Pedestrian and bicycle injuries from being struck while walking or cycling happen in two stages. First you hit the vehicle. Then you hit the ground.
What injuries do pedestrians and cyclists get when hit by a car?
The second hit often does more damage, and it gets missed more. A walker struck at moderate speed is lifted, spun and dropped. He usually lands on the shoulder, hip or head. The landing injuries are separate from the strike injuries.
Cyclists add a third hit: the bike itself. Handlebars can hurt the belly and chest. The bike can land on the rider. These injuries are common, and they are easy to lump in with the rest of the trauma.
What happens in the weeks after being hit by a car?
Scene and emergency
Head injury, broken bones and internal injury come first. A helmet does not rule out concussion.
First week
Once you are home, the pain from the landing usually gets easier to map. It is clearer than it was in the emergency room.
Weeks two to eight
Shoulder, hip and sacroiliac injuries from the landing show up as the obvious injuries settle. This is when a full check of muscles, joints and bones helps most.
Beyond two months
Pain that lasts, nerve pain most of all, needs an exact diagnosis. Post-traumatic CRPS (a severe pain disorder that can follow an injury) is a real risk after a limb injury. Time matters with it.
Which pedestrian and bicycle injuries get missed?
The injury missed most often in this group is the sacroiliac joint (where the spine meets the pelvis). Landing on one side loads the pelvis unevenly. When pain on one side of the low back and buttock follows, it often gets blamed on bruising for months. It does not show on any scan. It is confirmed only by image-guided injection.
The second is the shoulder. Landing on an outstretched hand or right on the shoulder injures the rotator cuff and labrum. Wounds you can see easily hide these injuries. Shoulder pain that lasts past six weeks after a fall needs a proper check.
Concussion is missed too often in cyclists in particular, because people assume the helmet stopped it. Helmets greatly lower the risk of skull fracture and severe brain injury. They do not stop the brain from moving inside the skull when the body stops fast.
When to get help immediately
Get emergency care for a worsening headache, vomiting, confusion, drowsiness, seizure, weakness or numbness on one side, belly pain or bloating, shortness of breath, or blood in the urine. If you cannot put weight on a leg after a fall, you need imaging.
To get checked, call or text us. We are at 12174 Natural Bridge Rd, Suite 110, St. Louis, MO 63044. No referral is needed and no attorney is required. See accident and injury care.
Common questions
I was wearing a helmet. Can I still have a concussion?
Yes. A helmet reduces skull fracture and severe brain injury. It does not stop the brain decelerating inside the skull.
Concussion and Head Injury covers how concussion presents and what usually gets missed.
My hip has hurt since I landed on it. Is that just bruising?
It might be. It might also be the sacroiliac joint or a hip injury. Pain still there at six weeks is worth a proper check.
Sacroiliac Joint Pain covers how that joint is diagnosed and treated.
Do you see cyclists who came off without a vehicle involved?
Yes. The landing injuries are the same whether or not a car was involved.
Why does my shoulder still hurt weeks after being hit?
Landing on an outstretched hand or straight onto the shoulder can tear the rotator cuff or the labrum, and those injuries hide behind more visible wounds. Shoulder, hip and sacroiliac injuries from the landing usually show themselves in weeks two to eight. Shoulder pain that lasts past six weeks after a fall deserves a proper assessment.
What should I watch for after being hit by a car while walking or cycling?
Get emergency care for a worsening headache, vomiting, confusion, drowsiness, a seizure, weakness or numbness on one side, belly pain or swelling, trouble breathing, or blood in the urine. If you cannot put weight on a leg after the fall, you need imaging. Helmet or no helmet, a concussion is still possible.
Can bicycle handlebars cause injuries in a crash?
Yes. Cyclists take a third hit that walkers do not: the bicycle itself. Handlebar injuries to the belly and chest, and injuries from the bike landing on the rider, are common. They are easy to lump in with the rest of the crash. So name them when you are checked, most of all if the pain is not settling.
Sources
- Nolet PS et al. Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis. Accident; analysis and prevention, 2020. PubMed 32438092
- Levin HS et al. Diagnosis, prognosis, and clinical management of mild traumatic brain injury. The Lancet. Neurology, 2015. PubMed 25801547
- Smits EJ et al. Expert consensus and perspectives on recovery following road traffic crashes: a Delphi study. Disability and rehabilitation, 2022. PubMed 33305970
- Cunha-Diniz F et al. Trauma outcomes in nonfatal road traffic accidents: a Portuguese medico-legal approach. Forensic sciences research, 2022. PubMed 36353310
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.