Monday, October 19, 2015

Whiplash "Basics"




            Whiplash is a non-medical term typically describing what happens to the head and neck when a person is struck from behind in a motor vehicle collision. Let’s look at some basic facts about whiplash:

·         Before cars, trains were the main source of whiplash and was called “railroad spine.”
·         Better terms for whiplash injuries include “cervical acceleration-deceleration” (CAD) which describes the mechanism of the injury, and/or the term "whiplash associated disorders" (WAD), which describes the residual injury symptoms.
·         Whiplash is one of the most common non-fatal injuries involved in car crashes.
·         There are over one million whiplash injuries per year due to car crashes alone.
·         An estimated 3.8 per 1,000 people per year have a whiplash injury.
·         In the United States alone, 6.2% of the population has “late whiplash syndrome” (symptoms that do not resolve at one year).
·         1 in 5 cases (20%) remain symptomatic at one year post-injury of which only 11.5% returned to work and only 35.4% of that number returned to the same level of work after 20 years.
·         The majority of whiplash cases occur in the fourth decade of life, females>males.
·         Whiplash can occur from slips, falls, and brawls, as well as from horse-riding, cycling injuries, and contact sports.
·         Injury from whiplash can occur at speeds of 15 mph or less.
·         In the “classic” rear end collision, there are four phases of injury (time: 300msec)
o        Initial (0msec) – before the collision (the neck is stable)
o        Retraction (1-150msec) – “whiplash” starts where the head/neck stay in the original position but the trunk is moving forwards by the car seat. This is where the “S” shaped curve occurs (viewing the spine from the side).
o        Extension (150-200msec) – the whole neck bends backwards (hopefully stopped by a properly placed head rest).
o        Rebound (200-300msec) – the tight, stretched muscles in the front of the neck propels the head forward immediately after the extension phase.
·         We simply cannot voluntarily contract our neck muscles fast enough to avoid injury, as injury to the neck occurs within 500msec. and voluntary contraction or bracing takes 800msec or longer.
·         Injury is worse when the seat is reclined as our body can “ramp” up and over the seat and headrest. Also, a springy seat back increases the rebound affect.
·         Prompt treatment is better than waiting for a long time. Manipulation is a highly effective (i.e., COME SEE US!) treatment option.


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