It happens in a heartbeat. One second you're stepping off a curb or checking a blind spot, and the next, the world tilts. Getting run over by a car is fundamentally different from being struck by one. When a vehicle hits you, there’s an impact, a secondary flight through the air, and then the ground. But being "run over" implies the weight of a two-ton machine actually passing over a human body. It is a specific, terrifying category of trauma that emergency room doctors and trauma surgeons treat with a very particular kind of urgency.
Physics is a cruel master.
When you think about the average sedan, you’re looking at roughly 3,000 to 4,000 pounds. SUVs and trucks? They easily push 6,000 pounds. If a tire moves over a limb or a torso, that weight isn’t just a number on a spec sheet anymore. It becomes a crushing force that exceeds the tensile strength of human bone and the elasticity of internal organs.
The Biomechanics of a Run Over Accident
Most people assume the impact is what kills. Often, it’s the compression. Trauma surgeons frequently categorize these injuries into "crush" and "shear." When a tire rolls over a person, it doesn't just press down. It also pushes forward. This creates a degloving effect. Basically, the skin and the underlying fascia are ripped away from the muscle and bone because the friction of the tire is moving in a different direction than the body’s inertia. It’s gruesome, honestly.
Speed changes everything, but maybe not how you think. At low speeds—think a car backing out of a driveway—the injury is almost entirely compressive. The bones snap under the steady weight. At higher speeds, the body is often knocked down first and then the wheels pass over it. This "knock-down-and-roll" sequence is why pedestrian-vehicle incidents have such a high mortality rate. According to the National Highway Traffic Safety Administration (NHTSA), pedestrian fatalities have been climbing steadily over the last decade, reaching levels we haven't seen since the early 80s.
It’s a physics problem. Modern cars are taller. Higher grilles hit humans in the chest or head rather than the legs. If you're hit in the chest and then pushed under the car, your chances of survival drop off a cliff.
What Actually Happens to the Body?
Let's get into the weeds of the medical reality. When a human is run over by a car, the most immediate threat isn't always a broken bone. It's internal hemorrhaging.
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Solid organs like the liver and spleen are basically sponges filled with blood. Under the pressure of a vehicle’s tire, these organs can rupture or "shatter." Surgeons at Level 1 trauma centers—places like Bellevue in NYC or Cedars-Sinai in LA—often use a grading scale for these lacerations. A Grade V liver laceration is essentially the organ being torn into pieces. You can’t "stitch" that back together easily.
Then there’s the "Pelvic Ring."
Think of the pelvis like a pretzel. It’s hard to break a pretzel in just one place. If the weight of a car passes over the hips, the pelvic ring usually snaps in at least two spots. This is a massive medical emergency because the pelvis is home to several major arteries. You can lose your entire blood volume into your pelvic cavity in a matter of minutes without a single drop of blood ever touching the pavement.
- Chest Compression: This leads to a "flail chest," where multiple ribs are broken in multiple places, leaving a segment of the chest wall floating. It makes breathing nearly impossible.
- Pneumothorax: A broken rib can puncture a lung like a needle into a balloon.
- Traumatic Asphyxia: This happens when the pressure on the chest is so great that blood is forced backward from the heart into the veins of the neck and head. It’s rare but unmistakable to paramedics because of the deep purple discoloration it leaves on the victim's face.
The "Run Over" vs. "Struck By" Distinction
In legal and insurance worlds, these terms aren't interchangeable. If you're "struck," you might have a claim against the driver for negligence in braking. If you're "run over," there's often an investigation into "last clear chance" or whether the driver should have felt the bump and stopped.
Kinda weird to think about, but the legal nuances can change a victim's recovery path. Personal injury attorneys often look for "crush patterns" on the clothing. Tire tread marks on skin or fabric are definitive proof of a run-over event, which usually implies the driver was completely unaware of the pedestrian's presence.
Why SUVs are Deadlier
It's not just the weight. It’s the geometry.
Smaller cars tend to hit people low, causing leg fractures but often flipping the person onto the hood. This is actually "safer" (if you can call it that) because the hood acts as a crumple zone. SUVs have a high, flat front. Instead of being tossed onto the car, the victim is pushed downward. Once a person is under the vehicle, the "run over" becomes almost inevitable.
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The Insurance Institute for Highway Safety (IIHS) has released multiple studies showing that vehicles with hood heights greater than 40 inches are roughly 45% more likely to cause a pedestrian fatality than those with heights of 30 inches or less. It’s a literal wall of steel.
Survival and the "Golden Hour"
If someone is run over by a car, the next sixty minutes are everything. This is what trauma docs call the "Golden Hour." If the patient doesn't get to a surgical suite within that window, the risk of death from "the lethal triad" (hypothermia, acidosis, and coagulopathy) skyrockets.
Internal bleeding is the silent killer here. A person might be conscious and talking right after the car moves off them. Adrenaline is a hell of a drug. But inside, they are bleeding out. This is why paramedics will almost always apply a pelvic binder or use "Stop the Bleed" protocols immediately.
Compartment Syndrome: The Secondary Threat
Even if someone survives the initial surgery, they aren't out of the woods. Compartment syndrome is a nightmare. When a limb is crushed, the muscles swell. But muscle is wrapped in tough tissue called fascia that doesn't stretch. The pressure builds up so high that it cuts off blood flow to the rest of the limb. If a surgeon doesn't perform a fasciotomy—literally slicing the limb open to let the muscle swell—the tissue dies, and amputation becomes the only option.
The Long Road Back
Recovery isn't just physical. It’s psychological.
Most survivors of being run over by a car deal with significant PTSD. The sound is what they remember. The sound of metal on bone or the "thud" of the tire.
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Physically, we're talking about years of physical therapy. Pelvic fractures often mean months of being non-weight bearing. You’re stuck in a bed or a wheelchair, waiting for the "pretzel" to knit back together. Nerve damage is also common. If a tire rolls over a shoulder, it can stretch the brachial plexus—the bundle of nerves that controls the arm—leading to permanent paralysis of the hand or fingers.
What to Do If You Witness This
If you see someone get run over, don't just stand there. But also, don't move them.
- Call 911 immediately. Give them the exact location and tell them it’s a "pedestrian vs. vehicle with a run-over." That specific phrasing triggers a higher-tier response.
- Keep them still. If they have a spinal injury or a fractured pelvis, moving them could sever an artery or the spinal cord.
- Talk to them. Keep them conscious. Ask their name. Tell them help is coming.
- Stop any visible bleeding. If there's a spurting wound on a limb, use a belt or a cloth as a makeshift tourniquet, though a real one is better.
Actionable Insights for Victims and Families
If you or a loved one are navigating the aftermath of being run over by a car, there are specific steps that matter more than others in those first few weeks.
1. Secure the Evidence Early
Don't wait for the police report. Police are often overworked and might miss things. If there were witnesses, get their numbers. If there are businesses nearby, ask for their security footage within 48 hours. Most systems overwrite data every 3-7 days.
2. Document the "Minor" Injuries
The doctors will focus on the broken femur or the ruptured spleen. You need to document the "road rash," the bruising, and the psychological state. These "minor" things are huge factors in long-term disability claims. Take photos of everything once the patient is stable.
3. Request a Trauma Social Worker
Most Level 1 trauma centers have them. They are the bridge between the medical world and the real world. They can help navigate the insurance nightmare that follows a catastrophic accident.
4. Understand the "Maximum Medical Improvement" (MMI)
In the legal sense, you shouldn't settle any claims until you reach MMI. This is the point where doctors say, "this is as good as you're going to get." If you settle before then, you might realize six months later that you need a $50,000 hip replacement that isn't covered.
The reality is that the human body is remarkably resilient, but it has limits. Being run over by a car tests those limits to the extreme. The path forward is rarely a straight line, but understanding the physics and the medical stakes involved is the first step toward reclaiming some sense of control.
Next Steps for Recovery
- Seek out a specialized trauma therapist who deals with "motor vehicle accident" (MVA) PTSD.
- Consult with a physiatrist—a doctor who specializes in physical medicine and rehabilitation—to create a long-term mobility plan.
- Keep a "pain and limitation" journal to track how the injuries affect daily life, which is vital for both medical and legal documentation.