If you’ve ridden a bike you’ve fallen off one: it’s inevitable with only two wheels on your wagon. Most of the time you’ll get away with a scrape and a dented ego, but it’s worth being prepared for something a little worse.

When bikers do take a tumble they end up with fairly predictable injuries. Here we look at the most likely ones, and how to treat them. It’s best to have clean hands before handling an injury – and remember that these tips are no substitute for proper first-aid training.

Cuts and grazes – The pavement looks smooth when its gliding under your wheels, but it’s not too forgiving if you come off. Riders pick up grazes and cuts in almost any accident – they can even happen through clothes.
Treatment – use tap or bottled water to flush dirt from cuts and grazes. Pat dry with a sterile dressing or clean cloth.

For bad cuts, stem the bleeding by applying direct pressure with a sterile dressing or a pad of clean cloth. Only use your fingers if you don’t have anything else suitable. Lie the rider down and, checking first for fractures, raise the injury above their body if possible. Get medical help if the bleeding continues.

Sprains and bruises – You can pick up bruises from bike parts or from the ground, or get a sprain by landing awkwardly. Though it hurts, it’s unlikely to be a big problem.
Treatment – Minimise swelling and bruising with an ice pack on the affected area for the first day, but for no more than 20 minutes at a time. Rest sprains for a day or two before beginning very gentle movement exercises.

Fractures - Landing awkwardly, even on a soft surface, can fracture a bone – seek medical advice if suspected.
Treatment – Don’t move a rider with a fractured bone unless they’re in immediate danger (such as from fast traffic). Reassure them and keep them still while you steady an injured limb with your hands – don’t move it unnecessarily. Stem any bleeding with a sterile pad as above, then bandage if necessary. Keep the casualty warm, but don’t let them eat or drink in case they need an operation.

First Aid

Head injury – Head injuries are pretty rare, but even seemingly trivial ones can be catastrophic if left untreated. Look for cuts or lumps on the head or a damaged helmet which might suggest a knock – a rider might not be aware that they’ve hit their head. Always seek medical advice if a head injury is suspected, and don’t let the casualty eat or drink.
Treatment – Be careful: a rider with a head injury may have also hurt their neck. If unconscious, the first priority is to ensure that their airway is clear of any fluids and that the tongue hasn’t fallen to the back of the throat. If they’re not breathing, perform rescue breathing by pinching their nose, breathing in fresh air and carefully breathing out into their mouth. This should inflate their lungs. An ambulance should be called urgently – the 999 operator can give further first aid advice.

A conscious rider should be encouraged to go to hospital, particularly if they lost consciousness after the accident or if you suspect a heavy impact. It’s essential if they develop a headache, vomiting, confusion, drowsiness or double-vision.

Top tips for safe urban cycling

Be safe – anticipate the actions of drivers, pedestrians and other cyclists. Ride within the law so they can predict yours
Be seen – wear high-vis clothing. Use bike lights
Cover up – trousers and long-sleeved tops reduce grazing, as do gloves. A properly fitted bike helmet can lower the chance of a head injury – replace every five years, or if you fall on it.
Kit up – carry a small bike first aid kit, with some sterile dressings and bandages. A foil emergency blanket can keep a fallen rider warm. A fully-charged mobile is invaluable.