Evenepoel and a fractured pelvis

My hip – post operation

It was shocking to see footage of Remco Evenepoel’s horrific crash in Il Lombardia. Reports indicate that he broke his pelvis after falling from a bridge into a ravine. This follows the injuries sustained by his Deceuninck-QuickStep team mate Fabio Jakobsen in the Tour of Poland.

The video above shows the repairs to my pelvis carried out by the specialist team at St George’s Hospital. My accident was less spectacular than Remco’s, I just hit a large pothole, while riding in the Kent lanes last March. It took the ambulance two and a half hours to arrive, as this was just at the beginning of the COVID-19 crisis. In fact, lock-down was announced on the evening of my crash. There was a lot of uncertainty about the virus back then, so it was a pretty scary time to be in hospital. Nevertheless I have immense respect and gratitude for the NHS staff who looked after me.

I was given crutches the day after the operation and returned home the day after that, with strict instructions to remain non-weight-bearing on the injured leg for six weeks and then only partial weight-bearing for the next six weeks. An NHS physiotherapist contacted me and regularly provided a progression of exercises. I set myself additional challenges, like doing extra press-ups.

After six weeks of doing no proper exercise, I had lost 4kg. The circumference of my left thigh was 5cm less than the right. However, following a review at the hospital, I was given permission to start gentle exercise on my static turbo trainer. I began by removing the left pedal and performing single leg drills, but after a couple of days it was easier to put my injured leg on the pedal as a passenger. This also gave the hip some mobility.

After a week on the turbo, I was up to one hour a day at about 160 watts. It took a long time to increase this above 200 watts. I watched a lot of old cycling films, without any particular urge to go on Zwift. I started riding outside in mid-June, 12 weeks post op. My Garmin pedals allowed me to monitor the left-right balance as well as average power.The following chart shows that 21 weeks after my accident, balance is hovering around 48:52 and five minute power is back over 300 watts.

Left/Right Balance and 5 minute Peak Power, since crash date

The psychological aspect of rehabilitation has been very important. I have focussed on targets and deadlines, marking each little achievement as a milestone. I am now walking without a limp, though running is still off limits. I even went kitesurfing a couple of weeks ago (don’t tell my surgeon about that one). I have been busy learning Italian, composing music and programming in Python.

Since heading back out on the roads, I have been riding cautiously, as my hip will not regain full strength until next spring. I plan to enter a couple of time trials to rekindle a sense of competition, without the danger of riding in a peloton. Racing again next season remains a goal.

Probably the most important mental aspect has been to stay positive at all times and never to spend time feeling sorry for oneself. This has been difficult as, inevitably, there have been a couple of set-backs when progress has seemed to reverse. But on the whole, my recovery has been astounding and, like Chris Froome, I remain optimistic about regaining my peak.

Remco will be back on the road next season, with the potential to pick up some results later in the year.

Author: science4performance

I am passionate about applying the scientific method to improve performance

6 thoughts on “Evenepoel and a fractured pelvis”

  1. I suffered a posterior wall fracture (blew acetabulum into 4 pieces) and have a similar plate and screw set up. It was last July. I was 59 yo. Aggressive rehab, a lot of pool and stationary stuff along w bands and weight machines. Walking was a real goal and it was 6 months before I was out doors on the road again. I’m at about 90% now 13 months later in the injured leg. My goals were ride my age (in miles) on my b’day in april and reride the commute that resulted in me coming together w a stationary car on the anniversary of the mistake. I wish Evenpoul all the best. Am shocked they are being conservative and not plating the fracture.

    Like

  2. Sorry to hear about your accident, but glad to know you are back to 90%. My surgeon told me hips like cycling, as it provides mobility and muscle strength without the repeated impact of a sport like running.

    Like

  3. I suffered a pretty serious right acetabulum fracture on 1st May 2020 after being knocked off the bike by an oncoming “cyclist” ( a twenty-something who was sensibly using his phone while riding) and landed on the corner of a granite kerb. It also took a notch out of the femoral head; and nearly ten months on I am awaiting a total hip replacement to rectify the injuries.
    I have been walking again without crutches for about 5-6 months but any significant mileage and speed on the bike is out of the question because the damage to the hip socket has meant my right leg is about an inch shorter than my left.
    The surgeon, who is fortunately for me very experienced with this type of injury, is confident of equalizing the leg lengths so I am hopeful of being back on the bike after the op.
    The muscle wasting in my right thigh is pretty disconcerting though. The irony of it is that after over 30 years of regularly riding on the road (I’m 53) and never sustaining a bad injury, I was knocked off the bike in a bike lane which I was forced to use because of roadworks. C’est la vie.
    And I’d never heard of an acetabulum prior to 1st May 2020!!

    Like

  4. Wow, I thought I was looking at the X-ray of my injury.
    Great to know that there is a potential light at the end of the tunnel, many thanks for sharing guys.

    This is the hardest thing I have ever faced physically, great to hear how everyone is facing the challenge.

    My story is a sorry tale , of riding next to Lake Ontario in Canada, looked like the path was just wet from lake spray, turned-out there was ice underneath the water. Lost traction on both wheels, the path was narrow with low walls on each side, I think I arched my back to avoid hitting the wall on the other side with my head and ended up with all of the impact on the femur. Result was 7 pelvic fractures and blown acetabulum.
    Injury was on the 2nd April 2021, Surgery roughly a week later, now 6 weeks in post surgery. Also in the middle of a covid spike here in Niagara.
    I’m zero load bearing for another 2 weeks, for a target of 8 weeks in total, I have a follow up consultation with the surgeon next week to determine next steps.
    I’m 58 years old and used to run or cycle almost everyday. I’m doing some very light mobility exercises, all non-load bearing, lost a stack of muscle from the injured leg.
    Fingers crossed I can start some light Turbo/zwift training in a few weeks time.

    Like

    1. Hi David,
      I am very sorry to hear about your injury. The first thing I can say, from personal experience and as someone of similar age, is that you can get through this and that you will get back to cycling and running. 14 months on, I am cycling 250km a week, running and hiking up mountains without pain or hindrance.
      When you see your surgeon next week, ask if you can start short single leg sessions on a static turbo bike. I soon started allowing my injured leg to travel as a passenger on the other pedal, which was great for mobility. I was on crutches for 12 weeks, but by the end of this I was already doing up to one hour a day on the turbo, at low but steadily increasing power, as well as all physio exercises. Soon after this, my first tentative bike ride outside was a huge milestone. I used my Garmin vector pedals to monitory my power and left/right balance over time. Be careful not to do too much too soon. I suffered two painful and frustrating setbacks from pushing myself too hard while my muscles were still asymmetrical. It takes 12 months for the bone to heal, so I stayed off the running for 9 months and then avoided hard surfaces. Unfortunately I did not have access to a swimming pool, due to COVID. At 9 months, I found a physio who helped me make the important psychological step from rehabilitation back to training. I started targeted exercises at the gym, until it closed again with lockdown. On the anniversary of my op, I ran around the 12km loop of Richmond Park.
      Follow the advice of your surgeon and physio, set goals and, importantly, stay positive. Let me know how you get on.
      Gavin

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s