Recovery after (pedestrian) being hit by bus

[englishgarden]

Hi,

I was recently hit by a bus whilst crossing a pedestrian crossing. The bus had almost stopped but not completely and there was a 'smack' of impact if you like. The bus hit me behind, on my bum basically (saw mark on my coat) and on my left side I think (think I sort of turned), but my memory is vague on this. I was pushed and fell on my two hands.

The pain immediately after accident:

- lower back pain and coccyx pain, pain in buttocks, esp left side
- left wrist pain
- dizziness
- some neck pain

Two or three days after accident:

- more severe neck pain
- pain in hip when moving left leg
- very strange shooting pains in bottom of head/ top of neck
-pain in left foot (it is 'tired' after being used)
-dizziness
-very tired
-psychologically not optimistic like before but I would not say I am depressed nor does the psychologist

I have been examined in A&E and by a general doctor and have now started physio (some 7 weeks after the accident!). I've had the following treatment from A&E and general doctor:

-wrist support for left wrist and didn't use wrist for a week, after that started to write again
-neck collar which I now don't wear much but at the beginning wore all the time

The following x-rays:
- head (lots of different ones)
- left wrist
- back down to the bottom of my back

- scanner for the neck (where it works with magnetism)
-MRI scan for the wrist

All of these didn't reveal anything worrying.

Now I have started physio, I have had 2 sessions and my physiotherapist seems extremely concerned. He says:

-right shoulder is completely blocked (never felt any pain before at all!)
-there are significant things wrong with my hips
- left kidney is blocked.
-problems with head muscles and neck

His advice: do things more slowly and work on aquiring 'gentleness' in my life and movements!

Info concerning my previous health history:

-rather low blood pressure
-history of fainting and dizziness
- serious nosebleeds throughout primary school (lost a lot of blood)
-slight asthma (mostly when I was younger) and hayfever
-migraines which came with the dizziness/ headaches (had stopped, didn't have them for a few years)

I was a relatively active 20 year old studying abroad and now I feel okay actually, despite the accident, but my physio is worrying me a lot (he is actually a physio and osteopath) and seems really very concerned. I am also finding it difficult to relax during physio (i've only had 2 sessions). Never really had any othr 'accidents' bar a couple of non-serious riding accidents when 12/13 (haven't mentioned this to physio - should I?). The riding accidents weren't traumatic like this bus accident and I have ridden since without problems (in fact, it was when I wasn't experienced and since then I learnt to sit better in the saddle although I currently do not ride due to the cost).

This accident has shaken me up a fair bit and my boyfriend (long term boyfriend so he knows what I'm like) has said that whilst I am in his opinion naturally gentle and loving, I have anxious moments, and that since the accident, I have become extremely anxious. I didn't really find it very helpful to tell me to be more gentle in life since I am already conscious it's something I need to work on...

Any advice about relaxing during physio and trusting that this guy knows what he's doing?!

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[gcoe]

Hi Englishgarden

It is quite normal to be shaken up by such a close shave with eternity. in fact it sounds like things are working out ok. Did the psychologist mention anything about having a bit of a reaction to the trauma? This can cause anxiety. If it is worrying you, you can always go back to the psychologist. They often have some good practical tips for managing this

With the physio: I wonder if this practitionr is the best person for you?

While only an examination can reveal wt is going on I am skeptical about some of the feedback you have received: i don't really know what the right shoulder " is completely blocked " is supposed to mean. This is not a musculoskeletal diagnosis. It is also way beyond the scope of a physio or osteopath to diagnose a kidney problem. Personally if this what he/ she actually said i sniff a rat - you may be being conned and end up getting a whole lot of treatment that isn't needed. It may be your practitioner is quite alternative. In which case you have to make up your mind whether you want to buy into that framework of therapy.

However If you are feeling a bit vulnerable at present I would tend to see someone who is can manage any resudual musculoskletal injuries in a psitve and supportive way within a framework of you becoming more physically active and empowering you to take control over your rehab

[englishgarden]

Hi, thanks for the reply. The psychologist said that in her opinion I am dealing as well as I can with what has happened. She said that I have post-traumatic stress syndrome (100% usual given what has happened), that it's normal to be tense and have anxious moments, but that the most important thing is that these are becoming less intense (which they are) and that I have a good support network of friends, boyfriend, family, work colleages (I work part-time but not much), which I do.

She said to try and keep doing what I'm doing: go back to the place where it happened (at first accompagnied) so I become less fearful, try and get out into nature, let people know that sometimes I'll be more tetchy because I'm a bit anxious.

My physio is actually French speaking (as I am in western Switzerland), but the word he used several times was quite clearly 'blocked'. With the kidneys, he also said that it was 'blocked' and troubling him. I have had extensive blood tests before though (because of fainting) and all was fine. The problem may also be that he is French-speaking and I've only been living in French-speaking Switzerland for just under 2 years, so, not sure if that is helping. There aren't many fluent English speaker physios where I live though.

The physio also specialises in something to do with energies, something to do with taking the other person's pain, which really isn't the kind of therapy I'd like. However he did say that here he has just been working as an osteo and physio. In some ways though I guess I found he was overstepping what a physio is supposed to do and moving onto more spiritual suggestions about the way I lead my life (i.e. 'need to be more gentle') etc. which just annoyed me. I found it all a bit dramatic to be honest. I'm sure plently of people have worse injuries and I'd rather he not scare me by suggesting that things are wildly wrong/ not how they should be- unless they really are, but I never got this feeling!

However, it was my doctor who advised me to see this physio, and I do 100% trust her...

[gcoe]

Hi englishgarden

It sounds like the psychologist is right on to it and is giving you good advice.and it sounds like you Re doing really well!

As for the physio it sounds to me you share some doubts about the apprpriateness of the approach. Although the dr has advised you to trust your practitioner - and I agree that it is important for the therapy that you can trust the physio, that trust has to be earned by the practitioner. If he/she is dishing out misinformation (which he/ she most certainly is) then personally I would shop around.*

By the way I am not suggesting he is deiberately lying - probably quite sincere about it. But practitioners beieve weird ideas about the body/mind just as patients do. While there remains lots of gaps in our knowledge, through good science we know a lot about how to assess and manage injuries without resorting to fanciful ideas about blocked shoulders and kidneys.*

Just a general comment: the body generally does a fantastic job of repairing itself after soft tissue injuries even without any therapy. The role of physiotherapy is to facilitate those processes and also to counter any compensatory changes that may arise. For example with pain and inflammation certain muscles often become weak so appropriate assessment and strengtheing, we can counter this. Likewise getting fit can be a great way to manage pain, improve self confidence and manage anxiety. But we often need some gidance after injury so we don't interrupt healing by overly stressing repairing tissues. While massage and mobilisation can be helpful at the right place, at the right time, on the whole we have found that taking on a more active approach of getting people going and guiding that resumption of activity is far more helpful, reduces rehab time and reduces psychogical distress.

[englishgarden]

I'm going to see the psychologist soon, just before I see the physio, so I will speak to her about my concerns. I found the physio advice rather 'wooly' but it seems that here in Switzerland they go for alternative therapies much more than in the UK, where I lived previously.

He does seem to have good intentions and generally care - i.e. fitted me into tight schedule to create 1 hr appointments instead of usual 30 mins and also he is the most popular physio at the clinic (all the other patients seem really happy) so I don't know. Maybe physio is just less concrete than other medical treatment, or there's simply a lack of communication between the practitioner and myself.

Also, I don't really have much pain, I feel okay. I went for a ~1 1/2 hour leisurely walk yesterday and felt fine. I can still walk, run (not going to but I could), dance, just feel slightly achey sometimes, but nothing extreme. At the end of last session I asked about what kind of sport or physical activity might be useful (I suggested swimming or yoga) and he basically dismissed my question and then gave the 'be gentle' advice which didn't really respond to the question of which sport might be most suitable for me...

I kind of want to believe the treatment is suitable but am still not convinced. Even the physio did say though (after 2 sessions) that he wasn't sure I was responding to the treatment in the way he would have imagined. Will see what happens next time and after talking to psychologist. I guess it's difficult to know because I've never had physio before I wasn't sure what to expect. Thanks for your comments - they echo what I found and give me a bit more info about what physio normally consists of.

[englishgarden]

Hi gcoe,

just to give a bit more info...

had physio today, was really tense and anxious at beginning (kind of dreading it) but finally I managed to concentrate on my breathing, and then it seemed to be much better. I seemed to have reached a state where I really just accepted whatever he was doing, rather than being curious, and it seemed to help. He was also more communicative today and more positive - seems that some of what he did last session has helped because he 'tested' areas again and there was improvement already. He said basically what is really difficult is that I have loads of things everywhere which need working on, due to the impact of the bus collision, and he also said I won't necessarily feel all the pain, but that doesn't mean that physio can't improve it, nor that there isn't something wrong.

I also saw the psychologist this morning, before the physio, and she helped me see it in a more positive way - i.e. someone very experience helping you mend and get back to how you were before, maybe even better, provided I don't block it and go against it. Also she mentioned that what I am feeling is not necessarily the whole picture (like the shoulder which I hadn't felt in a painful way but which I feel like I have since 'refelt' - it's kind of light and more sensation now) and that they have 6 years minimum training, so he must know his job.

The physio also said he felt this time it went much better than last time. I actually walked out feeling better, 'lighter' and much more looking forward to next session. Off to get ready for dinner with friends now. Phew!