What is Whiplash ?
Whiplash is usually known in literature as an acceleration and deceleration injury to the cervical spine ( the cervical spine makes up the bones of the neck).
Whilst a car accident is by far the most common cause for whiplash we have also seen cases at Mullumbimby Chiropractic caused by ski-boat accidents, surfing, parachute jumping and even heavy metal dancing (hard to believe, but true).
To understand how a whiplash injury occurs it is useful to have a look at the cervical spine and the forces involved in an acceleration and deceleration injury.
The cervical spine has sacrificed its stability for mobility. That means it has a finely built bone structure and depends on its muscles and ligaments for support and protection. This allows us to turn our heads and look around when reversing a car.
The disadvantage is that the muscles and ligaments of the cervical spine are often damaged when intense accelerating and decelerating forces are applied in, for example, a car accident.
Anatomy of a Whiplash Injury
One thing that really amazed me when I first began to work with whiplash injuries, is the time delay.
Usually you have an car accident, walk away and think: “wow that what was close.” But then later you find out it wasn’t close, you have in fact been injured.
Thankfully fractures of the spine (the most serious of complications) are very rare. A more common injury is significant injury to the soft tissues. The soft tissues of the spine are small muscles, ligaments and nerves. Often, the problem is worse when you saw the collision coming, as you tense your muscles more before impact which allows them to tear more easily.
The pain initially settles down after about a week and then things start to go a bit pear-shaped. About 4-6 weeks after the initial accident the pain often gets worse and the injuries you were would have healed, has not.
So what has gone wrong?
The answer lies in how the forces work when your spine is injured in an acceleration and deceleration injury.
There are 2 forces are at work here:
1. Hyperflexion:
The neck is rapidly forced forward so that the chin is moved towards the chest. This leads to tearing of large muscles at the back of your spine (like the Trapezius), tearing of small ligaments that run between each vertebra in the spine, and possibly tearing of the cervical spinal discs.
2. Hyper-extension:
The neck is rapidly extended so that the back of the head is forced back and down towards the spine. This causes tearing of the muscles at the front of your neck (such as the SternoCleidoMastoid (SCM)) and can also cause damage and swelling in the facet joints and capsules which control movement at the back of the spine ( See diagram below).
Chiropractic Management of Whiplash Injuries
It is essential to first establish exactly what happened and rule out any chance of a more unstable injury (such as fracture). It is surprising how many fractures go undiagnosed after a whiplash injury; some of these being very unstable and dangerous. An x-ray after a significant injury to the neck is almost always required, even when you might feel like you are “ok.”
When fractures have been ruled out, the next step is to restore a normal range of motion as promptly as possible. Recent studies have shown that using soft collars for more than 72 hours after the accident is likely to prolong the recovery time and lead to a loss of the normal range of motion.
Chiropractic treatment focuses mainly on decreasing pain and stiffness in the neck. As the injury begins to settle, we also look at restoring good joint motion in each of the affected spinal segments.
If there is one important take-home message with whiplash injuries its: slow down and be patient. Ligaments take much longer to repair than bones and muscles due to their poor blood supply.
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