Picture yourself driving when, suddenly, your car gets rear-ended. The result? A sudden and unexpected jolt that can have a significant impact on your body.
During such an incident, your body undergoes a sequence of rapid movements.
Initially at rest, your torso lurches forward due to the force of the collision. However, your head, due to inertia, stays momentarily behind. This causes your neck to extend backward forcefully, leading to an abrupt strain on muscles and tendons.
Then, as your head catches up with your body's forward movement, it snaps forward rapidly, causing an intense flexion of your neck. This series of motions characterizes what we refer to as a whiplash injury, or more accurately, a Whiplash Associated Disorder (WAD).
WAD manifests in various distressing symptoms following an acceleration/deceleration injury to the neck, commonly occurring in motor vehicle accidents (MVA).
Symptoms can be diverse, ranging from neck pain and stiffness to dizziness, tingling or numbness in the upper extremities, headaches, and arm pain.
From my experience, the most common complaints I encounter among individuals suffering from WAD include musculoskeletal pain and limited movement, decreased neuromotor control and weakness, and radiating symptoms into the upper extremities.
I understand the challenges and frustrations that accompany such injuries. The discomfort, both physical and emotional, can be overwhelming. However, I want to assure you that there are effective treatments available to address these symptoms.
In this article, I'll guide you through my approach to treating neck pain and the specific impairments resulting from a whiplash injury. My goal is to offer practical solutions and guidance to help you in your recovery journey.
So, if you're dealing with the aftermath of a whiplash injury, know that you're not alone, and there are strategies and treatments that can make a meaningful difference in your healing process.
Before we discuss how to treat whiplash
Understanding the prevalence and implications of whiplash injuries is crucial before delving into the complexities of its effects and treatments. Whiplash injuries, often arising from motor vehicle accidents (MVAs), have a significant and widespread impact on society.
In Europe and North America, statistics reveal a substantial number of individuals seeking emergency care due to whiplash injuries, with over 300 people per 100,000 affected annually. Moreover, in Australia, approximately 75% of survivable road traffic crash injuries are attributed to whiplash-related incidents. 1
The financial burden imposed by these injuries is staggering. In the United States alone, the costs associated with whiplash injuries reached a staggering $230 billion annually in 2000. These figures underscore the significant economic and social consequences resulting from the prevalence of whiplash injuries in modern society. 1
Diagnosing Whiplash Associated Disorders (WAD) primarily relies on the symptoms reported by patients. Symptoms typically include neck pain and related discomfort following a traumatic event, commonly a motor vehicle accident. The Quebec Task Force provides a classification system categorizing whiplash injuries into grades ranging from WAD I to WAD IV, based on the severity of signs and symptoms. 1
Most frequently, WAD II—characterized by neck pain and musculoskeletal signs such as decreased range of motion and localized tenderness—is encountered. In many cases, especially when no progressive neurological deficits are present and red flags are excluded, imaging studies might not be deemed necessary.
This emphasizes the importance of seeking evaluation by a qualified healthcare professional, such as a physical therapist, to accurately assess the condition and rule out any emergent conditions or complications. Their expertise in recognizing the signs and symptoms associated with whiplash injuries can be crucial in guiding appropriate care and intervention.
Understanding the factors contributing to your recovery is pivotal in regaining functionality post-whiplash. These limitations can significantly impact your daily activities, including driving and various routine tasks.
Musculoskeletal pain and restricted movement
Whiplash clients commonly report a range of impairments including pain, restricted range of motion, muscle weakness, joint stiffness, tightness, and fear of movement.
The injury causes dysfunction and damage to the joints and muscles in the neck, often leading to complaints of neck pain accompanied by cervicogenic headaches. These headaches stem from issues within the upper cervical spine joints.
Manual therapy proves effective in facilitating muscle relaxation, enhancing blood circulation, improving range of motion and strength, and desensitizing aggravated tissues. I've explored in detail how different manual techniques can effectively treat cervicogenic headaches in this article.
Addressing pain-related muscle weakness necessitates integrating diverse exercises tailored to strengthen the neck and shoulder areas, crucial in whiplash injury rehabilitation. Collaborating with a physical therapist allows for an individualized plan focusing on the specific muscles requiring strengthening and guiding safe and effective recovery strategies.
My favored approach involves the synergistic use of manual therapy and targeted exercises.
While rest is essential initially following the injury, I emphasize an active approach to restore your previous level of function.
Movement is key to your recovery journey.
An active return to daily activities helps in the overall healing process, and together, we work towards gradually restoring your function and mobility.
Decreased neuromotor control and weakness
One of the most common questions that I get asked in the clinic is “Why does my head feel so heavy?”
In the clinic, I like to describe a whiplash injury similar to an ankle sprain. When you sprain your ankle, most commonly a lateral ankle sprain, the ligaments and soft tissues become overstretched or torn which affects all sorts of nerve endings and mechanoreceptors.
When this happens, the tissues become weak and lose neuromotor control. This is why we can tend to see those with chronic ankle sprains having hypermobility and/or more “floppy” ankles requiring us to strengthen and build that control and support back up. Well, the same thing happens with the muscles of the neck and shoulders.
The deep neck flexors, small muscles that attach deep down from one cervical vertebrae to the next, are responsible for maintaining postural stability in the head and neck. After a whiplash injury, these small muscles lose their ability to stabilize and the much larger trapezius and sternocleidomastoid muscles can tend to overwork to make up for the difference in muscle balance, leading to more pain.
By performing specific postural re-education exercises with slow, intent movements we can help train your neck muscles to get back to their original function. To keep it short, I’ll talk a bit more about what types of exercises I find beneficial in a future post, stay tuned!
Radicular symptoms into the upper extremity
Cervical radiculopathy occurs when the nerve roots emerging from the cervical and upper thoracic spine endure compression due to a herniated disc or damage/degeneration of the cervical facet joints, often resulting from an MVA.
This compression leads to neural tension, causing sensations of pain, numbness, tingling, or weakness that radiate down into the affected arm, severely impacting daily function.
A physical therapist employs various diagnostic tests to identify the likely source of your symptoms. Additionally, there are specialized techniques that can be utilized or taught to alleviate and improve these symptoms.
These techniques may involve specific exercises such as nerve glides or nerve flossing, postural re-education exercises, or hands-on approaches like traction and decompression to alleviate your symptoms.
It's essential to understand that nerves possess the ability to heal. However, they are among the slowest tissues in the body to regenerate. It's important to acknowledge that significant improvement and desensitization of the nerve tissue may take time and consistent effort.
Final thoughts
I firmly believe exercise and manual therapy are critical in the recovery process for any specific musculoskeletal strength or movement impairments and employ both interventions in my treatment style.
Educating my clients about their condition by teaching about the functional anatomy and biomechanics of the head and neck as well as evaluating their functional limitations are and explaining how these different impairments are affecting their function has been the most important factor in helping my clients get out of pain faster.
Discussing how pain affects the peripheral and central nervous system and the benefits that physical therapy can provide are the fastest way to get a client’s nervous system to downregulate and allow the rehabilitation process to begin.
It is important to remember that your mind and body are very powerful, and with the right guidance you can learn to use the both of them to heal and take back control of your life.
If you suffer from whiplash or have any specific questions about how to treat whiplash, schedule a free phone consultation with me by clicking here and filling out the form with your information!
**Disclaimer: The information provided in this article is intended for educational and entertainment purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for personalized guidance and recommendations regarding your specific health concerns. The content presented here is based on general knowledge and research available up to the date of this article's publication. Any reliance on the information provided is at your own discretion and risk. The author and publisher do not assume any liability for any actions taken based on the information presented in this article.
References:
Sterling, M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy, 60(1), 5–12. https://doi.org/10.1016/j.jphys.2013.12.004
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