Carmen Small remembers hearing a rider shout an expletive and her name. More than a minute later, she woke up.

The 37-year-old road cyclist from Durango retired from the sport this week as severe symptoms of a concussion effectively put an end to her career. The wreck happened March 11 at the Ronde van Drenthe in the Netherlands. Six months later, Small still has headaches every day and feels pain in her neck and jaw.

After the wreck, Small returned to Colorado and received treatment at the Olympic Training Center in Colorado Springs in hopes to restore her ability to compete. Twelve weeks after the accident, she returned to Europe and hoped to get back on the bike and perform well enough to compete in the Giro Rosa in Italy. She competed in one local race, and her head told her it was time to retire from cycling and not risk another concussion that could have further life-threatening consequences.

“There were 12 of us in a break, and I had gone to the back of the pack to see where the chasing group was,” Small said of the buildup to the wreck during a May interview with The Durango Herald. “I know from experience that if you look behind you, you go the other way. I went to the side of the group to look so I wouldn’t have any problems. I was getting back to the front, and I think what happened is the girl behind me looked back and she hit me. I heard ‘Oh (expletive) Carmen,’ and then she’s hitting me. I blacked out after that, completely out for a minute.”

Small was taken to the hospital and returned to her cycling team’s house in Belgium. She essentially slept for three days, waking up momentarily to eat or use the bathroom.

When she returned to Durango a week after the accident, friends and family members knew there was something serious wrong with her.

“She was real short with people,” said Small’s father, Alan. “She didn’t want to talk much. She was in an awful lot of pain, I know that.”

That’s when she went to Colorado Springs for three weeks to receive constant treatment. Fixing a bout of vertigo was her first goal along with correcting several other severe symptoms that led to daily nausea. After three weeks, Small returned to Durango after battling severe depression during her time in Colorado Springs.

“It was a hard call to make, but I had to come back home to Durango,” she said. “I was super depressed. I couldn’t even go for a walk or hike without feeling sick. At that point, it wasn’t even about racing again. It was, ‘How can I function again like a human?’ That was my only motivation, being able to go to the grocery store or out to eat without having a panic attack or feeling like a crazy person.”

The March concussion wasn’t Small’s first. Her first in cycling came in 2006 as an amateur. She broke her collar bone and was knocked unconscious.

“The collar bone was broke, so everyone put attention on that,” she said. “I was throwing up. Was that from the broken bone and pain meds or the concussion? No one looked into it. I was a teacher then and not a full-time racer, so I rested and healed and didn’t treat it properly.”

The first major concussion of Small’s cycling career came in 2010. Again, she was knocked out.

“I was confused on where I was. I asked how we got the team van to Europe, and we were in the U.S.,” she said.

“I didn’t even know if I had health insurance. I told the team to call my husband to see if I had insurance. At that point I had been divorced for two years. But no one said I had a major concussion. They were concerned about getting stitches on a gash on my arm. It was almost funny how screwed up I was, but it wasn’t a worry beyond people checking on me at night.”

Small had another minor concussion in 2013 at the Pan American Championships. She lost by only three seconds in the time trial despite the crash.

“We didn’t check to see if my helmet was cracked or anything,” Small said. “I was really emotional and raced two days later in the road race. I got back home to Durango and was super sick, couldn’t go to the grocery store without laying down in my car. I found out I had a concussion.

“But as an athlete, I was like, ‘Just tape my foot to the pedal so I can finish.’ As a rider, you’re not OK to make that decision, but as a competitor you always want to finish the race.”

Small broke her collar bone twice and separated her shoulder during her career. Looking back, she said those injuries were easy compared to concussions. Small’s father said watching his daughter compete as a pro for 10 years was stressful because of the risk of injuries.

“Her entire bicycle career I always was on pins and needles wondering if something really bad would happen,” Alan said.

“She’s had some pretty good wrecks. On the concussion thing, I kind of knew about them and her having a few. I’ve had friends who have had them. You’re always hoping for the best and that they will finally resolve themselves. Now, she still has headaches. It’s definitely worrisome.”

Small has watched as other cyclists have suffered severe concussions, and many riders have reached out to her in recent months. But it is hard for her to give advice, noting that every concussion is different. She has only one bit of advice for any person that suffers even a minor injury.

“You have to go get treatment from a neurologist right away,” she said.

“It’s not clear what you should do, but you have to get checked by a professional and keep getting checked if you have symptoms. If you have a headache, you should not return to play. Get help, whatever that means.”

jlivingston@durangoherald.com