Mountain Bike Injury – Thigh Impaled by Brake Lever

Not me – my wife, Margo.

Before Crashing

While I have been trail riding and trail running on technical trails since 1988, my wife Margo, although fit, generally stays off of steep, rocky stuff. She likes rail trails, or the easy trails near Lake of the Woods (Oregon) – but she only gets on single track about once per year.

I was delighted, of course, last Sunday when she agreed to do a “real” mountain bike ride with me. We headed out from home and rode to Moore Park via the Link River Trail, then up the Ridgeview, Blueberry and Linda’s Trails then we descended via the Half Gallon and Big Sky Trails.

Note small hole in tights

As we rode I tried to let her know when various hazards were coming, and we both walked through most of the rock gardens. We were almost to the bottom of Big Sky Trail, and ready to finish up on a couple of easy trails, when I (foolishly) commented, “Well, you made it. No crashes. Great job.”

And while we rode the last bit of trail I was hoping that she would suddenly start to love “real” mountain biking, and was thinking how if she did like it she would really need a newer, better bike than the super heavy ten year old hard tail she rides – I heard her crash behind me.

It was sort of a freak accident on a slightly rocky downhill section approaching the last switchback on Big Sky Trail. I turned back to see her prone on top of her bike – she had evidently done an endo.

“Are you alright?”

“I don’t don’t know which way to move my leg,” she said. She couldn’t get her left leg off of her bike. She was stuck.

I dismounted and ran back to her, and immediately lifted her, by her hips, straight up off of the bike, rotated her to a supine position, and placed her on the ground next to her bike.

“Are you hurt?”

“I don’t think so.”

She stood up and I noticed she had a little hole in the front of her (brand new) tights. The upper, inner left thigh.


“We better check that.” She pulled down her tights and there was a small wound about one square centimeter with some subcutaneous fat bulging out and a small trickle of blood. It looked just like an incision for a laparoscopic port. “Shit! It went in. We need to get you to the emergency department to deal with this.”

Surprisingly, she seemed fine. No pain. Very little bleeding. She did not appear to be in distress other than being understandably freaked out. It’s fortunate that Margo didn’t realize what had actually happened until much later.

Before Treatment

I made a makeshift bandage out of a bandanna I carry with me for this exact purpose, we pulled her tights back up, and began to ride out. I didn’t want to have to ride all the way home so I called a friend to meet us at Moore Park to take Margo to the hospital. It turns out she was 100 miles away on a kayak trip. We then called our son Terry and he loaded up his three small children and met us at the gingerbread house at Moore Park.

I don’t recall ever seeing Margo pedal a mountain bike so quickly on a trail as that last mile or so back to the gingerbread house! I trailed behind her marinating in “survivor guilt.”

Terry dropped us off at the Emergency Department and brought our bikes home. This was our first ED visit in twenty plus years. I’m sorry to admit that I “pulled the doctor card” and asked them to tell the ER doc on call that I was there (we’re personal friends) and we got right in. So much for hours of waiting in the ED reception area.

“She’s a rock.”

From there it was uneventful. This was a very blunt trauma; but it was clear from the bruise on the back of her thigh that when she crashed the brake lever handle went all the way through her and hit the back of her thigh. Luckily, because the end was so blunt (it actually had a bulb-like tip) it didn’t cut anything and surely went right around any nerves or blood vessels.

Treatment consisted of a tetanus booster, a gram of Ancef (antibiotic), flushing the wound out with sterile saline, and then trimming the rough areas and bulging subcutaneous fat. She was also given a prescription for ten days on an oral antibiotic. No sutures (so it could drain if need be).

after txstorecrash-33
After Debridement

Margo was a rock. It reminded me of the line in Repo Man where Bud lies to Otto that his wife is pregnant and he needed Otto to take her car (actually getting Otto to repo a car for him). Later Otto asks, “What happened to your old lady?” Otto replies, “My old lady? Oh, shit, I forgot all about her. Well, she’ll take the bus. She’s a rock.”

After it was all over and she finally realized what had happened, and how far that stupid brake lever handle penetrated her thigh, well, she started getting a bit dizzy. Every time we got up to leave she had to lie down again; but we eventually went home. Poor Margo.

Relaxing after a bike ride

At this point, four days later, she’s doing fine and still only has minimal pain. But “it’s creepy pain” she says – because it is only in the back of her leg, not where it went in.

Doing an internet search on this injury I find that it really isn’t an uncommon injury, although I hope to never see it again. In some cases the brake lever had become stuck in the injured rider. And the thigh is the most common site, but not the only site. There are some pretty gruesome descriptions of this injury if you want to check them out.

heading homestorecrash-36
She didn’t want to put the tights back on

I’m happy I just pulled her up off of the brake lever immediately. Some of these poor people were clowning around for hours with a person stuck to the bicycle. That sounds unpleasant and might be an example of people making things more complicated than they need to be. See the video below for an example of a brake lever that actually became stuck in a young woman’s thigh.

This young woman had an injury similar to Margo’s injury

After this injury I doubt that I will get Margo back out on the single track any time soon – but I truly do think it is important that she at least get back on her bike again soon; otherwise she may have difficulty enjoying riding her mountain bike again.

As for me, I already rode that some trail again. Here is a photo of my bike placed at the spot (and position) where she crashed:

This is my bike at the site of Margo’s crash

If anybody has any experience with this type of injury, or if you have any comments at all, please reply below.

Sorry about the lack of atrial fibrillation content in this post. Scroll down for plenty of a fib content.


26 thoughts on “Mountain Bike Injury – Thigh Impaled by Brake Lever

  1. Sweet! Now you’re talking my kind of language – TRAUMA! I’d been wondering when you were gonna’ post again. See? Something good does come out of the bad! As you suggest, gotta’ get ‘er back up in the saddle again ASAP to keep that fear monster away.

    • Yeah hopefully she’ll ride again soon. She has now officially decided that she officially doesn’t like technical trail riding stating that she probably should have started something like that at an earlier age.

  2. Pingback: Emergency Pack for Trail Running or Mountain Biking While on Anticoagulants (Coumadin, Xarelto, Pradaxa, Plavix) | A Fib Runner – Distance Running and Mountain Biking With Atrial Fibrillation

  3. This just happened to me today! I couldn’t believe that the brake lever punctured me but it was the only possible option. I rode the Armstrong trail in Tahoe and made it through the super technical portion with no problem. On the “easy” portion, I just slipped and couldn’t clip out on the left side, so my leg must have forced the bike to slam down on me while the brake lever puncture my inner thigh. I could actually see the fat cells and even residue of the fat on the brake lever! I freaked out but luckily wasn’t alone. My husband tied his shirt around the wound and I rode the rest of the trail with one leg since I was afraid to make the wound worse. After 20 minutes, we made it to the bottom and rushed to urgent care. The team flushed out the wound, then numbed it to check for any gravel or dirt. The doctor gave me 5 stitches. It is so swollen and sore and I can barely bend my leg now. I know I have to knee damage tho so just resting it for now. I am sure I’ll be a little apprehensive but can’t wait to get back out. I was on a new bike and I think I just wasn’t use to it. The best advice is to ride in your ability and ride cautiously. Don’t o faster than your ability! I know I wasn’t going to fast but clearly I wasn’t use to this bike and should’ve taken it on a few mellow rides first. Life is full of lessons though and I’m grateful the injury wasn’t worse.

  4. My 11 year old son just fell victim to this same injury yesterday while attending youth group at his school. His bike flipped and his right thigh just above his knee was impaled by the brake lever. He panicked and pulled the brake lever out of his leg, which was covered in flesh. Pastor called me I hurried to the school to pick him up and rush him off to ED. After numbing the area, x-Rays and irrigating Doc examined him. Wound tunneled in my son’s thigh knuckle deep (by measure of the Dr’s fingers, which were much longer than mine) all the way into my son’s Quad. He received stitches to the inside and outside of the wound, 10 day course of antibiotics and rest. He had some obvious pain today as to be expected from the trauma and manipulation of putting him back together. His biggest complaint of pain is as you described not at the initial point of impact, but at the furthest point. He describes it as an aching, throbbing pain.

    An ironic side note… The Physician that sutured my son up had the very same thing happen to him, same leg and almost at the very same spot on his thigh. My son got a kick out of the Dr pulling up his scrub pant leg to reveal his battle wound also.

  5. I had a wreck this past weekend and had a Shimano XT brake lever go completely in my upper arm. All two inches was stuck and took a few yanks to get my arm off. A bunch of blood and some meat was on my jersey. At the ER I received an X-ray, tetanus shot, stitches and prescription for antibiotics. I missed anything important and I will make a full recovery.

  6. Had to look this up as I thought I was the only one who suffered such a freak accident. Mountain biking in Arizona on a trail that was just a bit beyond my comfort zone. I so relate to your wife’s position! 5 miles into the ride and climbing, things were starting to level out and start descending but I was mentally tired from the relentless attention to all the rocks, cactus etc.
    Down I went in slow motion, ha, I thought, I got this! Landing pretty lightly on the knee and hand as i was going so slow, then Boom, i actually saw the brake lever puncture my right upper arm.
    Gross!! Pulled it out, yelled for my husband to come back, and who appears, but a group of boy scouts on a 20 mile hike.:) They bandaged me and insisted on walking my husband and I out to our car. Lucky also, no serious damage, other than to my wallet as I am a Canadian using the US healthcare system… ouch!
    Never thought a handle with such a rounded edge could puncture a body so easily.
    So glad all these posts have a happy ending

    • Outstanding. You know, in a way the blunt brake handle is the best thing to land on. If Margo had landed on a stick or branch that was pointy she might have severed an artery which of course would have had a terrible result.

  7. I had this same injury on on my right inner thigh. We couldn’t figure out what did it because the brake leaver wasn’t in it when I I noticed the blood. Then we figured out it had to be the brake leaver. I went Frisco hospital in Colorado. My wound was about 4″deep and and a 1 1/2 wide. And we all agreed it was the brake lever it was a clean wound, only thing they did wrong was they didn’t give any antibiotics. We were on vacation so when I got in Moab 4 days later I went to a Med check an they gave me antibiotic. They put 4 stitches in but it seeped blood for 2 weeks, after I got the stitches out it finally stopped. But know one could believe I wasn’t in more pain. It’s been 4 weeks an I still have a knot there. I was black and blue from the top of my leg to the middle of my calf. But it went a way, pretty fast i used Attica cream. I am hoping it fills in cause right now I have a dip with a knot below it, not very pretty in shorts,
    Hope Margo does ok.

    • Margo has done fine except that the thigh she injured is somehow slightly smaller in appearance since the injury. She as absolutely no weakness or other functional complications. She’s not going to be mountain biking on “real” trails anymore, and I don’t blame her. I’ve been trail riding for 30 years, but she has rarely ridden trails, so a lot of skills I take for granted are skills she doesn’t possess. Her scar is unremarkable and nearly unnoticeable.

  8. This just happened to my 10 yr old son last Sunday! He was on the boardwalk at the beach & slipped out on sand. Brake lever went into his upper inner thigh, probably about 2″ from his groin (thank god it didn’t hit his man parts) He must have hit something because there was a lot of blood. An ambulance came & took him to the hospital and he got to take home 4 stitches with him. I wouldn’t have even thought it was possible & how painful since its so big & blunt, ouch! Glad your wife recovered well! Lets hope my son does the same!

  9. Similar experience with Margo, but she was treated better than I am. Was on an activity with the school and accidentally hurt myself during mountain biking, but then I needed to carry out other activities in the following days, which required me to move and walk. It was lucky that Margo had got enough rest. Now there is still a scar on my thigh (maybe because isn’t treated properly/did too much activities during that period). Sigh.

  10. I’m glad to hear that Margo is doing well. I was surprised that a few people had this accident before, I thought that I was the only unlucky one. I reckon that I’m not going to ride bicycle for the rest of my life. 😥

      • But the experience was such a nightmare to me, and my scar is still there. When I ride, I will probably think of how sad my parents looked after finding out I encountered such an accident. I felt sorry for them cuz they must have felt heartbroken. 😦

  11. This just happened to my 10 year old son, 2 weeks ago. Air ambulance ride to the hospital with the brake lever still in. 3 layers of internal stitching after surgery to remove it. He is doing great now. My wonder is, what can I do to the brake levers so we don’t have to go through this again???

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