Whiplash Injuries

Whiplash Injuries are most often the result of a car accident (usually a rear-end collision). It can also be caused by a forceful collision in physical sports such as football, basketball and soccer or in a serious fall or even from amusement park rides.

The term whiplash refers not to one particular injury but to a violent forward/backward or lateral motion of the head, which usually causes multiple neck injuries. It is really a sprain/strain or a cervical flexion/extension injury.

 Whiplash refers to the whipping movement of the neck forward and backward in the course of an accident or collision.  It does not refer to the actual specific injury. The neck itself has made a whip-like motion bending first towards and then away from the point of impact. As the head moves rapidly in one direction, the muscles in the neck receive the message to contract. The momentum of the head can cause strain or sprain to the muscles and ligaments in the neck as the head reaches the end of its movement.

Cervical sprain refers to the damaged ligaments.  Cervical strain refers to the injured muscles/tendons. Cervical Sprain is the most common neck injury.  The direction of the force can influence the severity of the injury.

Traditionally, a cervical collar has been part of the treatment for whiplash injuries. Whitney Lowe in his article on whiplash injuries at Massage Magazine says:

"Most practitioners now realize that unless there is a severe level of damage, early, protected mobilization is far more beneficial than immobilization in a collar."

Three physical mechanisms that help explain the severity of whiplash are:

1. Stretch Reflex - The muscle spindle and Golgi tendon organs trigger a contraction resulting in a rebound movement know as the stretch reflex mechanism.  The overstretching of tissue combined with a strong reflexive contraction results in muscle, tendon and ligament tears.  Capsular ligaments of the facet and the discs are also at risk.

2. Magnification of Acceleration - The rebound movement is compounded by the need for the head to catch up with the body. (After all it is connected.) Acceleration is magnified based on the mechanical structure of the neck and the physics of the movement. For every action there is an equal and opposite reaction.  This is magnified in whiplash injuries due to the contraction of the muscles in response to the overstretch, thereby increasing the acceleration and speed of the reaction.

3. Compression - The head moves through space via the shortest path - a straight line instead of through it's normal arc.  These forces can cause a shearing effect in the disc which can contribute to disc degeneration and the early onset of osteoarthritis.  These are a complication of whiplash injuries that do not show up for months or even years which is why it is important for people with such injuries get help with their whiplash compensation claims.  The result of this movement is a downward g-force equal to approximately 2000 to 3000 pounds per square inch depending on additional factors (acceleration, friction, inertia, force, mass, seatbelts, headrests, direction of the head on impact, genetic predisposition and more.

Signs and Symptoms (Refer to Doctor!):

1. Nausea

2. "feels like my head will fall off if I lean back" - injury of posterior cervicals

3. "feels to weak to hold my head up"- injury of the anterior cervical spine and SCM's)

4. Vertigo- possible nerve impingement in upper cervicals

5. lack of cervical extension, accompanied by dizziness and nausea

6. blurred vision, tired eyes

7. weakness or tingling down the arms

Cervical Assessment

Contraindications

Articles

Whiplash by Ben Benjamin on Massage Today

Cervical Injuries 3 part series- Ben Benjamin on www.massagetherapy.com 
      Cervical Injuries: Part 1 Essential Principles
      Cervical Injuries Part 2
      Cervical Injuries Part 3 - Treatment

Successfully Treating Cervical Trauma Using Deep-Tissue Techniques By Don McCann, MA, LMT

Learn how to bill for Whiplash Claims

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