Whiplash is a term used to describe the mechanism of injury whereby the whipping action of the neck is caused by an acceleration-deceleration movement, the most common being motor vehicle accidents. We use the term whiplash associated disorder (WAD) for this injury. The most common symptoms of WAD include:
- Neck pain and stiffness
- Worsening pain with neck movement
- Reduced range of motion in the neck
- Shoulder, arm or hand pain or pins and needles/numbness
- General fatigue
It is important to note that there can be a delay in symptoms for up to 48 hours following the whiplash injury. Other less common symptoms can also include ringing in the ears, blurred vision, memory problems, difficulty concentrating, vertigo, anxiety and irritability.
What causes Whiplash?
Any injury that forces the neck into a whipping like motion can cause whiplash to different degrees. The three main causes are:
- Motor Vehicle accidents – by far the most common cause of whiplash associated disorders. In particular rear end collisions that force the head back and then to whip forward
- Contact sports – e.g. getting tackled playing rugby league
- Assault or fighting – e.g. being punched or shaken roughly.
What happens to the neck during Whiplash?
The most common type of whiplash is a rear end motor vehicle accident i.e. being rear-ended. This picture illustrates exactly what movements go through the neck when this happens:
As you can see across the pictures, accidents put a lot of pressure on the neck in different manners; first compressing the back of the neck and then stretching the back of the neck. This can result in injury to any of the structures around the neck most commonly the ligaments, muscles, joints and bones in the neck.
How does Physiotherapy help treat my whiplash?
Physiotherapy for whiplash associated disorders is the cornerstone of treatment. Physiotherapists have a detailed understanding of the anatomy underpinning the disorder and have vast amounts of “hands on” experience treating patients with whiplash conditions. During our initial assessment we will take a detailed history of the exact incident and symptoms you have and conduct a physiotherapy assessment. Some important aspects of the assessment will include: assessing your pain level, neck range of motion, any arm or lower back pain and headaches, during this stage we may also use questionnaires and in more severe cases look at imaging such as X-rays or MRIs to get a more complete picture of your symptoms.
Once we have an overall assessment of your WAD we can begin treatment straight away in our first session. Every case of WAD is different depending on your exact mechanism of injury however treatment can be thought of in three distinct stages.
Stage one’s goal is to help settle the pain and discomfort. We will use treatment tools such as massage, gentle mobilisations, passive movements and gentle exercises. It may be the last thing you feel like doing but evidence-based practice suggests that it is important to move your neck early and often to help reduce pain. It is important to do this in a way that does not significantly increase in your symptoms. These active movements can be quite subtle and need to be guided by our physiotherapists to ensure you know how to activate the right muscles.
Stage two involves progressing the exercises to strengthen and improve the postural control of your neck muscles. We will give you a home exercise program specific to your deficits and ask you to do these exercises multiple times per day. This is where we will need you to be consistent and diligent with your home exercise program.
Stage three involves transitioning towards any sport specific movements such as running, jumping, changing direction with a focus on neck control and positioning during such movements.