Whiplash
Mathew Foreman, Physiotherapist
Whiplash is a real pain in the neck, and we mean that very literally.
It occurs when a sudden acceleration or deceleration force impacts the body causing the head and neck to move quickly and forcefully, for example during high force collisions such as motor vehicle accidents or contact injuries in sports. This often sees the head and neck move in one direction then another, or sometimes in multiple directions depending on the exact mechanism of injury. The pain or injury that results from whiplash is termed a whiplash associated disorder (WAD).
In severe cases of WAD, significant structural musculoskeletal or neurological injury such as fractures, disc, joint, ligamentous, nerve root, spinal cord or even brain injury can occur. Having said that, pain and dysfunction quite often occur in the absence of major structural injury. It is common for people with WAD to present with pain and dysfunction despite having undergone imaging (X-Ray, CT or MRI) which found no major structural injury. The reason is that whiplash associated disorder can have many contributing factors.
The deep muscles in the front of the neck that are strained by whiplash injuries subsequently become weaker. These muscles are important for providing the joints of the neck with dynamic support, so when they become weak or tired people often experience difficulty with prolonged activity, difficulty maintaining correct posture and may feel like their head is too heavy for their body. Secondly, the nerve pathways that provide sensory information to our nervous system about our head and neck can become sensitised following whiplash injuries. This can be due to the forceful mechanism of injury in whiplash and the nervous system adapting to continued pain.
Whiplash can be a challenging injury that can take longer to recover from than a simple sprain injury. The good news is that, once any serious structural injury has been ruled out, there are plenty of research-based management strategies for whiplash which your treating physiotherapist can advise you on to aid your recovery .
Use these 5 tips from the Advance Healthcare physiotherapy team:
Try to stay active! Don’t reduce your normal level activity too much. While you may still be experiencing pain, breaking up activity with short rest periods will assist in managing this. This is a strategy called pacing (see our blog on pacing your injury here)
Practise motor control exercises that target the weakened supporting muscles of the spine and develop the muscles groups that support good posture. Your physiotherapist can help you with these
Engage in an active and structured exercise program that helps you regain any loss of strength, movement or fitness that has occurred since the injury
Maintain a positive outlook and try relaxation exercises to help you reduce stress and negative emotion, which have been shown to be associated with a slower recovery. We love the Smiling Minds app
If your exercise and activity levels have already reduced substantially since your injury and you’re now ready to get moving again, don’t go too hard, too fast. Return to your normal level of exercise in a gradual way, making small but frequent progressions in exercise and activity each session. This will help you gradually regain strength and movement and desensitise the sensitised nerve pathways
Whiplash injuries can sometimes be painful and prolonged, however our tips are designed to move you towards a smoother recovery process, in conjunction with treatment and advice from your physiotherapist.
Mathew Foreman practices from Advance Healthcare Hoppers Crossing and Geelong. He has experience treating whiplash associated disorder and has completed post graduate studies in musculoskeletal physiotherapy.