Many of us, including yours truly, have had car accidents. Some of us major – like hitting a tree square on at 50 MPH – some of us minor – like being shunted from behind by your partner on the drive! Some of us will have severe whiplash type symptoms, some of us will have none. And in the Baltic States people don’t even know what whiplash is…
What Is Whiplash?
Well Wikipediea tells me that “Whiplash” is a colloquialism. For those who haven’t swallowed a dictionary that means slang. So in medical terms the phrase “Whiplash” means nothing. In the Physiotherapy world the term “Cervical acceleration-deceleration injury” is used. This, of course, also means nothing! Lets just call it whiplash for now and accept that it causes something to hurt in or around your neck!
What Are The Bits That Hurt Then?
Would you let me get away with saying any muscles in your neck?! I thought not! The truth is it can be though. It’s our jobs to find out which ones and why. Lets try to first understand the mechanisms and then we can discuss muscles.
So the injuries are caused by sudden acceleration and then deceleration of your head on your neck. The muscles controlling these movement may get over stretched when your head is forced too far in one direction. This will cause a tightening as the muscle heals, or maybe more correctly, get’s over the shock of the impact. As the muscles tighten, then the muscles that oppose this tightness will also over work and tighten and you can end up feeling like your neck is in a vice.
Ligaments can get involved in your pain too if yanked too far. However, these will heal with 6 weeks so anything longer standing than that will most likely be maintained by your altered movement pattern from the tight muscles. If we throw into the mix the affect of the tight muscles on the joints in then we have a good recipe for some wide ranging pain.
In very severe cases you can damage joints and nerves too but chances are if you’ve done that you won’t be able to keep your head up and you certainly won’t be reading this!
Which muscles are involved are primarily due to the direction of the impact. For straight front to back shunts the muscles involved are the ones that pull the head downwards (primarily Sternocleidomastoid) and the muscles that pull the head backwards (Splenius Capitus and Splenius Cervicis). For the impacts from the side we’re more likely to be looking at muscles on each side of the head, primarily Upper Trapezius and the Scalene muscles. For rotational direction it’s normally a complex mix of all of the above!
You’ll probably note that all of these muscles attach on or close to the skull and so can be the cause of associated headaches and migraines.
Why Do Some People Get It Really Badly?
Now obviously severity of the initial injury is a factor. But this is not the whole story. I’ve seen people walk away from major smashes and be right as rain in a few weeks. Conversely, I’ve seen people come away from a fairly innocuous bump and be in all kinds of pain for years afterwards – until of course we get our hands on them!
Which other muscles are affected by the accident are also a factor. We always assess the person as a whole when we see anyone struggling with “whiplash.” Psychological trauma is arguably the largest determinant of the amount of pain people feel. The nastier and more traumatic the experience the more the body physically holds onto the memory of that event. Almost like going into it’s shell. Still holding the body, or parts of the body, in a protective and inefficient moving pattern leading to muscles tiring, tightening and staying painful.
As we explored in our post 50 Shades Of Pain this psychological part of the condition is huge. Our main goal with our clients with the condition is to interrupt the movement patterns that are causing the pain. Get the person to see that their injuries can be eased and the movement can be pain free. When they feel the improvement the can believe they can be fixed and their own confidence in their body soon returns.
Why Doesn’t It Exist In The Baltic States?
As we just mentioned the brain is a huge factor in getting over these conditions. In the Western World and the litigation society in the which we live sometimes it is “advantageous” for us to have whiplash. This has lead to many people expecting to have neck pain after any kind of car accident. In the immortal words of renowned Physiotherapist Douglas Heel – “Whatever you believe you’ll probably be right!”
In the Baltic States no such beliefs exist. There are far less court cases and as such reports of “whiplash” type injuries after road traffic accidents are significantly lower than in the rest of the developed world. Quoting Wikipedia, here in the UK “whiplash” accounts for 14% of every drivers premium.
What Can I Do About It?
What ever you do don’t put your head in one of these neck collars. If anyone has advised you to do that please give me their details and I will shoot them! This is physiotherapy from the dark ages!
(I suppose I should put a caveat on this in that if your have a spinal fracture maybe immobilisation is ok but chances are that your first port of call would have been A&E and not this blog!)
So lets be more positive. What can we do? Keep moving it. Most of the pain will be coming from the muscles. This is because muscles have more pain receptors than joints, ligaments or other tissues. Whatever you do don’t avoid things for the fear of making things worse! When you let conditions affect your quality of life that’s only going one way. Remember pain is not damage. Just crack on, do as much as the pain will allow. Some days will be worse than others – especially if you’re having a stressful day.
If you want to start to get more movement, more freedom, less pain and get your life back we’re only a phone call away – . If not us then whoever you feel is best placed to help you. But trust me, action is better than inaction.
What If I’ve Had It For A Long Time?
Well if you’re coming to see us we like a challenge! In seriousness we find that once we have found the cause of the movement pattern that is maintaining the pain things will improve dramatically. It doesn’t seem to matter how long the pain has been there. It’s more about what we can do about it.
Get out there enjoy everything you want to do again. Banish the physical and emotional memory of that car crash. Oh, and if you’ve got whiplash from head banging to Iron Maiden too much, we can sort that out for you too!
This article first appeared on our Swindon site.
