The Psychophysiology of Repeated Skiing and Cycling Crashes
How we respond to falls is very important for recovering from them.
Posted August 2, 2019
This is a very timely guest essay by Bruce Gottlieb, a somatic therapist and up-close-and-personal observer of far too many skiing and cycling crashes.
This year's recently completed Tour de France, in which there were a number of repeated crashes by the same cyclists, made me revisit some ideas I've been thinking about for some time. When we train physically, we are getting our bodies strong, so they will perform as desired when the time comes. When we practice, we are better prepared.
I remember being at a bicycle camp of two Olympic medalists, and they had us practice bumping into one another on the right side, on the left side, and using our front wheel to bump the rear wheel of the bike in front of us, and then having our rear-wheel hit by the person behind us. We also practiced falling on the grass.
This practice prepared my body to proprioceptively feel and respond to what I call sub-optimal events. Then, when they would happen in real-time, not only was the sensation familiar so I wouldn’t have a startled response, I even had the ability to have a positive corrective response. I call this “appropriately reactive” instead of “overly reactive,” which has the potential to cause one of those sub-optimal/overreactive responses. Training for those sub-optimal moments is essential preparation because life and racing do not always cooperate with our best-laid plans.
How many people do you know who have had multiple car accidents, especially of the same variety? People who have been rear-ended in a car frequently have had this experience more than once. I worked with one gentleman who had four rollover accidents, and how about that one friend who always seems to be in the wrong place at the wrong time. I suspect you can also see yourself somewhere in the “repeat” accident arena.
When I worked with ski racers, I was amazed by my observations of what happened when they fell in practice. Around 80 percent of those who fell would fall again somewhere between the gate above or the gate below the previous fall. I became curious about this observation because it seemed to be more than random chance that so many different people shared the same basic experience.
As a point of reference, professional bike racers who fall during a stage race have the propensity to fall again during the same race, sometimes during the same stage. Both the ski racer and bicycle racer also shared the same post-fall behavior; they would jump back up on their feet almost immediately and try to move on with what they were doing before the fall.
I asked myself, were these ski racers and bike racers falling due to psychological reasons? Were drivers involved in repeat accidents repeating similar patterns for psychological reasons? Or was there something physiological happening? Or perhaps both?
If you study any form of somatic therapy, you know that when our body suffers a trauma, it is highly likely we will have some kind of physiological constriction of muscle and fascia. Our amygdala will have an “automatic” response to a similar trigger and set off the autonomic nervous system (ANS) into a self-protective response. Will this reaction be a conscious response and an unconscious response, a psychological issue and a physiological issue, a psychological response that produces an automatic inhibition, or a physiological response that sets the ANS in motion to produce a physiological, autonomic, self-protective response?
When our body becomes constricted due to trauma, we need to help it restore its natural, flowing rhythm. Specifically, when we fall, several things happen in our bodies, and for professional athletes, this is typically amplified, because, on top of the normal response, they lose trust in their body’s ability to perform as it has and as it needs to intuitively.
Professional athletes do not want to think about what their bodies need to do. Rather they need to trust their bodies to do what their muscles have been trained to do intuitively. When they fall, however, they introduce the ANS into the mix, and this can disrupt the previous “physiological flow.”
Let’s analyze what happens when we fall. We typically go through the following sequence.
1. A loss of orientation to gravity due to the surprising quickness of what made us fall
2. A loss of balance
3. Rapid, failed attempts to re-orient
4. Tension and bracing in the body
5. Preparation for impact
6. Shame, fear, or terror (depending)
9. Injury assessment
10. The brain lags behind the event that happened in a nano-second, and the body already has stored the trigger and what it believes to be an excellent self-protective response.
In some cases, due to the shame and/or embarrassment of falling, or due to being a professional athlete and needing to stay in the game, or whatever the reason, most, if not all, people tend to jump up, declare they’re OK, and keep going as if nothing happened. This is a beautiful demonstration of psychological resilience that will help keep them in the game. However, we need more than our psychological resilience to maintain race performance perfection.
After we fall, each of the above 10 items needs to be restored in our body, so it will be in sync with our minds and with our resilience. It’s not as simple as mind over matter, because in this case, what happened to our body matters, and our body can and will develop its own response system. In this article, I will not go into detail about how to restore each of the above, lost pieces, but rather I give an example of the importance of restoring the body’s natural abilities.
Returning to ski racers on practice runs, I describe the steps I had each racer take after a fall, and the difference it made to the percentage of those who crashed on the next training run.
After a crash they had to:
1. Do a physical assessment of their injuries.
2. Stay on the ground in the position they landed.
3. Orient to gravity from this position.
4. Roll onto one side.
5. Sit up.
6. Stand up.
7. Orient to gravity from a standing position.
8. Side-step up the hill to one gate above where they crashed.
9. Slowly ski through the gate in which they crashed and two following gates.
10. "Let 'er rip."
This entire process takes about 5-8 minutes, depending on many factors. Those who followed the above protocol did not crash on their next run. The repeat crashing percentage dropped from roughly 80 percent to 0 percent.
I am writing about ski racers when they are training, because, during a race, it is not possible to have them participate in the corrective protocol. I would liken this to the bumping and falling drills we practiced at bike camp. Ski racers, unlike bicycle racers, usually do not have the opportunity to get up and continue racing. The point here is that when the ski racers had the opportunity to participate in a corrective fall protocol, their propensity to repeat a crash had greatly diminished.
Unless grievously injured, bike racers typically try to get up immediately once their bike is ready to roll or a replacement bike is put under them. They continue racing, with the expectation that a second lost can mean the difference between winning and losing a race or hamper their ability to help a teammate.
The disrupted synergy between body and mind and ANS response do not have the opportunity to reset. Team managers could use this information, and an after-the-ace protocol could be established for the fallen bike racer that would greatly diminish their propensity to have a repeat crash.
As a motorcycle pilot for the race medic in many different professional cycling events, I would ride within view of a recently fallen bike racer. Depending on the severity of the crash, it could take 5-10 minutes for the adrenaline rush post-crash to wear off, after which the rider would hold onto my shoulder while we were moving along, and the medic would lean off the motorcycle to administer the necessary first aid. This would allow the bicyclist to remain in the race and minimize time lost due to the fall.
A bike racer is expected to focus on racing. It is for this reason that they are likely to crash again during another stage of this race. I repeat, however, a post-race reset protocol can be administered that would diminish and possibly extinguish the likelihood of another crash.
Somatic therapy is critical for resolving somatic issues: Responding to a crash is both psychological and physiological.
We are descendants of our animal ancestors, and we have retained our reptilian primitive brain functions as they had and have today. Survival comes first. Events, places, and people who trigger previous sub-optimal results also trigger sub-optimal physiological responses as well as sub-optimal psychological responses today, and these responses are likely to block the messages to the neocortex.
Today’s event will not get responded to as today’s event. We need “today” to be evaluated for “today,” which means our reptilian brain’s self-protective responses and our psychological responses need to pass through the neocortex so this trilogy of systems can have the fluid response needed to make an assessment in the present.
Only when we are present, and all internal systems are speaking the same “now language,” will we be able to limit our repetitive, sub-optimal responses. They're optimal in terms of how our reptilian brain responds to and remembers various events, but sub-optimal in terms of what may be the best decision after a crash that involves the neocortex. How we respond to crashes is both psychological and physiological. It’s important to keep the 3 P’s in mind: psychology, physiology, and proprioception.
Somatic therapy is critical for resolving somatic issues.
Bruce Gottlieb has been doing psychotherapy and somatic therapy work for more than 50 years, and he has worked with Olympic athletes honing their mental acuity. He was a medical motorcycle driver for the head medic for the Coor's Classic, Tour du Trump, and the Tour DuPont. He motorcycled for seven Ironman World Championships and played a key role in the 1996 Olympic games. He has witnessed countless crashes and has been involved firsthand with medical care for professional cyclists during the races.
We hope someone will share data they have on repeated crashes or begin collecting relevant information, because when we talk with many cyclists, they often say, "Oh yeah, repeated crashes are real." I raced bikes for many years, and crashes do happen. Riding along at 35 miles per hour a fraction of an inch off another wheel while surrounded by 25 or more cyclists involves a lot of trust, well-honed skills, and a good dose of luck.
Often, the first question that comes to a cyclist's mind after they've fallen is, "How's my bike?" I know Bruce is speaking the truth when he talks about practicing falls—something I did—and how to recover from them. I'm also interested in data on how nonhumans respond to injuries after they fall.