QUESTION: I’m a 67 year old cyclist, primarily road/gravel though I love the occasional fling downhill through the woods on my mountain bike.
I fell off a high ladder in mid-December and fractured 5 cervical vertebrae. I’m in a neck brace for the next month or so. I had 2 vastly different neurosurgical opinions. The first advised a neck fusion. The other (a cyclist) said he did not think surgery was advised! I’m going with the latter. Currently I’m doing a lot of walking (5-10 miles/day), and riding the trainer, trying to rebuild the fitness I’ve lost.
I have been researching head and neck protection, and haven’t been able to find anything that protects the cervical area. And while bicycle helmets protect the head, they reportedly may contribute to cervical and spinal cord injuries. (Journal of Surgical Reseach, v 258, Vyas et al: Adult Bicycle Collisions: Impact of Helmet Use on Head and Cervical Spine Injury).
So, I’m in a dilemma, looking for guidance. Besides a VT 5-star helmet, what other other protective gear should I consider (short of bubble wrap, LOL)? And how should I stage my return to riding? I love gravel racing and don’t envision giving it up (I even got an entry into SBT GRVL (Red) 2024, and my goal is to have fun and make the finish.
Any sage advice and direction is appreciated! – Chuck H
RBR REPLIES: That fall sounds scary! I’m glad you’re recovering.
One of my cycling buddies hit a tree in a mountain bike race several years ago and ended up fracturing his C3 vertebra. He didn’t initially know it was fractured and finished the race. Days later he visited a chiropractor because his neck still hurt, and the chiropractor saw that something was wrong and sent him straight to the hospital. He ended up requiring surgery and did get a fusion in his neck, and he’s still riding today. The doctors told him that he could have ended up paralyzed in the time period between the crash and when he finally got to the hospital.
So I definitely can see your point about wanting to protect your neck after the accident you’ve experienced.
As you already discovered, there is not a lot of cycling equipment out there specifically designed to protect your neck. I really only found one option, and I’m not sure if it would be reasonable or not.
A company called EVS Moto makes a neck protection device called a race collar that’s designed for dirt biking. It’s unclear to me if it would be too hot or too heavy to do a long bike ride wearing one. I have seen in the reviews that a few people have purchased them for bmx or downhill mountain biking.
As for the other part of your question, we unfortunately cannot give any medical advice, but since the one doctor you visited who did not recommend surgery is also a cyclist, maybe it’s possible to reach back out to them or get a referral to a doctor or physical therapist who can recommend a safe cycling plan to start riding again.
Readers, is there anything you are doing to protect your neck for road, gravel or mountain biking?
Dwight Siers says
I fractured C1,C2 in on the road and had them fused. Think would get some more opinions from professional doctors before proceeding
Fred says
I’m not sure how that EVS protection device can help a neck because it seems like it fits too loosely to prevent excessive movement. I would have to see it in action to understand it better.
There was a made in Sweden device called the Hövding, which is a helmet neck brace in one, in fact all it looks like is a large collar around you, you don’t even wear a helmet, when an accident situation is detected an airbag blows and covers your head and neck. But they are no longer in business.
The problem with any type of these collar devices is that your neck is going to sweat like crazy, there’s no way to get around that either.
The best protection currently available is a MIPS helmet, the MIPS device slips reducing the rotational motion stress your neck will receive in an accident by around 50%, it’s not a perfect solution, but it’s better than nothing.
If your helmet doesn’t have the MIPS protection system, seriously consider it, go to Virginia Tech Helmet Ratings, click on bicycle. The helmets are listed in order to the degree of protection they performed at, the higher up the ranking list the better the helmet even though there are a bunch of helmets now that get their 5-star rating, there is another thing on those helmets called a score, the lower the score the better the helmet, not sure why they did that but just think golf.
Keith says
I believe that a wave-cell helmet now provides better protection than even a MÍPS helmet.
Mike baczkowski says
Fractured a C 5 when hit by a car in 2005 had it fused. Been riding ever since although with a raised stem and handlebar. Riding a specialized creo e bike at 84 yrs old
Barry Bogart says
My neck is a mess, mainly because of DDD and multiple accidents resulting in whiplash. Also, not helpful was likely 30 years if Randonneur riding with a stem that was too low. In Paris-Brest in 2003 I DNF’d on the way back from Brest with Shermer’s Neck. Not much later I switched to a kind of 3-D Trekker bar which was comfortabe but not aerodynamic! I still have neck issues. I can’t extend up so can’t ride on the drops at all. And it is impossible for me to do a shoulder check. A mirror is a necessity.
My advice is to ease off the cycling until you heal, and get some physio. You need your neck!
Chris says
There are people out there who want to share their horror story about a neck fusion that went bad, but not all fusion stories are lifestyle killers. I am here to say….don’t be afraid of the neck fusion, the recovery wasn’t really that bad at all. I had my c4,c5, and c6 fused (two separate surgeries 4 months apart) about 7 years ago. I played football for 12 years in the 70s and 80s. Neck problems just caught up to me at age 50. I had the surgery done because I suddenly lost strength in my right arm and couldn’t feel my right hand. It was toward the end of a long MTB and cyclocross season where I had raced about 20-25 times that year. I am glad that I had the surgery done and have 100% of my arm strength back. My hand is still a little numb, but that is just a small inconvenience that I can tolerate.
I still ride and race road/gravel/MTB/cyclocross/BMX. Yes, BMX at age 57. I do my stretching and neck exercises every day. If I skip a day, I am usually a little sore the following day.
I have tried two neck braces for riding, one made by Leatt and one made by EVS. They each provide extra confidence to the rider. Unfortunately, they only work with full face helmets like the ones we wear for BMX. I don’t think you will find a brace for a non-full face helmet.
I did my first road ride about 90-100 days after my surgery, but I didn’t ride off-road for about a year. My surgeon was also a mountain biker. He told me that my neck was now the strongest part of my body, so not to worry after year 1. I have had my share of crashes in the past 5 years on gravel, MTB, and BMX. Okay, one on the road too. I ride about 5 days per week and crashes will happen. Regardless, I still love cycling and refused to let my neck injury change my lifestyle.
Chuck H says
Chris,
Thanks for sharing your story. So far my physical therapy has been going well, and I have started riding road and gravel again. While I have a long way to get back to where I was before the ladder incident, I am optimistic and enjoying riding outdoors again! Chuck H
Chris Holmwood says
Hi from down under.
there’s an analysis of cycling related deaths and hospitalisation done by the Australian Institute of Health and Wellfare at…..
https://www.aihw.gov.au/getmedia/fbff1344-6b3f-4b2a-8649-fb879dcd69ab/aihw-injcat-203.pdf.aspx?inline=true
Its pretty clear that severity of injury increases dramatically for cyclists over 45 compared with those under. 45 see summary page v and vi.
Transferring this into concepts of absolute risk (say hospitalisation risk per 1000 riding hours) is difficult because population data on cycling participation (number of person hours per year, for example, age stratified) is difficult to find. I suspect the growth in injuries in AUS is due to more participation, judging by the number of bike shops here!
The AIHW data does not mention spine or vertebra so I’d says risks are low. However they can be catastrophic in the true sense of the word.
Orthopediucs/neurosurgery is not my specialty (Im an Addiction Medicine specialist) but if I’ had just got through a cervical fracture from a fall off a ladder without neurological problems, I think I’d be extremely cautious about cycling again, sadly, and accepting that would be very difficult for me.
Interestingly the reference to Weaver and peacock 2019, states that rates of vertebral fracture and hip fracture increase makedly in older people but they are talking about all #s, not just bike related, and this would be due to osteoporosis.
Michael baczkowski says
Hi folks I was t-boned by an auto on my bike at the age of 65 19 years ago Had a c4-c5 fusion took a couple of years to regain physical and mental health. ( PTSD )been riding ever since road now gravel e-bike don’t neglect the physical and mental aspects