Motor Vehicle Injuries
"Whiplash injuries are common. Chiropractic is the only proven effective treatment in chronic cases." S Khan, J Cook, et al. The Journal of Orthopaedic Medicine 21(1) 1999.
Motor vehicle injuries are a modern form of trauma, resulting in musculo-ligamentous injury, brain injuries, herniated discs and even broken bones. These unique types of injuries did not begin until the railroads were introduced in the 19th century. Travel could be injurious and even lethal at times. The degrees of injury possible in todays modern world range from "walking away" to internal head and spine injuries that don't show up on x-ray or MRI and all the way to death.
Mechanism of Injury
Nearly 1/3 of all collisions are rear impact collisions. These rear impact collisions are responsible for an overwhelming majority of the injuries people sustain.
Normal motion of the neck (cervical spine) is a smooth motion. Every single vertebra is to glide smoothly on top of each other. This allows for the simple and effortless motion of bending ones head forward and backward. At rest, the neck has a graceful "C" shape. With backwards bending, the "C" shape increases. With forward bending, the "C" shape reverses.
However, the neck motion during a rapid rear impact collision is completely different from daily bending motions. The first thing that happens to the body at impact is that the car seat pushes the torso forward while the head remains stationary. This results in the lower neck being forced to straighten and compress violently. There is injury to the neck joints, nerves and tiny blood vessels at this moment.
Next, the torso continues its forward motion. The lower neck undergoes rapid sharp bending as it is continues to be driven forward from the head (which is remaining stationary due to inertia). At this point, the neck has lost its normal "C" shape and is "S" shaped. It is here the lower neck experiences more injury, tearing and undergoes more trauma. The neck can have deep internal injuries long before the head ever moves in the proverbial "whiplash" motion.
After the moment in time where "S" shape appears, the head begins to move and is "whipped" backwards. This is the classical "whiplash" that many associate with motor vehicle collisions. Internally, there may already be internal spine injuries at this point as the outer neck muscles and tissues (there are even glands in the neck) undergo additional injury.
During this time where the neck is being injured, similiar injuries may be occuring in the low back. Injuries in part can come from the torso being violently driven forward from not only the neck, but also the low back. There is the potential for compression, shearing and violent tearing of tissues also.
This is how a relatively "low speed" collision can result in such widespread injury and disability. The injuries are all deep and internal. We know that many of the injuries to the deep spine still cannot be viewed on modern MRI, CT scan or x-ray.
Other factors can contribute to increased risk of injury are angle of collision, speed and size of both cars, road conditions, injured person's head position (looking right or left at time of impact could result in excessive tearing/injury on one side of the spine), gender, awareness of impending collision and even seat belts.
To summarize, during a collision, the head and chest are "driven" in opposite directions in a very short period of time. This results in violent, internal twisting, shearing and compression forces that are potentially injurious.
- Neck Pain
- Jaw Pain
- Thoracic Outlet Symptoms
- Low Back Pain
- Difficulty Swallowing
- Carpal Tunnel Syndrome
- Difficulty Sleeping
- Difficulty with Concentration
- If you feel any symptoms within hours up to several weeks or months post collision, you should be evaluated. Depending on the severity of the injury (not the collision) a visit to a local ER may be needed.
- Once life threatening injuries are ruled out, you need to be fully evaluated for musculo-ligamentous injury, brain injuries, herniated discs and even broken bones.
- You should seek evaluation with a doctor that has had training and is competent to do a good workup. For example, if you are suffering, you need at a minimum the trauma x-ray series. If you are treated with medication or with manual therapy, but no films have been taken, this is not the best sign.
- The doctors you seek care from (medical and chiropractic) need to be willing to co-manage your injury.
- Try to become as active as you can in a pain free range of motion, even if that range is very small.
- Exercise helps the outer muscles of the body, but not the injured joints. Injured joints typically begin to malfunction. This is termed vertebral joint dysfunction. Joint dysfunction from injury responds best to appropriate manual therapy, not exercise.
To summarize, once life threatening injuries from a motor vehicle collision have been ruled out, schedule a chiropractic exam to assesses the nature and severity of your injuries. Once a working diagnosis has been reached, then specific and appropriate treatment and advice can be given.
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