There's an array of things holding Lawson Craddock and his fractured scapula together in his quest to reach what amounts to his intermediate finish line Sunday, on the eve of the first rest day of the 2018 Tour de France.
An elaborate web of two-tone green argyle physio tape fans out over Craddock's left shoulder and bicep. He's managing pain with acetaminophen and ibuprofen, which is "what I would give someone who wasn't doing the bike race -- it's not sexy, but it works," said EF Education First-Drapac team doctor Kevin Sprouse.
Team chiropractor and physical therapist Matt Rabin checks in with Craddock in the evening after the stage finish and in the morning before he remounts, debriefing him on how his body feels and leading him through stretching and activation movements to loosen and limber him up from the inevitable stiffness that sets in overnight.
But the most important tool in the 26-year-old Texan's kit is his mindset. The ultimate sports cliché of taking things one day at a time has never been more applicable or necessary for Craddock, who is actually taking the race one segment of road at a time as he guts out the pain and discomfort with positive thinking.
That attitude will be of utmost importance Sunday as the Tour riders take on 15 separate sections of cobblestone surface totaling more than 13 miles of the 97.2-mile Stage 9 course from Arras to Roubaix. The jouncing, treacherous stony roads can undo riders even when they're in peak form, let alone one who is dealing with near-constant physical distress. And Craddock said he hasn't really raced on cobbles since he was a U-23 rider.
"I'd prefer not to be the lanterne rouge," Craddock said from the EF team bus on Thursday, alluding to the caboose nickname conferred on the last-place rider in the Tour. "But just still being in the race is really encouraging. Honestly, I'm really happy that through a negative situation, I've been able to make it about something bigger than just me."
Craddock is clinging to the end of the rope in 170th place, an hour behind leader Greg Van Avermaet of Belgium and 17 minutes shy of the next-closest rider as of Sunday morning. He is holding on for the people who helped him rebound after a 2017 season essentially lost to overtraining syndrome. He's there for his team leader, Rigoberto Uran, the veteran Colombian who finished second overall in the Tour last year and aspires to move up one more step. "That dream isn't dead yet," said Craddock, who still hopes to be of service to Uran in the mountains.
And Craddock increasingly is willing himself through each day for a cause he's helping back home in Houston: funding repairs for the Hurricane Harvey-damaged Alkek Velodrome.
He had planned to support the facility even before he was injured, by auctioning his custom "HoustonStrong" bike shoes, and is donating $100 for each stage he finishes. The immense social media attention drawn by his fight to stay in the race has generated almost $78,000 in donations so far.
"There's a line and a balance between pain and discomfort. ... It's about understanding in his mind that what he's experiencing is largely discomfort with fleeting periods of pain." EF Education First-Drapac chiropractor and physical therapist Matt Rabin
Craddock crashed in the feed zone halfway through Stage 1 of the Tour last Saturday, when he hit a hydration bottle that popped off another rider's bike. He received medical attention from the race doctor for the most visually dramatic aspect of his injury -- lacerations above his eye that sent blood pouring down his face. He did not have concussion symptoms or the kind of damage to his helmet that would indicate head trauma, according to Sprouse, who theorized that Craddock caught his eyebrow on something sharp as he went down. The bruises on his face are already fading.
Far more troublesome and painful was the hairline fracture, which was revealed by an ultrasound (it didn't show up on X-rays) after the stage. It is between 1-2 centimeters long and runs back to front in what is called the spine of the scapula -- a triangular ridge of bone that runs horizontally across the upper shoulder blade. The fracture is stable, and Craddock does not risk doing more damage to it by riding, Sprouse said.
The soft tissue injury and inflammation around the bone is actually a more acute issue. "People fixate on the fracture, but the real pain and discomfort comes from the surrounding muscles that tighten up and guard the injury," said Sprouse, an emergency and sports medicine physician based out of Knoxville, Tennessee.
Craddock said he and Sprouse built a solid, trusting relationship last season as Craddock tried to bring his body back from the abyss of exhaustion he tumbled into. This year, his third with the team, he was striving -- more sensibly -- to return to the form that earned him two top-five placements at the Tour of California and enabled him to finish his debut Tour de France in 2016. He looked to be moving in that direction in the first half of 2018.
When Sprouse told Craddock he could safely continue in the race, the rider believed him. A lot of the daily support to keep that conviction going has fallen to Rabin, who has tried to give Craddock guideposts to distinguish between pain that is to be expected and pain that would be worrisome.
"There's a line and a balance between pain and discomfort and I encourage him to breathe into it," said Rabin. "It's about understanding in his mind that what he's experiencing is largely discomfort with fleeting periods of pain.
"Most people will do more when they're asked to do it for someone else, and that definitely has been the case with him."
Nowhere was that better illustrated than in Craddock's pleasantly surprising performance in the Stage 3 team time trial, where he was able to not only hang on in but also take some pulls until late in the 35-kilometer course. Rabin said one key was getting Craddock into the tucked position on the time trial bike beforehand and evaluating how it felt.
Yet no amount of mental fortitude can make up the gap when the pace in the peloton goes frantic for one reason or another -- split by crosswinds, or jousting for position at the base of a climb. Changes in rhythm, even those that are routine for a rider of Craddock's caliber, such as accelerating out of a turn, pose the most challenges for him now.
"When you find yourself at the back and everyone else is racing and you're just riding -- that's difficult," Craddock said in a characteristic understatement. He uses the Garmin map on his bike to try and anticipate what kind of line to take out of a turn, trying to stay in a comfort zone even though he knows true comfort is illusory right now. He's sharing his biometric data, fed by a strap he wears during the race race.
One of the most significant factors in Craddock's healing and continued ability to stay in the saddle is adequate sleep, something that has improved since the first couple of raw, anxious days after the crash. Small tips that anyone can benefit from -- a fully dark room, no backlit screens, timing of the evening meal -- have helped him.
His treatment is normal in other aspects. The team mechanics haven't messed with his bike fit because doing so could create other problems. Aside from the work he and Rabin are doing to increase the range of motion in his shoulder, he's receiving a normal sports massage every evening, albeit with some special attention to areas where he might be imbalanced or overcompensating due to the injury.
Craddock would rather be celebrated for another kind of accomplishment, but he modestly concedes he is proud of himself for what he's done at the 2018 Tour so far. He said the stretch has been more difficult than anything he endured last year. When he feels stressed, he allows his mind to go to the family of promising U.S. pro Chad Young, who died last year at age 21 after injuries suffered in the Tour of the Gila race.
"My pain is nothing compared to theirs, hearing that Chad was never coming home," Craddock said. "It's hard for me to complain, getting to do what I love."