For a lot of people with a back that got hurt in a crash, the worst part of driving is not the drive. It is the door. Lowering into the seat in the driveway. Climbing out in the parking lot at work. The grocery store on Gravois, where the space next to you is tight and you have to twist to get your legs out. Ten seconds, twice per trip, and it is the moment that makes you catch your breath.

This chapter is about those ten seconds: why they are hard on a sore low back, a few ways people make them easier, and why how you get in and out of a car is worth describing at the exam.

Why the car is the hard part

Getting into a car asks a back to do several things it would rather not do while it is sore, and to do them all at once:

  • Lower the hips below the knees. Most sedan seats sit low, so you are squatting into them without much to hold.
  • Twist while bent. The usual way in is one leg first, then a rotation of the body, then the second leg. That rotation happens with your weight half on the seat and half on one foot.
  • Balance on one leg. Lifting the second leg over the door sill takes the support away from one side of the pelvis.
  • Pull or push with the arms. Grabbing the roof or the wheel to haul yourself in or out moves load through the back.

Tall trucks and SUVs trade the squat for a climb. A running board, a grab handle and a big step down all put different demands on the same sore back. Neither kind of vehicle is easy after a crash. They are just hard in different ways.

Getting into a sedan

A method many people with sore backs find easier is to sit first and turn second, instead of stepping in one leg at a time:

  1. Move the seat back as far as it goes before you start, so your legs have space.
  2. Stand with your back to the open door, the backs of your legs close to the seat.
  3. Put one hand on the door frame or the seat back and lower yourself straight down onto the seat. Keep your head low so you do not hit the roof.
  4. Keep your knees together and turn your whole body, hips and shoulders at once, lifting both legs into the car together.
  5. Bring the seat forward to driving position once you are settled.

Some people put a plastic bag or a slippery folder on a cloth seat so the turn slides instead of drags. Take it out before you drive.

Getting out

Reverse it. Move the seat back. Turn your whole body toward the door with your knees together and put both feet on the ground. Scoot to the edge of the seat, put a hand on the door frame, and stand straight up, using your legs rather than pulling on the roof. Take a second before you walk.

If the first few steps after a drive are stiff, that is common. Note how long it takes to ease off. That is useful information for an examiner.

Trucks and SUVs

With a taller vehicle, face the seat when you climb in. Use the grab handle for balance more than for pulling. Step onto the running board, then turn and sit, then bring the legs in together. Getting out, turn toward the door first, step down to the running board, and then to the ground. Do not jump down from the seat. That landing goes straight up through the low back.

Small things that help

  • Park where the door can open all the way. An end spot or a space beside a curb island is worth a longer walk.
  • Put everything within reach before you sit. Phone, keys, sunglasses and your bag on the passenger seat, not on the floor behind you.
  • Let someone else load the trunk. Lifting groceries out of a trunk means bending forward and lifting while reaching, which is often worse than the getting in and out.
  • Hand off the child seat for a few days. Leaning into a back seat to buckle a child is one of the harder things a sore back is asked to do. If someone else can do it this week, let them.
  • Ride instead of drive, if you can. A passenger can take the method slowly without a line of cars waiting.

None of this is treatment. It takes the avoidable strain out of something you have to do anyway. The week between chapter covers sitting, sleeping and driving in the days before the exam.

What the car tells the exam

An examiner learns a lot from how a person moves, and getting in and out of a car is one of the most specific movements you can describe. At the visit, be ready to say:

  • Which part hurts: lowering down, the turn, lifting the legs, or standing up.
  • Where it hurts when it happens, and whether it is a sharp catch or a slow ache.
  • Whether you need your hands to get out, and whether that is new since the crash.
  • Whether it is worse after a short trip or a long one, and how long it takes to walk normally afterward.

"I have to use both hands on the door frame to stand up from my car, and the first five steps are short" is a much better sentence than "my back is sore." It gives the exam something specific to check, and it sets a line you can compare against in a few weeks. The first visit chapter covers the rest of what to bring.

When it is not a door problem

If you cannot get out of the car because a leg will not hold you, or there is new numbness in the groin or inner thighs, or you have lost control of your bladder or bowels, that is an emergency room trip right now, not a clinic call. The same goes for chest pain or a severe headache. The ER or clinic chapter has the full list.

If the door is the hardest part of your day, get the back examined this week at Missouri Injury Clinic. When you call Tesson Ferry at (314) 530-5480, Hazelwood at (314) 627-1411 or O'Fallon at (636) 280-0990, ask where to park and how far the walk is. Addresses and hours are here.