Tutorial: Road Rash Care

While there are plans for a whole bunch of tutorials on longboard care as well as trick tips I figured I’d start the tutorial series off with one that every skater will inevitably encounter: road rash. Road rash happens when you fall on asphalt, there’s little you can do to prevent it (aside from wearing full leathers, and even that’s not fool proof) and once you do it hurts like nobody’s business. So what do you do once you’ve taken a hard spill? First of all get up, dust yourself off and make sure you’re OK (since you’re wearing your helmet, you shouldn’t be too beat up).

Note: I’m not a medical professional nor am I claiming to be. The advice I’m offering here is what I’ve learned through both personal experience (that’s some of my most recent road rash in the picture) and from reading other people’s advice and talking to doctors. If you have questions about your injuries talk to your doctor.

Cleaning

Before you can do too much you need to clean the wounds and get the dirt, sand, rocks, and whatever else has managed to get into the wound. This is going to hurt, most likely hurt bad. The easiest way to clean the wound is to jump into the shower with warm water. Be careful as to not go too hot (it’ll sting much worse), keep the water luke warm and let it run over the wounds. Scrub the areas with a wash cloth and some antibacterial soap, don’t sure too much pressure as you could make things worse. Just use moderate pressure and let the water and wash cloth do the work. Once the wounds are all cleaned up get out and pat yourself dry.

I’ll say that again, PAT yourself dry instead of wiping water off. Pay special attention to the road rash as it’ll hurt if you end up wiping it with the towel. Just pat it all dry so that when you put the Neosporin or bacitracin on the ointment will stay on the wounds and be absorbed by the healing skin.

Bandaging

There are lots of different options for bandages and some debate as to wether or not you should cover the road rash at all. From both what I’ve read and doctors I’ve talked to covering the road rash for the first 5 days is a good idea both to keep things out of the healing wounds and keep things from brushing up against it. The more you can keep out of the healing road rash the less you’ll have to scrub in the future, it’s well worth it. Covering the road rash for the first few days will also absorb all the fluid and blood that will “weep” from the wound. Weeping is normal for the first couple days, you’ll see a rust-colored fluid draining out from it, keeping the wounds covered will prevent these fluids from getting all over everything you touch.

Once the wound is dry, apply a thin coat of either bacitracin or Neosporin (be careful with Neosporin as many people turn out to be allergic to it. If you’ve never used it go for bacitracin) over all the affected areas. This will not only help keep the wounds from getting infected, but will also help keep the skin moisturized and help limit the amount of scarring you’ll have. Get used to doing this, you want to keep the wound moist with either bacitracin or Neosporin for the first few days to make sure you don’t get an infection and to keep it moist.

Now that the wound has some good ole goop smeared over it, it’s time to actually bandage it up. I’ve found that the CVS Non-stick Gauze work the best for this application. They are coated with an almost plastic film that keeps them from sticking to the wound and still allows them to be super absorbant. For the areas that got really ripped up these things work wonders. If you just have a little road burn (the skin has been broken, bruised, darkened but not raw) the CVS Non-stick Advanced Dressings work really well too. They are a somewhat see-thru mesh coated with petroleum jelly (which will also help keep the wound moist) that will keep things off the healing skin. Securing these needs to be done with a roll of gauze as they don’t stick by themselves. Roll the gauze as best you can over the wound and secure it with a piece of medical tape. It’s best to not tape anything directly to the skin around the wound since removing the tape could do additional damage. Simply tape the gauze to itself or tuck the end into itself and it should stay pretty snug.

Maintenance

Now that you’re all bandaged up you need to simply maintain the wounds. Change the dressings twice a day (after you shower and before bed work well) and reapply more bacitracin or Neosporin each time you change them. If you’re bleeding a lot or weeping a lot you might want to change them more often, do what you think feels best.

Once the wounds stop weeping and the wounds begin to show signs that new skin is present you can switch away from the bacitracin or Neosporin and use either petroleum jelly or Aquaphor (the dermatologist’s duct tape) to keep the skin moist. Again, this will help prevent scabbing (which also reduces itching, score!) and scarring later on.

You want to keep a close eye on how you’re healing. Watch for any signs of infection and if you have any questions don’t hesitate to call a doctor. Keeping the wound clean and moist will help you get back to skating quickly and minimize permanent damage. You should notice the pain will diminish significantly every day and by day 3 or 4 you should be able to shower with little to no pain. About a week out the wounds will begin looking like they’re much more healed up and at 2 to 3 weeks you should be close to healed up. Everyone gets better at their own pace though, so be patient and diligent at taking care of your injuries.

Finally, I really can’t stress it enough, if you have real questions, see a doctor! Otherwise happy healing and happy skating!

Update: Our friends at the Northern Skate Alliance have posted a page dedicated to photos of “collateral damage” received while skating. There are some gnarly cases or road rash and some pictures with blood so beware.