A Trip in the Dark

A Trip in the Dark

A Trip in the Dark

Many of you will, by now, have heard of my little accident on bonfire night in the woods near Gethin Forest Bike Park. I thought I ought to try put something on paper to see if there any lessons to be learnt from my experience.

The remoteness of my position marked by the X.

It was a standard Tuesday night run in the dark in winter up a mountain in South Wales. The ground was wet following recent rain and there was a lot of standing water around in the puddles on the tracks. On the night there was no wind and no rain and air temperature was about 7 degrees. I had gone with the faster group as I felt I have been running well following a recent increase in training. I am preparing for the Cape Wrath Ultra in May, 400km over 8 days. We had done all of the uphill and had just started the return along the top of the ridge heading back towards the downhill and the cars. We were in a muddy, rutted track with puddles in the ruts. I was mostly running on the ridges between the ruts to avoid the unseen dangers in the puddles and to prevent getting too wet and cold. My foot slipped suddenly on a greasy bit of mud and my foot shot sideways into one of the puddles. I felt it suddenly stop and I felt that sudden snapping sensation and sounds of tearing shooting up my leg as I plunged forward onto my outstretched arms. I juddered to a halt on my front in the track and rolled onto my back to look at the damage. What I saw was not a pretty sight. My foot was pointing 50 degrees out to the side in a very unnatural shape. I knew immediately from my years working in casualty, that this was a fracture-dislocation and is one of the more serious ankle injuries. I could see the others now disappearing into the distance and didn’t want to be left alone so shouted for help. Fortunately, they heard me and made their way back to me to see what had happened.

The scene of the slip

Ii was suggested that they carry me off the mountain down to the cars over 3km away as the crow flies. My foot was flopping around every time it moved and I knew this wasn’t going to be an option. I knew it was going to require mountain rescue and ambulance at the least and possibly a helicopter to get me off the mountain. After some discussion Claire dialled 999 and called for help. The next job was telling them where we were. Easier said than done as there is a plethora of tracks in that part of the woods. I have an app on my phone called OS locate which gives you your coordinates and were able to give them those, as well as general directions from the Gethin Park Woods main entrance. While we were waiting for the cavalry to arrive there were several tasks that could and should be achieved. My memory is a bit hazy as to the exact sequence but the most important in my mind was getting my foot straight. My casualty training had taught me that you try to reduce this type fracture as quickly as possible before the nerve and blood supply to the foot is irreparably damaged. There is not much finesse to this as it largely consists of grabbing the foot and pulling in the same direction as the leg is pointing. I saw Martyn ahead of me and asked him to do it. A worried expression came over his face and he rightly looked hesitant. I realised that Claire was standing next to me and as a qualified doctor couldn’t think of anyone better to do it. She grabbed my foot firmly and I braced anticipating shed loads of pain. Much to my surprise the foot came straight relatively easily with lots of grating and twanging and vibration shooting up the bones in my leg – but no pain. I presume this was partly because I was on an adrenaline and endorphin fuelled high but also because the bruising and swelling you expect around a fracture had not yet occurred. The leg was straight within 3 minutes of the original injury. I asked Ake to hold my leg in position as it still felt unstable and wobbly on the end of my leg while I put on hat, gloves, leggings (on my good leg) and waterproof top.

I was aware of the cold and was starting to shiver now I was no longer moving. I suspect this was largely a nervous reaction rather than just the cold. Martyn, Matt and Marcus then went down to the cars to get warmer clothing and also to be in a position to guide the rescuers up when they arrived. Claire and Martyn had also lent me spare tops to add to the layers keeping me from going hypothermic. I also move away from the puddle and sat on my bum bag to try and conserve as much heat as possible. Matt and Martyn returned with more warm clothes and wrapped me up as much as possible. After what seemed an age Marcus reappeared with two ambulancemen in tow. Richie and Mark were superb and had gone above and beyond the call of duty. They had managed to get the night warden of the park to open the gate and driven the ambulance to about a kilometre away from where I was on the gravel forestry tracks. My foot was put in a gutter splint and I was lifted on to the scoop stretcher. Between Martyn, Claire, Marcus, Matt, Ake and the ambulanceman, Mark and Richie, they carried me off the mountain and down to the waiting ambulance. I never found out if mountain rescue had been called or whether they were waiting for ambulance crew assessment.

The cavalry arrives. Thanks Mark and Richie.

As you can imagine this took time, despite an immediate response from my friends, an immediate call to the ambulance, a fast recognition of my position and a quick allocation of the crew to me. The whole exercise of going up and down the mountain meant that it was 3 hours from the original injury to my arrival in casualty at Prince Charles hospital. Realistically I don’t think we could have done it much quicker.

The x-ray picture taken in hospital showing the excellent position Claire had got the fracture into. If you look closely, in addition the obvious fracture on the shaft of the fibula you can see that the talus has sifted to the right and gaps have opened up between the talus and tibia on the inner side of the ankle and between the fibula and tibia above the talus. This is an unstable fracture as all the ligaments holding the ankle joint together have all snapped

So, what are the lessons to be learnt apart from not going out running in dark nights in winter up muddy hills? That isn’t going to happen so what can we learn? Firstly, some things went well, I almost always carry a bum bag with a first aid kit and full body cover on me nowadays. This was invaluable on the night in preventing me getting cold. In the event it had been raining and windy would probably have prevented me from getting hypothermia. The first aid kit was useless for this major injury and didn’t make the difference between getting off the mountain unaided and needing rescue. They are not designed for this purpose. I was going to need rescue anyway. Knowing your position was vital and the OS locate app is a useful tool for that. The three words app would be a good alternative and possibly easier to use. Having a good group of people to run with was also really important. If there had just been two of us then the whole saga would have become more difficult. It would almost certainly have meant the casualty (me) being left alone while help was sought. If I had been alone then in that location, I would probably have still been okay as there was good mobile phone signal. If I had been alone in an area without signal, then I might well not be here now. By the time anyone had realised I was missing and sent out search parties and they had found me then I would probably have been dead from hypothermia. A sobering thought.

In summary

  1. Enjoy off-road running but don’t take unnecessary risks
  2. Running alone at night in remote country in winter can be serious if you are injured
  3. Ensure someone knows where you will be running and stick to that route
  4. Don’t rely on the ambulance service to contact mountain rescue. This should be done through the police and will require a separate phone call if needed
  5. Carry full body cover and a first aid kit (for more minor injuries). A small Bivvy bag such as the SOL could prove invaluable if it is wet and cold. For group runs consider having a portable splint in the emergency equipment: devices such as a SAM splint are light and small, but could make the difference with getting off the mountain without calling for help.
  6. Carry a charged mobile phone, and have a location app on your phoneIf running alone then live tracking from your phone could be a lifesaver. These are available through Strava pro or Buddy Beacon on Viewranger at a cost – though these apps can affect battery life in the cold
  7. Carry a whistle – they’re very light, and so much louder than trying to shout for help. If no one hears you, you’re on your own.
  8. I was wearing iNov8’s but even these won’t prevent slips on greasy mud, never wear road-running trainers
  9. Know a bit of first aid and put yourself on a course
  10. Run with a great club such as MDC, where people look out for each other

With immeasurable thanks to Martyn, Matt, Claire, Ake and Marcus. I owe a huge debt that I can never repay. Will a beer do instead?                                                                            Alan