As we end the year and enter the winter season and the likely occurrence of bad driving weather, I wanted to discuss the most common motor vehicle accident (MVA) injury we see, Whiplash Associated Disorder, also referred to as WAD. Although MMD Chiropractic is not considered an MVA clinic, we do and will see a handful of MVA injuries every winter.
Motor vehicle accident injuries can be minimal or quite extensive with multiple areas of injury. The most common injury is to the spine, in particular, the neck, due to the fact that we don’t physically restrain the neck when we drive. A seat belt has 2 sections, a lap belt and a chest belt. This will 1) restrain the body from ejecting from the car, but will also 2) prevent excessive forward motion of the body. But the neck is freely able to move. And even if airbags go off, our neck can still sustain injury.
When hit from the back, first our neck goes backwards into extension, then forwards into flexion, and depending on the amount of impact, this motion may repeat a few times. When hit from the front, the opposite actions will occur. First flexion of the neck followed by extension. When hit from the side, lateral flexion of the neck or side bending will occur, first to the side being hit on then to the other side. But each accident may be slightly different depending on the circumstances of the accident. Regardless, the motions of the neck first go through an accelerated motion, then a deceleration to stop the motion. During this phase of deceleration, the muscles and ligaments can be damaged or torn.
WADs are graded based on the severity of the symptoms. See the chart below.
The majority of WAD injuries are minor, in the WAD I or II grades. The main difference between these two classifications is mobility. But keep in mind that there have been minor tears to muscles, the definition of a strain, and to ligaments, the definition of a sprain. It is not unlikely for this sprain/strain to take 2-3 months to heal fully. As the grade of the WAD increases, the likelihood of long term symptoms increases and of course, the length of time to heal is prolonged.
Whiplash injuries don’t only result from a car accident. Many that sustain a concussion also suffer from whiplash, which explains many of the neck symptoms that occur. Whether the concussion results from a head-to-head contact or a fall to the ground hitting the head, the neck still goes through the acceleration motion and then the deceleration, a forceful stop in motion.
Treatment for WAD will go through the same rehabilitation phases as any other injury once there has been a full assessment completed, including a neurological exam and fracture has been ruled out.
Acute care for pain– ice, pain meds if needed, rest from physical activities
Recovery of ROM– work on restoring range of motion
Strengthening– isometric exercises, add contraction with motion, add negative motions or eccentric exercises to work on building up the deceleration contractions
Reconditioning-work on endurance with strengthening
Sports/work specific skills– add in specific sports or work related motions previously unable to do
Prevention– maintenance type exercise to maintain range of motion and strength
Return to play/work without restrictions.
Have you or someone you know been in a car accident? Be sure to be assessed by a healthcare provider, regardless if you are in pain or not. Most whiplash symptoms do not become apparent for 24-48 hours after the injury. So even if you feel fine after the accident, do not deny healthcare coverage immediately. If you are unsure of what to do following an accident, please see our info board in our reception area. If you are still unsure, please do not hesitate to contact our clinic for information regarding your health.