It’s tough to train for a 1,000-mile bike race across Kyrgyzstan when four months out you’re injured in a high-speed crash.

Such is the plight of experienced Bend cyclist Jesse Blough, who was hurt during the Gorge Gravel Grinder’s 96-mile loop outside The Dalles in April.

Preparing for the Central Asia 1,000-mile race in August, Blough figured the gravel road race’s distance and the 8,000-foot elevation gain would be good training for the 120-mile days he intended to crank out on his supply-straddled bike throughout Kyrgyzstan.

Around the 40-mile mark, while Blough sped down a deep gravel road, trying to catch up with a group of cyclists, a severe crosswind grabbed Blough’s front wheel. As Blough counter steered to correct the slide, the gust caused his rear wheel to also lose traction. Blough slammed into the road.

“All the energy of going 30 mph went right down onto my hip,” Blough said.

Laying in the middle of the road still straddling his bike, Blough ran through a mobility test: arms, fingers, head and neck — everything was fine except his left leg, which he couldn’t move at the hip. The pain set in.

At the hospital, Blough learned that he had broken the head of his femur laterally and in three pieces. After surgery — during which doctors inserted titanium rods into the bone — Blough had to acclimate to his new reality: He would no longer run and ride 20 hours a week. He’d be able to work from home, but Blough, bedridden for the initial weeks of recovery, would have to deal with some serious restlessness.

“That was the toughest part, for sure,” Blough said. “(The only thing) to mentally occupy my brain was that I’m not going to be able to do the things that I wanted to do all season.”

Inevitable setbacks

For most athletes, whether they’re amateurs or professionals, they will have to deal with a massive setback, usually due to an injury, said ­Melina Halpern, a Bend-based licensed professional counselor with an emphasis on athletic performance.

“I would be minimizing it to say that there isn’t a level of grief involved for any athlete who has to sideline their activity,” she said. “I think there has to be a real awareness of that. There is a loss.”

“Some injuries are inconveniencing, and some, like Blough’s, are devastating. It’s imperative that an athlete accept the fact that the recovery, and its tedious exercises, is imperative for their future,” Halpern said.

For now, 100-mile bike rides are out for Blough. Four weeks since the accident, Blough is relatively mobile — if cautiously so — yet his hip is still nonweight-bearing. Blough does several repetitions of the leg exercises he learned from the house visits paid by a physical therapist, an occupational therapist and a nurse. Showers are still complicated and loaded with peril. Answering his front door requires Blough to carefully walk down stairs with crutches. This is his new normal, said Halpern, who also owns the Bend-based Grit Performance, a mental performance studio. Eager to regain mobility, Blough admits he does more leg workouts than he’s been prescribed when feeling idle working mostly from home.

Perhaps boldly, Blough has set up his road bike on a stationary trainer in his living room, which he gingerly pedals with his good leg.

“I’m technically allowed to ride the trainer, but I’m not allowed to use my left leg in any kind of forceful effort,” he said.

Blough still intends to travel to Kyrgyzstan to compete in the Silk Road Mountain Race. He looks forward to discussing this goal with the physical therapist he’ll be assigned to after a check-up later this month. But Blough’s aware that, after more than a month without training, his fitness has been reduced to nothing.

“Every (medical professional) I talked to said: ‘You’re pretty much starting over. Assume that you don’t have any of the power that you used to. You’ll be able to do what the average person just starting out (with bike training) is going to be able to do,’” Blough said. “That’s the expectation that I have: All the work I have been doing for the past two years is just gone. And I have three months to get it back before my race in Asia.”

The knife’s edge

Dave Cieslowski, a physical therapist at Focus Physical Therapy, said Blough’s injury is relatively extreme compared to the types of injuries he typically sees — even among national- and Olympic-caliber athletes. That Blough has already shown himself as an overachiever in his recovery is good, Cieslowski said, but the enthusiasm may need to be tempered.

“We have to say, ‘OK, here’s a gold star for nailing your stuff, but you’re doing it a bit too much,’” he said. “‘Let’s back off just a little bit. Or take a rest day.’”

At Focus, Cieslowski and his colleagues walk similarly ambitious patients along “a knife edge” of ideal rehabilitation.

“It’s a delicate balance,” Cieslowski said. “Some days you fall on the side where things are good, and sometimes you fall on the side where things are bad. You’re constantly having to adjust to always be on the edge, all the time. For some people who are pushing too hard, they’re always falling on the more painful side. In the long run, they’re actually going to hamper their recovery.”

When an athlete like Blough enters physical therapy at Focus, staff run him through a full evaluation of strength and range of motion. With patients whose injuries are as severe as Blough’s, physical therapists take into account tissue-healing time and appropriately prescribe exercises for what their tissues can handle, Cieslowski said. Slow and steady recuperation can actually make athletes stronger than they were before, he said. Weightlifting — think squats, dead lifts and split squats — is often the final stage of the rehabilitative process for an injury like Blough’s.

“We have the opportunity to actually make them better by addressing strength differences and things like that,” Cieslowski said. “The goal isn’t simply hitting (a particular race); it’s ‘Let’s hit this event and actually have you be stronger than you were when you were injured and have a really good performance.’”

Too much, too soon?

Does Cieslowski think Blough should still plan on racing 1,000 miles across mountains in just three months?

Cieslowski, also the traveling physical therapist for the U.S. Nordic Combined Ski Team, has seen athletes get injured and still make their races. What works in Blough’s favor is that cycling, as a nonweight-bearing sport, doesn’t require a full range of hip motion, Cieslowski said.

“However, the (race’s) length and location are not necessarily in his favor,” he added with a chuckle. “If it was a one-day, 150-mile ride, that would be one thing, but a 1,000-mile ride over multiple days … if something goes wrong, or if he’s not ready for that, it could be a bad situation. Will there be good medical care available? Are you going to be able to get out of there if you’re four days into this and things are really going south? Going into it knowing that you might not complete it can be pretty valuable. We’re not necessarily saying no, but it’s always good to have a plan.”

Blough remains optimistic. By the end of the month, he hopes to go for his first outdoor bike ride since the crash.

“I’m looking forward to spending some time on the bike again,” Blough said, adding that the lateral twisting motion required to click out of clipless pedals may not yet be feasible. “I might just use flat pedals.”

— Reporter: 541-617-7816, pmadsen@bendbulletin.com

20274554