Returning to walking or cycling after being hit by a vehicle
How to tell if you are ready to walk or ride again and ease back in
Perhaps you were crossing on a green light when a turning car hit you. Perhaps a driver passed too close while you were riding to work, or backed into you as you rolled your wheelchair through a parking lot. Your body may be healing now. Yet the thought of stepping off a curb or pushing off on your bike can still make your heart pound.
Many people hurt this way want their old routines back, like the walk to the bus or the evening loop with the dog. Others are not sure they ever want to ride on the road again. Both are fair places to start.
This guide takes three questions one at a time. Is your body ready? Does your fear feel like something you can work with? And is the trip you have in mind as safe as it can be? Here, walking also covers rolling in a wheelchair or using a walker, cane or scooter.
Why going back out can feel so hard
When you walk or ride, nothing stands between you and a moving car. Some people remember the screech of brakes. Others remember nothing and feel uneasy without knowing why. A street that once felt ordinary can now feel dangerous.
You are far from alone. In 2024, an estimated 71,635 people were injured while walking in U.S. traffic crashes, and 7,080 were killed [6]. That same year, about 52,887 cyclists were hurt and 1,103 died [9]. Since 2022, those cyclist counts have included people riding e-bikes [9].
What research says about people hit on foot or on a bike
- One study followed 1,148 people for up to three years after they came to a hospital emergency department following a road crash. People hurt on foot, on bicycles, on motorcycles and in cars had few differences in emotional or social outcomes, even though their injuries differed [1].
- In one year results from the same team, based at an Oxford hospital, 17% of cyclists and 13% of pedestrians reported anxiety about travel. Passengers had the highest rate, at 28% [10]. Only small numbers of people hit on foot or on a bike took part, so treat these figures as rough.
- A study compared 238 injured cyclists with 234 injured car occupants. On average, the cyclists had better emotional health [11]. Fewer showed signs of likely posttraumatic stress disorder (PTSD) [11]. With PTSD, reactions to a trauma stay strong for a month or more and make ordinary days hard to manage. Cyclists had more distress if they were younger, felt they might die in the crash, had poorer health before it, or spent longer in the hospital [11].
- In a 2022 survey of cyclists after cycling crashes, fear or anxiety was more common in women, in people with a past history of depression, and after more severe crashes [12].
- A Canadian study of 1,480 people treated at trauma centers found that pedestrians had more severe injuries, on average, than people hurt in cars [13]. Between 45% and 50% of the motorists and pedestrians did not know how long their recovery would take [13].
These findings describe groups and show links, so they cannot prove cause. A low group average cannot tell you how you will feel. In the Oxford study, people’s overall outcomes were considerably worse than their physical injuries alone would predict [10].
Three kinds of ready
Your body, your nerves and your route can recover at different speeds. Your surgeon may clear you to walk a mile while your stomach still knots at every crosswalk. Or you may feel eager to ride long before your healing wrist can squeeze a brake lever.
Riders can follow a similar plan. See getting back on a motorcycle after a crash.
Keeping them apart shows you which one needs work and who can help. Feeling brave cannot tell you whether your knee can handle a sudden stop. A medical clearance, in turn, does not oblige you to go out tomorrow.
Comparison compiled by Safety Behind the Wheel Foundation
Three kinds of readiness at a glance
| Type | What it covers | Who can help | Signs to slow down |
|---|---|---|---|
| Medical | Healing, strength, balance, vision, pain, head injury recovery | Your doctor, physical therapist or occupational therapist | Pain that grows, dizziness, unsteady steps, blurred vision |
| Emotional | Fear, startle, reliving the crash, avoiding reminders | You, people you trust, a trauma focused therapist | Panic that will not settle, fear that blocks daily needs |
| Environmental | Route, time of day, light, traffic speed, crossings, bike lanes | Route planning, a walking or riding partner | Fast traffic, no sidewalk, dark roads, no safe crossing |
Sources: Concussions Ontario advice cards [2]; MSKTC [3]; NIMH [14]; NHTSA [6, 9].
Medical readiness comes first
Check with your care team before you add distance, get back on a bike or start using a new mobility aid. Your injuries may affect how you walk, balance, see, turn your head or react to sudden movement. Some of those changes are easy to miss in a quiet hallway but show up fast at a busy corner.
Head injuries need their own clearance
Concussion advice cards from an Ontario clinical guideline say to check with a doctor about the right time to drive, bike or use heavy machinery again [2]. The same cards list balance problems, dizziness and blurred vision among possible symptoms [2]. They also advise a slow, gradual return to normal routines [2]. On a bike or at a crossing, you need steady balance and quick reactions, so ask about both if you hit your head.
Strength, pain and physical therapy
A physical therapist can work with you on strength, balance and walking, and can help decide when to add hills, stairs or distance. Some basic exercise advice comes from a factsheet written for people with spinal cord injury [3]. It suggests talking with your doctor or physical therapist about your exercise goals and going easy at first [3]. It also says to tell your care team about pain that is new or getting worse [3]. Ask your own team which of these steps fit your injuries and which symptoms mean you should stop.
Cycling asks for skills that walking does not. You need to grip and brake, look over your shoulder, put a foot down fast and steady the bike. Ask your therapist whether you can practice them in the clinic or on a stationary bike first.
Medicines and new equipment
Ask your doctor or pharmacist whether any medicine you take for pain, sleep or mood could affect your balance or reactions near traffic. Never stop or change a medicine on your own to feel sharper for a walk or ride.
If you now use a wheelchair, walker, brace or prosthesis, training with it belongs to medical readiness. The spinal cord injury factsheet notes that staying active may call for special equipment [3].
Rebuilding confidence at your own pace
Fear after being hit makes sense. Feeling afraid during and after a traumatic event is natural, says the National Institute of Mental Health (NIMH). Most people’s symptoms ease with time [14]. A patient guide written by the Department of Veterans Affairs (VA) and the Department of Defense lists upsetting memories, feeling on edge and poor sleep as normal reactions [4].
Most people want to stay away from reminders of a trauma, the American Psychological Association (APA) notes [5]. Avoiding them brings relief in the moment. Over time, though, the APA says that steering clear of every reminder tends to feed the fear [5].
Build a ladder of small steps
Once your care team says your body is ready, list the trips you want to make, from easiest to hardest. Only list steps that are safe in real life, such as a quiet block in daylight. Fast, busy roads stay off the list until much later, if ever.
Imagine a 41 year old woman who was hit by a turning SUV near her office. Her first step might be a daytime walk around her own block with a friend. Next could come crossing at a signal on a quiet street, then walking part of her old route at lunchtime. She might wait to pass the crash corner until she feels ready, or choose another way for good.
Now imagine a 58 year old man who was struck from behind while riding. After he is cleared, he might start on an indoor trainer, then circle an empty parking lot on a Sunday morning. Later he could try a short daylight ride on a paved trail with a friend.
Move up a step when the current one starts to feel manageable, and drop back on a hard day. Slow breathing helps some people. It can also help to bring a calm friend and decide ahead of time where you will turn back.
When fear needs trauma focused care
Sometimes fear does not ease. The PTSD symptoms that NIMH lists include reliving the event, avoiding reminders, and feeling tense or easily startled [14]. For adults, a diagnosis requires a set of symptoms lasting at least one month, and a qualified professional needs to make it [14]. The VA and Defense Department guide says that if your reactions are upsetting or are not getting better, it is worth asking about PTSD [4].
Consider reaching out if fear keeps you from buying groceries, going to work or seeing people you care about. Nightmares or a pounding heart at the sound of brakes are good reasons to ask as well.
Treatments with strong evidence
The VA and Defense Department guide calls several trauma focused talk therapies highly recommended for PTSD [4]. It also says studies show that psychotherapy works best [4].
- Prolonged exposure (PE) guides you, step by step, toward the memories, feelings and places you have been steering around [4]. You and your therapist agree on real world steps to practice between sessions. A full course is about 8 to 15 sessions [5].
- Cognitive processing therapy (CPT) teaches skills for changing upsetting thoughts and feelings linked to the crash [4].
- Eye movement desensitization and reprocessing (EMDR) is a therapy that helps you process the memory of the trauma [4].
Medicines help some people too. You and your provider can choose a treatment together [4]. Few riders in the 2022 cyclist survey received treatment, so it is worth asking whether therapy could help you [12].
If fear turns into hopelessness
Fear and pain can wear you down. If you have thoughts of suicide, reach out now. Support is there. It helps.
- Calls and texts to 988 go to the 988 Suicide and Crisis Lifeline. If you would rather type, you can chat through 988lifeline.org [15].
- If you are a veteran or service member, press 1 after dialing 988 to reach the Veterans Crisis Line, or send a text to 838255 [15].
- For help in Spanish, call 988 and choose option 2 [15].
- If you or someone near you is in immediate danger, call 911.
Choosing safer times, places and routes
The real risk on a street can be higher or lower than your fear suggests. Planning can bring it down. U.S. crash data show when and where most deaths of people on foot and on bikes happen.
- In 2024, 76% of pedestrian deaths happened in the dark. The hours from 6 to 8:59 p.m. had the largest share, and 73% of deaths happened away from intersections [6].
- For cyclists, 52% of 2024 deaths happened in the dark, and 60% happened away from intersections. On weekdays, the hours from 6 to 8:59 p.m. had the largest share of deaths [9].
- Speed matters a great deal. A 2011 AAA Foundation for Traffic Safety study of U.S. crashes estimated that a person on foot hit at 23 mph has, on average, a 25% risk of severe injury [7]. At 39 mph, that risk rises to 75% [7]. Risks are higher for older people [7].
Street design that helps
A Federal Highway Administration (FHWA) study looked at stretches of road between intersections. It estimated that turning a standard bike lane into one separated by flexible posts could cut bike crashes there by about half [8]. Earlier studies reviewed in the report found that most riders surveyed felt safer in separated lanes [8]. At intersections the picture is mixed: another FHWA report found that separated lanes lowered crashes in some settings but not in others [16].
Habits that lower risk
The National Highway Traffic Safety Administration (NHTSA) offers these tips for walking [6]:
- Use sidewalks or paths where they exist. Where they do not, walk on the shoulder facing oncoming cars.
- Cross at crosswalks or corners when you can.
- Wear bright colors by day, and reflective gear or a flashlight at night.
- Keep your phone put away, and avoid alcohol and drugs when you walk.
For cycling, NHTSA advises a helmet that fits well on every ride and riding with the flow of traffic [9]. Wear bright or fluorescent clothing, and at night use a front light plus a red rear reflector or flashing light [9]. NHTSA also tells drivers to leave at least 3 feet when passing a cyclist [9].
These habits lower risk without removing it, and the crash that hurt you may have had nothing to do with anything you did.
Checklist from Safety Behind the Wheel Foundation
- My care team has said this kind of activity is OK for me now.
- I picked a route with sidewalks, a trail or a separated bike lane, and slower traffic where possible.
- I am going in daylight, or I have lights and reflective gear if I could be out near dusk.
- I replaced any bike helmet that was damaged or in the crash, as the Centers for Disease Control and Prevention advises [17].
- If my bike, wheelchair or other mobility aid was in the crash, a bike shop or equipment supplier has looked it over.
- Someone knows my route and when I expect to be back.
- My phone is charged and stays in my pocket or bag while I move.
- I know where I can stop and rest. I have a turnaround point I am allowed to use.
Mobility aids, adaptive cycling and places that matter
Some people come back to walking with a new wheelchair, walker, cane, brace or prosthesis. Others used one long before the crash. Rolling to the store is a full return to getting around. The aim is to reach the places you care about in a way that works for your body.
Finding equipment that fits
A factsheet for people with spinal cord injury suggests trying equipment before you buy it [18]. Many adaptive sports programs will lend or rent you a chair so you can try a sport first [18]. Community groups and nonprofits sometimes run free or low cost programs. Learning a new skill takes time [18]. Hand cycling, where you turn the pedals with your arms, is one example of an adaptive sport [18].
People with spinal cord injury who take part in adaptive sports or recreation are more likely to keep a positive mood and to feel included in their communities [18]. The exercise factsheet for the same group lists better mood among the benefits of regular activity [3].
Start with a place you care about
Confidence often grows faster when the trip has a purpose. Think about where you miss going, such as a friend’s porch, the library or the bench by the pond. Choose one place that is close and well lit, on a route you trust.
You can also break a trip into parts. Take a ride or a bus for most of the way and walk or roll the last few blocks. Ask a friend to meet you halfway, or plan a rest stop at a bench in the middle.
If a broken sidewalk, missing curb ramp or dark crossing makes a trip unsafe, you can report it to your city or county.
Questions to ask your care team
Question checklist from Safety Behind the Wheel Foundation
- Which activities am I cleared for now, from short walks and stairs to riding outdoors?
- Are there movements I should avoid for now, such as twisting, lifting my bike or putting full weight on one leg?
- Could my head injury, vision, balance or medicines slow my reactions near traffic?
- Can physical therapy include practice with curbs, uneven ground and getting on and off a bike?
- What symptoms mean I should stop and call you?
- Would a different mobility aid, brace or adaptive bike help me get around more easily?
- My fear is strong. Can you refer me to someone who offers trauma focused therapy?
- How will we decide when it makes sense to go farther or ride in traffic?
Frequently asked questions
Is it normal to avoid the street where I was hit?
Yes. The APA notes that most people want to avoid reminders of a trauma [5]. You do not have to return to that spot to recover. If avoiding it starts to cut you off from places you need, a therapist can help you plan steps toward them [5].
Do most cyclists go back to riding?
In the 2022 survey of cyclists after crashes, most went back to riding at their earlier level, but how long it took varied widely [12].
What if my family pushes me to walk again before I am ready?
They likely want to see you well. You can thank them and still set the pace. Tell them your care team is guiding the physical side. After a concussion, for example, Ontario guideline advice cards call for a slow, gradual return to your routine [2]. You can add that you are working on the fear in small steps, and that company on the walks you choose helps more than pressure.
What if I never want to ride on the road again?
That is your decision. You might prefer trails, indoor cycling, walking or swimming. Adaptive sports are another choice. Many programs let you try equipment before you buy [18]. For people with spinal cord injury, regular exercise is linked with better mood [3].
The bottom line
Recommendation from Safety Behind the Wheel Foundation
Going out again after being hit means checking your body, your fear and your route separately. Your care team decides when your body is ready. Fear often eases with small planned steps. Trauma focused therapy can help when it does not. Route choices like daylight and slower streets lower the risk that remains.
You set the pace. Start with a place that matters to you, and change the plan whenever you need to.
Sources and further reading
- 1Mayou R, Bryant B. Consequences of road traffic accidents for different types of road user. Injury. 2003;34(3):197-202. doi.org/10.1016/S0020-1383(0200285-1)
- 2Guidelines for concussion/mTBI and persistent symptoms, 3rd edition. Appendix 1.4: Brain injury advice cards, short versions. Concussions Ontario. concussionsontario.org/…/appendix-1-4.pdf
- 3Blauwet C, Donovan J. Exercise after spinal cord injury. Model Systems Knowledge Translation Center. 2016. msktc.org/…/exercise-after-spinal-cord-…
- 4U.S. Department of Veterans Affairs and U.S. Department of Defense. VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder: patient summary. June 2023. healthquality.va.gov/…/VA-DOD-CPG-PTSD-Patient-Sum…
- 5American Psychological Association. Prolonged exposure (PE). Clinical practice guideline for the treatment of PTSD. Updated April 2025. apa.org/…/prolonged-exposure
- 6National Highway Traffic Safety Administration. Pedestrians: 2024 data. Traffic Safety Facts (DOT HS 813 818). June 2026. crashstats.nhtsa.dot.gov/…/813818
- 7Tefft BC. Impact speed and a pedestrian’s risk of severe injury or death. AAA Foundation for Traffic Safety. September 2011. aaafoundation.org/…/impact-speed-pedestrians-ri…
- 8Dixon K, Avelar-Moran R, Mousavi Seyedeh M. Developing crash modification factors for separated bicycle lanes (FHWA-HRT-23-078). Federal Highway Administration. September 2023. highways.dot.gov/media/33856
- 9National Highway Traffic Safety Administration. Bicyclists and other cyclists: 2024 data. Traffic Safety Facts (DOT HS 813 822). July 2026. crashstats.nhtsa.dot.gov/…/813822
- 10Mayou R, Bryant B. Outcome in consecutive emergency department attenders following a road traffic accident. British Journal of Psychiatry. 2001;179(6):528-534. doi.org/10.1192/bjp.179.6.528
- 11Craig A, Elbers NA, Jagnoor J, et al. The psychological impact of traffic injuries sustained in a road crash by bicyclists: a prospective study. Traffic Injury Prevention. 2017;18(3):273-280. doi.org/10.1080/15389588.2016.1248760
- 12Kotler DH, Cushman DM, Rice S, et al. Fear, anxiety, and return to sport after cycling crashes: a survey of cyclists. Physical Medicine and Rehabilitation Clinics of North America. 2022;33(1):107-122. doi.org/10.1016/j.pmr.2021.08.008
- 13Pei LX, Chan H, Shum LK, et al. Demographic and clinical profile of an inception cohort of road trauma survivors. BMC Public Health. 2023;23(1):1534. doi.org/10.1186/s12889-023-16487-w
- 14National Institute of Mental Health. Post-traumatic stress disorder. NIH Publication No. 23-MH-8124. Revised 2023. nimh.nih.gov/…/post-traumatic-stress-disor…
- 15988 Suicide and Crisis Lifeline. Get help. Accessed October 2026. 988lifeline.org/get-help
- 16Federal Highway Administration. Development of crash modification factors for bicycle treatments at intersections (FHWA-HRT-23-020). August 2023. highways.dot.gov/…/FHWA-HRT-23-020.pdf
- 17Centers for Disease Control and Prevention. Get a HEADS UP on bike helmet safety (HEADS UP fact sheet). Accessed October 2026. cdc.gov/…/HeadsUp_HelmetFactSheet_Bik…
- 18Model Systems Knowledge Translation Center. Adaptive sports and recreation. 2016. msktc.org/…/adaptive-sports-and-recreat…
This article reflects the safety priorities of emotional recovery after road crashes and safety for people who walk, roll or ride. It is general education, not medical or mental health advice, and it cannot tell you when you personally are ready. Crash data and street designs change, so check official sources for current details. Talk with your own care team or a qualified professional before you change your activity. Reviewed October 2026.
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