Whoever said cycling isn't a contact sport must not have watched the 2008 Giro d'Italia. In the span of three weeks, Alberto Contador busted his elbow, Dave Zabriskie fractured his spine, and CSC teammates Bradley McGee and Stuart O'Grady snapped their collarbones.
The outcomes of these various calamites revealed at least two things: racing bikes is a tough way to earn a paycheck, and no two broken bones are the same. While Zabriskie, O'Grady and McGee dropped out of the Giro, Contador pushed on and won the Italian grand tour.
Understanding Fractures and Breaks
So how can one busted bone be so different from the next? And what's the difference between a fracture and a break anyway?
Well for starters, it's a common misconception that fractures are less serious than breaks. In fact, breaks and fractures are the same thing. Fracture is simply medical jargon for any break in the bone—be it separated or not.
Nondisplaced Left Clavicle Fracture - Photo Courtesy of VeloNews
Most cyclists sustain broken bones during a fall, perhaps an ill-fated, out-stretched hand or a sideways hip-slide wipeout. Either way, the rider's momentum trumps the strength of the bone—and snap! Where it breaks, however, is more complicated.
In general, upper extremities are more likely to be injured because riders extend their hands and arms in an attempt to brace the fall. When your hand hits the ground, force is transmitted up the arm until it finds the weakest link. That's why wrist, elbow and collarbone fractures are so common.
In Contador's case, he fractured the radial head where the forearm's radius bone meets the elbow joint. When the resulting shrapnel is still in the same neighborhood (like Contador's), treatment is typically a sling, some motion exercises and a few pain pills.
Displaced fractures, on the other hand, usually require surgery. For McGee and O'Grady, collarbones provided the unwanted shock absorption. The collarbone, a.k.a. clavicle, connects your upper extremities to your trunk sort of like a car's strut connects wheel to frame.
Turns out bicycle accidents are the most common cause of clavicle fractures, though these injuries typically heal on their own as long as the bone edges are stable for four to six weeks.