With more and more cars on the road there becomes chaos, and with chaos on the road there are accidents. Correlated with car accidents is commonly whiplash associated disorder or ‘WAD’. Whiplash is defined as an acceleration-deceleration mechanism of energy transfer to the neck; consequently leading to bony or soft tissue injuries which inturn may show a variety of clinical presentations. This injury is peculiar as it is not uncommon that symptoms may reside hours after the initial injury. WAD is most commonly presented with pain, stiffness, cervical muscle soreness, headaches and dizziness. In high velocity WAD deafness, memory loss, dysphasia and temporomandibular pain may also be present.
There are 5 grades of whiplash that we typically place people in to facilitate a swift recovery:
0 – no complaint in the neck and no signs
I – complaint of neck pain but no physical signs
II – complaint of neck pain and musculoskeletal signs (for example decreased range of motion)
III – complaint of neck pain and neurological signs (sensory defecits, weakness or decreased tendon jerk reflexes)
IV – complaint of neck pain and fracture/dislocation
Approximately 90% of WAD cases are classified as grade I-II.
Factors that most likely lead to a prolonged recovery:
· Higher initial neck pain levels
· Post-traumatic stress symptoms
· A negative expectation of recovery
· On going cervical range of motion problems
· Cold hyperalgesia (increased neurological sensitivity to pain)
In recent years the modified scope of treatment has been in promoting movement. Reintroducing gentle movement into areas that have experienced trauma allows for the direction of tissue being rebuilt to be laid in the natural direction. Gentle range of motion exercises allow for the maintenance of the mobility in that joint, if cessation of movement occurs it often leads to stiff and increased pain in muscles and cervical joints. A slight decrease in activities is often recommended in order to limit the chance of aggravating the injured site however gentle range of motion exercises should be prescribed and started ASAP. Examples of a few good exercises include:
· Chin tuck/neck retraction exercises
· Head rotation exercises in sitting or lying
· Chin nod exercise in lying
· Side bending in sitting
· Isometric rotation strengthening exercises
· Neck extension or rotation in 4-point-kneeling
Many studies show that conservative management of WAD has the greatest effect on recovery. Recommended treatments include:
· Exercise (stretching/strengthening/postural adjustments)
· Manual therapy
· Thoracic manipulations
· Trigger point needling
What do avoid?
COLLARS – One of the main recommendations concerning WAD is to keep mobile. Collars and cuffs aim to cease movement around the neck meaning that the joints/muscles stiffen up further and prolong recovery.
MUSCLE RELAXANTS – Centrally acting muscle relaxants are not advised as they do not act specifically on the muscles that have been injured.
No two spines are the same; therefore no two WADS’ are the same. At Thornleigh Performance Physiotherapy we pride ourselves on being able to cater treatment individually and can assure you that we will do whatever it takes to get you back to full health as quick as we can.
If you have any questions regarding your whiplash pain, or were interested in seeing if we can help you, feel free to give us a call. Here at Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, as well as advice on the best course of action for your condition to get you back in action sooner than you could’ve imagined. We have an expertise in musculoskeletal physiotherapy and are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Wahroonga, Westleigh, West Pennant Hills, and West Pymble. So give us a call on (02) 8411 2050 to get started on a journey to a better you.