Understanding whiplash is important since whiplash injuries to the neck frequently occur from motor vehicle accidents. Unfortunately, during the recovery process these injuries are often mismanaged.
A rear-end collision is the most common cause for injuries for the following reasons. Often you do not see the impact coming so you do not brace yourself adequately to absorb the shock. More importantly, there is little support for your head and neck while seated in a car. Upon impact your head and neck rapidly move backward to a hyperextended position and then forward to a hyper-flexed position. Quite simply the force of impact stretches your neck beyond its normal range of motion.
Muscles and ligaments are the structures in your neck that help restrict abnormal ranges of motion. For that reason, it is understandable that these tissues become sprained and strained from the abrupt movements or, in this case, upon impact.
Commonly misunderstood is the effect of hyperextension of the neck. Hyperextension generally causes the most damage to muscles and ligaments in both the front and the sides of the neck. This is true despite the fact that the victim complains of pain in the posterior aspect of the neck and shoulders. Palpation of soft tissue around the neck a few days after an accident will often uncover those tissues most involved.
It is common for people to not experience discomfort in their neck for several days or weeks following the accident. This is because it is easy to rest your neck and not place excessive forces upon it from activities of daily living. So an active inflammation process could be going on but not experienced because of your ability to somewhat protect your neck.
What occurs is that the soft tissue heals in a weak manner. You may not be aware that you have a problem until you do something stressful with your neck sometime later. By then, the changes that have occurred may be long lasting.
Understanding Whiplash – Treating This Condition
Injuries to the soft tissue around your neck need treatment in a way similar to any injury to soft tissue. You must first control the inflammation. Moist heat on an inflamed tissue will only cause the inflammation to worsen. You must follow progressive anti-inflammatory techniques including medication and ice therapy. Cervical collars are only appropriate when there is a significant injury requiring partial or complete immobility. As discomfort changes from pain to stiffness, you can begin to introduce heat in combination with ice.
Within the first 10 days of the injury, it is important to begin flexibility and strengthening exercises for the muscles and soft tissues around the neck. This will help prevent scar tissue formation and will accelerate the healing process. As soon as the neck is somewhat stable, it is extremely important to follows a complete general conditioning program working on strength, flexibility and aerobic conditioning for the upper quarter. People tend to become inactive following an accident, further adding to the significance of the soft tissue injuries in the neck. Regular exercise will prevent associated soft tissue from the effects of inactivity. Finally, if you question the severity of your injuries, obtain an evaluation from your medical professional. Infrequently, more severe injuries such as vertebral fractures and nerve irritation can occur.
Thomas Suspenski, PT, ATC
797 E Lancaster Ave. Suite 2
Please refer to patient education for other brief articles in our educational series. It is through these articles, in part, that we keep our patients (and others) informed of common injuries and conditions, their treatment and healthcare in general.