Self-Support: How to Repair Yourself on Tour
The second instalment of a three-part Self-Support series: Equip yourself with the right knowledge for when you suffer crashes, illness, or injury, on tour.
As bikepackers, we must often rely on ourselves when things need repairing on tour. We need to know how to fix our bikes, our equipment, and ourselves – or at least know where to look for help. That’s why we’ve compiled these handy Self-Support guides, with expert advice on how to equip yourself with the right tools and knowledge for when things need repairing.
In the second of our Self-Support guides, we’re tackling bodies: How to apply basic first aid to cuts and bruises, how to treat yourself for illness, how to manage overuse injuries, and more.
Essential First Aid Kit – Cuts and Bruises – Illness – Overuse Injuries
Section 1: Essential First Aid Kit
Three experienced riders share the contents of their essential first aid kits. Each differs slightly depending on the medical experience of the rider and the type of ride they are embarking on, but by picking out selected items from each, you will be able to assemble your tailored essential first aid kit.
Josh Kato:
The ultra-distance racer
Josh is a former Tour Divide race winner and an emergency medical technician. His kit is minimalist, and relies on his ability to improvise in the field.
- Anti-inflammatories (ibuprofen, aspirin)
- Anti-histamines (loratadine; found in Clarityn, acrivastine; found in Benadryl)
- Water purification tablets
- Hand sanitiser
- Wet wipes
- Gorilla tape
- Items to cut or use as compression items to stop bleeding (such as clothing)
Craig Fowler:
All-Round Outdoorsman
A bikepacker, thru-hiker, and editor of oneofsevenproject.com, Craig is an all-round outdoorsman. His kit offers both prevention and treatment items for illnesses, minor wounds, and overuse injuries.
- Pain killers (paracetamol, tylenol)
- Plasters / gauzes / bandages
- Kinesio tape
- Imodium
- Anti-bacterial ointment
- Sun screen
- Lip balm
Pain-killers, anti-inflammatories, and anti-histamines all feature in our experts' first aid kits.
Sterilising wipes are great for getting grit out of wounds, ensuring they are clean, before applying a bandage.
Josh Cunningham:
The long-haul tourer
Josh once spent a year riding his bike from London to Hong Kong, and is now an Apidura team member. His kit contains more items to treat minor wounds than the other two, a small amount of drugs to fight pain and illness, and some preventative items.
- Pain killers (paracetamol, tylenol)
- Anti-inflammatories (ibuprofen, aspirin)
- Anti-histamines (Loratadine; found in Clarityn, acrivastine; found in Benadryl)
- Plasters / gauzes / bandages
- Micropore tape
- Butterfly stitches
- Water purification tablets
- Sun screen
- Lip balm
- Wet wipes
- Sterilising wipes
- Safety pins
- Pen-knife (with scissors, knife, tweezers)
Section 2: Cuts and Bruises
Crashing is unfortunately part of riding a bike, and sometimes we do a little more damage to our bodies than we’d like. However, rather than crashes, most road scars tend come from less dramatic occurrences: mangling your knuckles on a chainring while cleaning your bike; bruising your shoulder while hauling your bike up some stairs; grazing your leg on a branch while hacking your way to a wild camp spot.
Here, we show you how to treat some of the more minor injuries, and prepare yourself for an emergency.
Basic First Aid for Cuts and Grazes
Wash the wound with soap and water as soon as possible to keep things clean. Covering with a bandaid (plaster) or gauze will keep the wound clean and help to prevent clothing from rubbing on the affected area. If the wound becomes red, warm, increasingly painful, or has discharge, or if you develop a fever, get to a doctor as soon as possible. Most minor abrasions heal quite well if they are cleaned immediately and are kept clean thereafter.
If you have pre-existing medical conditions that compromise your immunity or affect your circulation, be sure to talk with your doctor to make a plan before starting out.
Josh Kato
It’s good to have some sort of antiseptic cream or wipes with which to clean cuts, then some sort of bandage to cover the area. In a pinch, you could use duct tape or kinesio tape if your bandage won’t stay put. Clean the cut well, treat, and cover.
Craig Fowler
Superficial skin damage from crashes can be painful and annoying, but they shouldn't hold you back if treated correctly.
Basic First Aid for Bruises
Keep in mind that a bruise is internal bleeding, and nothing to laugh at, especially if you’ve taken a hit from your handlebar or other object to a vulnerable part of your body such as your abdomen. Blunt force trauma can be a life threatening emergency. Medical attention may be required for more than just a superficial bruise.
If possible try and rest the area, and keep it elevated above the level of your heart as much as possible. If you have a really large bruise or big lump (called a haematoma), or lots of pain after three days, you should try and get yourself seen by a doctor.
If you can, ice and elevate the bruise. Compression wrap it if possible (using clothes or a bandage), but not so tight that it will compromise blood flow or sensation. Take some tylenol (paracetamol) if needed – providing you don’t have an allergy to it.
Josh Kato
Preparing Yourself for an Emergency
An emergency beacon or cell phone is not a substitute for having a good pre-trip plan. Let family and friends know where you should be and when, then give this plan to someone who knows the general area too. Be sure to have more than one person aware of your itinerary, and go over it with them.
If you have a tracking beacon, be sure to share that tracking page with friends and family so they will have knowledge of the path you are on. In the event that your beacon or cell phone fail then you will need to ride or walk to a populated area or main road or trail, which you’ll only be able to do if you know where you are and where to go: You did look at maps to research the easiest routes to populated areas before you left, right?
Josh Kato
Emergency beacons such as a SPOT tracker can relay an SOS message to family members and emergency services.
If you are heading to remote areas, make sure you have a clear idea of where you are in relation to the nearest road or settlement at all times.
Getting Help in an Emergency
If you are travelling alone, carrying an emergency beacon such as a SPOT tracker (and having the appropriate subscription plan for it) can literally be a lifesaver when calling for help. However, you can’t rely on these 100%: Batteries die, devices can fail.
If you can’t move, try to make sure you are visible to passers by on ground and from the air. Lay out clothing items, rocks or branches in some form of regionally appropriate distress signal. Write a note (you do have paper and a pen right?) explaining what is wrong and any allergies or medical problems you have in case you cannot respond or become confused or unconscious. A simple survival whistle weighs almost nothing but can be heard from a long ways off. Realise your urgency but stay calm.
Josh Kato
Mobile phones can't always be relied upon to call for help. Try to have an alternative means of raising the alarm if necessary.
If you're seriously injured and alone, write a note explaining the situation for the benefit of passers-by.
Section 3: Illness
Picking up an illness, whether from a dodgy meal or dirty water, can spell disaster on tour. Here’s what to do if it happens, and how to avoid it happening in the first place.
Treating Gastroenteritis
Usually gut problems resolve themselves without antibiotics, but they shouldn’t be taken lightly. Pushing on while you’re losing fluid and electrolytes can be dangerous, so try to stay as hydrated as possible, and rest. If you have bloody diarrhoea or the bug lasts more than 3-5 days, you may need antibiotics or other medical treatment.
If you are going to a less developed country, where medication might be hard to come by, you should talk to your doctor and get appropriate antibiotics to have on hand.
Josh Kato
If you are suffering from illness, continuing to ride can often worsen the situation. It might not always be possible, but finding a hotel and resting up is often the best thing you can do.
Staying Healthy
Wash your hands! Soap and water is best for removing fecal bacteria. If you don’t have access to soap and water then hand sanitiser gels should be used liberally.
If collecting water from a natural source, use a water filter or water treatment chemicals, even if the water seems clear. There are numerous waterborne illnesses you can get, some of which cause more than just nausea and vomiting.
Preserved foods or dry foods are best if you don’t have a means of refrigeration. Be sure to use treated water or sufficiently boiled water for cooking or reconstituting food.
Josh Kato
Boiling any naturally-sourced water is imperative for making sure it's safe to drink. Even before boiling, you should filter your water too.
Diseases
When travelling in some parts of the world, you’ll need to be wary of the potentially fatal diseases that you could contract.
For example, there is a very real chance of catching malaria across many continents in areas prone to mosquitoes. Keep the risk at bay by using anti-malarial medication throughout your trip, and using spray to deter the mosquitoes.
Not so common, but equally as dangerous, is rabies. Considering that wild dogs famously love to chase cyclists, it is understandably a concern for a lot of riders – and people do get bitten. Take maximum care by getting rabies vaccinations before leaving, and remember that even if you’ve had the jabs, if you get bitten by a rabid (or indeed unrabid) animal, you’ll still need to seek medical help immediately afterwards.
Be sure to check with your doctor what diseases you might be exposing yourself to before any trip, and the respective vaccinations you will need.
Section 3: Overuse Injuries
Unfortunately, there is such a thing as too much time in the saddle, and it can have painful consequences. If your body starts saying ‘No’ to the rigours of a long-ride, here is what to do…
Preventing Saddle Sores
Before you even throw a leg over your saddle, you should figure out if your saddle is the right one for you. We’re all different, and just like a pair shoes, not every saddle is going to fit you. Test different saddles and have your sit bones measured to ensure you have the right saddle width. A good bike shop will have demo saddles you can try until you find the correct one.
Craig Fowler
Keep your bottom clean and your shorts as dry and clean as possible. A spare pair of shorts goes a long way, enabling you to rotate a clean pair. Wash your spare shorts at night, then hang them from your Packs while riding to dry out.
Use baby wipes to clean downstairs if you’re sleeping wild.
Stand up out of the saddle to relieve pressure whenever you can. Long downhills are especially good for this.
Take off your riding shorts as much as possible to keep them dry and aired out; Sleep time is no time to wear your grungy riding gear.
Carrying a couple of pairs of liner shorts to wear under an unpadded over-short may be lighter and easier to deal with than a couple of chamois cycling bibs. Going without a chamois short can be great if it works for you and you find clothing that doesn’t irritate your skin. Most chamois take a long time to dry and will keep moisture and other nasties in contact with your sensitive bits longer than a thin liner.
Josh Kato
Treating Saddle Sores
Many saddle sores are caused from a mixture of bacteria, friction, warmth and dampness. Carry anti-fungal cream and antibacterial cream to treat them. Acne cream containing benzoyl peroxide is a good topical antimicrobial that is especially useful if you get the pimple-like skin irritations.
Athletes foot cream (clotrimazole cream) is a good anti-fungal and most are supplied in a non-petroleum base. The petroleum-based products can turn into a soupy mess down below if used over multiple days without proper cleaning. Anti-fungal cream in combination with cleanliness can really help, delay, or prevent many sores from developing further. Every toilet break should be followed with clean wipes and the re-application of creams if needed.
If you need to, take a day or two off and rest, cleaning and airing out your undercarriage.
Josh Kato
Do all you can to reduce the risk of saddle sores by having the correct saddle position and maintaining cleanliness.
Sometimes you can develop sores where your skin is worn by the friction caused from long periods in the saddle. If this happens, apply sanitary towels to the inside of the chamois pad. This prevents further damage, and as long as you change the pads daily and keep the wounds clean, they will start to heal.
Treating Numb Hands and Feet
A good bike fit will go a long way in helping to prevent you getting numb hands and feet. Because your feet tend to swell when you ride, it can also be recommended that you opt for a slightly bigger shoe size. If you do find your feet become numb, try to source some high quality insoles that will help to support and cushion your feet. Also make sure when you stop to either take off or loosen your shoes, which will help with reducing swelling.
Numbness in the hands is going to be a result of too much pressure on them. This is where fit comes in, as better positioning will take that pressure off your hands. Things like a taller stem, riser bar, or taller risers on your aero bars all help with this, as they tilt your bodyweight back away from your hands.
Those with drop bars can double wrap their bars or add gel pads under their bar tape. Mountain bikers can add bar ends or use flattened grips that help distribute weight better. Padded riding gloves are another option as well.
While on the bike, try to change your hand position and shake your hands out regularly. It’s not always an option but simply stopping once in a while to alleviate the constant pressure will help with soreness and numbness.
Craig Fowler
Your position on the bike has a big impact on comfort. If you find your hands are becoming numb, you may need to adjust it to take the pressure off them.
If your feet are sore and swollen (from too much riding), take your shoes off whenever you stop to alleviate the stress.
Treating Knee Pain
Adjusting your seat height will often help with alleviating knee pain: Down for pain on the back of the knee, up for pain on the front – but always adjust in small increments.
Feet that are angled too far in or out can trigger many issues, so think about using flat pedals, or if you are using clipless then try adjusting them to take the pressure off. You might need to add some float to your cleats until things feel better.
Turning a smaller, easier gear can also put less strain on your knees, and help them to recover. Sleeping with your legs elevated and icing your knees can also be of great help.
Josh Kato
Tight muscles can lead to problems all over the body, but most commonly in the knee, hip and achilles. Regular stretching can help to prevent and cure pain stemming from tight muscles, as can massage. You can perform self-massage by sitting on a tennis ball, and rolling it underneath the afflicted area.
Neck Pain
Neck pain is usually a result of putting too much strain on your neck muscles, which in turn is usually a result of your position being too ‘aggressive’ – or low at the front end.
Try resting first to give your neck muscles some time to recover, then raise your handlebars.
Ultra-racers can suffer from ‘Shermer’s Neck’, which is basically a complete failing of the neck muscles. People have tried many inventive ways of supporting their head thereafter, but it is essentially time to go home if this happens!
Josh Cunningham
Lots of overuse injuries in cycling come as a result of tight, tired muscles. Regular stretching will help to keep muscles loose, and your body pain-free.
Achilles Pain
The achilles can take a long time to heal if it becomes irritated. To avoid it being a problem, make sure your seat isn’t too high and that you aren’t pushing too hard a gear, and stretch your calf regularly. Consider including some running or hiking into your routine, especially if your rides will require a lot of hike-a-bike, and be sure not to push off with your toes too much if you end up pushing your bike.
Sliding your cleats back will place significantly less pressure on your achilles. Some shoes won’t allow the cleat to go far back enough to prevent achilles strains over ultra-distances, and I’ve extended the cleat rail in my shoes using a dremel to get it to a position I’m comfortable with before. If you’re really prone to achilles pain, flat pedals and good shoes can help, as you can adjust your fore-aft foot position at will.
If you get pain during a ride, take it easy. Pushing through can really make it worse. Use kinesiology tape (there are numerous instructional videos showing how to do this), which save the day if applied early.
Josh Kato