pain has been surprisingly minimal; no painkillers needed since I left the hospital. Swelling and numbness are nearly gone. Other than that (and not biking of course) I'm pretty much back to normal. I should be back on the bike by December. Considering how bad things could have been I consider myself very lucky.

    Anyway, YMMV of course. Good luck with the recovery!
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  11. #11
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    Ouch, sounds like you made out worse than I did.

    My facial surgeon said I could go back to normal activity, I don't require any work on their end. My neurologist appt is tomorrow, which will really dictate the rest, he was the one that gave me the longest timeline on getting back to riding. Hopefully he will let me hit some gravel roads or something, I'm anxious to get back at it again.

    Hope you recover quickly, halfway through your jaw being shut. I can't imagine having to do that, I was really glad that my fractures broke in such a way that I didn't require any major surgery.

    Do you plan on going full face after this? I'm thinking about doing it full time for a while.

  12. #12
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    Good luck with the neurologist! I also had a very small air pocket and was sent home with antibiotics; so far no issues. To be honest not biking or being able to do much outside has been the worst part for me. The jaw definitely sucked at first but now that I have a few acceptable (blendable) recipes it's not too bad.

    Naturally I've thought a lot about gear after this. In my case I think my accident was so bad due to not riding with a "reserve" (too comfortable with the trail, not paying full attention, etc), and improperly wearing my helmet (it was loose enough that the visor just pushed the whole thing back on my head instead of absorbing any impact).

    I actually own a full face that I use for park riding, but I still can't imagine wearing it regularly for XC rides like I was on in this case. Instead I picked up a Bell Super which seems like a great compromise for the riding I typically do. We'll see how long I put up with the chin bar.
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  13. #13
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    Quote Originally Posted by Adodero View Post
    Do you plan on going full face after this? I'm thinking about doing it full time for a while.
    Check out the Fox Airframe. Most comfortable full face helmet ever for me. You seriously don't even realize it's a full face and airflow, while obviously not as good as a regular helmet, is excellent. I could easily wear it for every ride if I had to.
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  14. #14
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    Quote Originally Posted by k2rider1964 View Post
    Check out the Fox Airframe. Most comfortable full face helmet ever for me. You seriously don't even realize it's a full face and airflow, while obviously not as good as a regular helmet, is excellent. I could easily wear it for every ride if I had to.
    I actually own one of these and will be using it full time for a while. You are right, it's really comfortable and breathable. Especially since it's winter right now, it's easy to get away with it.

    Quote Originally Posted by PerfectZero View Post
    Good luck with the neurologist! I also had a very small air pocket and was sent home with antibiotics; so far no issues. To be honest not biking or being able to do much outside has been the worst part for me. The jaw definitely sucked at first but now that I have a few acceptable (blendable) recipes it's not too bad.
    I hear you. At first I was really worried about the consequences, serious potential for infection, etc, but now it's mainly an annoyance. I consider myself lucky in that regard, but it is really inconvenient not being able to drive, ride, or do anything.

    Naturally I've thought a lot about gear after this. In my case I think my accident was so bad due to not riding with a "reserve" (too comfortable with the trail, not paying full attention, etc)
    I work with a skills coach fairly often and I talked to him about a week after my accident. We get together about once every 3 months or so, but we were working together the week before my crash. He had pointed out that I was going too fast and doing too much in terms of jumping and boosting stuff compared to my level of experience and, mainly, where my vision was. Unfortunately, I didn't get the message and that put me where I am now. That isn't his fault, I actually thought about what he said on the way to the ER, although he said he felt bad he wasn't more insistent on it and should have brought it up more during our time and will when he sees this in the future. I think a lot for me is that I've been progressing a lot lately and I let myself get a little too far ahead of where I should be.

    His advice when I got back to riding was to start with Sunday stroll type pace, but also to consider disciplining myself to ride at 60-70% of my capability level on a regular basis. That was an interesting take away for me, because I tend to ride with people a lot faster than I am and probably push it harder than I should, but also feel sortof down on myself if I don't. I think there is a certain mental discipline associated with saying no to something or slowing yourself down even if you can go faster, which is something I think I've reached a point that I need to work on. His advice was to just decide to walk something you normally ride, to normalize the feeling of not doing a feature and realize that saying no is ok.

    Where did you crash? I was on Lower Black in Pisgah.

  15. #15
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    Quote Originally Posted by Adodero View Post
    His advice when I got back to riding was to start with Sunday stroll type pace, but also to consider disciplining myself to ride at 60-70% of my capability level on a regular basis.
    Yup, exactly. This basically doesn't happen with me on familiar trails unless I consciously dial it down.

    Happened to me up in Mammoth Lakes, CA.
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  16. #16
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    Quote Originally Posted by PerfectZero View Post
    Happened to me up in Mammoth Lakes, CA.
    That's where I broke my femur back in 2009...on a dirt bike.
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  17. #17
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    Quote Originally Posted by k2rider1964 View Post
    That's where I broke my femur back in 2009...on a dirt bike.
    The hospital staff seemed very experienced!
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  18. #18
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    Quote Originally Posted by PerfectZero View Post
    The hospital staff seemed very experienced!
    Hey Perfectzero I rode Cannell with you a couple years back. Hope you heal up well. Hope we can all ride again some time and get better!

  19. #19
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    Quote Originally Posted by trmn8er View Post
    Hey Perfectzero I rode Cannell with you a couple years back. Hope you heal up well. Hope we can all ride again some time and get better!
    Thanks! So far so good.
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  20. #20
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    I met with my neuro yesterday and he cleared me to ease back into riding, which was a relief. He told me 6 months in the hospital and everyone else said 5-6 weeks, so it seemed a bit surprising that I was cleared so easily.

    Part of me wonders if he told me that to keep me from starting back too soon, before I met with them again? I have no idea, but either way, I'm good to start riding again. I suppose there were some other unknowns in terms of infections and potential facial surgery, too.

    I got back on the bike today to ride around the neighborhood, I was definitely a bit skiddish and it felt a bit foreign. It's only been 3 weeks, but in some ways it feels like it's been longer. I guess we'll find out when I ride on the trail. I feel lucky to be back at it so soon, but I'm not sure what to expect when I get back on it.

    I also went back to see where I crashed. The distance from where I screwed up to where I ate a tree was really far, like maybe 60 feet. According to my feet per second calculation, it would have given me about 2-3 seconds at the speed I was going to figure out how to handle the situation. I guess I froze up or just couldn't get out of it, I have no clue. I remember riding along the edge of the trail, in the leaves and brush, thinking about how to get out of it, but the details between that point and when I hit the tree are a bit fuzzy. Looking at where I hit, there is a big log in the way, so I wonder if I hit it and lost control before hitting the tree.

  21. #21
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    Quote Originally Posted by PerfectZero View Post
    The hospital staff seemed very experienced!
    My surgeon, Michael Karch, is/was a US Snowboard Team surgeon and yeah, I'm sure they've seen it all working in Mammoth. They have all the standard injuries from skiers and snowboarders all Winter and then MTB's and dirt bikes all Summer. Those damn trees get in everybody's way.
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  22. #22
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    Quote Originally Posted by k2rider1964 View Post
    Check out the Fox Airframe. Most comfortable full face helmet ever for me. You seriously don't even realize it's a full face and airflow, while obviously not as good as a regular helmet, is excellent. I could easily wear it for every ride if I had to.

    k2, I looked for the Airframe on Google, but only came up with the Proframe. Is the Airframe an older model?
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  23. #23
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    I think a lot for me is that I've been progressing a lot lately and I let myself get a little too far ahead of where I should be.
    I had one of my worst crashes where my confidence and skill level hadn't had time to link up after a progression in my skill. The confidence level overtook my skill level!
    Since then I try to remind myself any time I am progressing or doing new stuff to take it slow and let the new skills sink in.
    Speedy recovery!

  24. #24
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    This saga is finally over for me. Quick timeline for future reference:

    13 Oct: initial accident; ct scans, swelling but no concussion, etc.
    Tree meet face, major facial trauma, time off bike??-screen-shot-2017-12-07-5.54.41-pm.png

    23 Oct: ORIF surgery; acquire titanium hardware, jaw wired shut.

    31 Oct: return to work, taking advantage of convenient halloween costume.

    21 Nov (surgery +4 wks): jaw unwired
    Tree meet face, major facial trauma, time off bike??-img_2523.jpg

    1 Dec (~surgery +6 wks): cleared to find another tree to bash my face against.

    5 Dec: first post-accident ride!
    Tree meet face, major facial trauma, time off bike??-img_2609.jpg

    fin
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  25. #25
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    That's a rad image! Good to see you're out there gettin after it already brother!

  26. #26
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    Quote Originally Posted by EatsDirt View Post
    That's a rad image! Good to see you're out there gettin after it already brother!
    Got a 3d printer at work...
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  27. #27
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    Quote Originally Posted by PerfectZero View Post
    Got a 3d printer at work...
    There's no question, it must be done.

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