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Inside Physio

Newsletter

10 August 2011

this issue

Whiplash Injury

P ro f e ssi o n a l D e ve l o p me n t

P.1&2

Physio Professionals prides itself in its continuing staff education initiatives.

Early intervention to prevent chronic whiplash What is whiplash?

Staff

Michelle Peauril Senior Physiotherapist Level III Sports Physio AIS

Iona MacInnes B Sc Physiotherapy

Andrew Crew

Whiplash is a relatively common injury that occurs to a person's neck following a sudden acceleration-deceleration force, most commonly from motor vehicle accidents. The term "whiplash" was first used in 1928. The term "railway spine" was used to describe a similar condition that was common in persons involved in train accidents prior to 1928. The term "whiplash injury" describes damage to both the bone structures and soft tissues, while "whiplash associated disorders" describes a more severe and chronic condition. Fortunately, whiplash is typically not a life threatening injury, but it can lead to a prolonged period of partial disability. There are significant economic expenses related to whiplash including:  medical care,

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

disability,

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sick leave,

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lost productivity, and

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litigation.

While most people involved in minor motor vehicle accidents recover quickly without any chronic symptoms, some continue to experience symptoms for years after the injury. This wide variation in symptoms after relatively minor injuries has led some to suggest that, in many cases, whiplash is not so much a

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real physiologic injury, but that symptoms are more created as a result of potential economic gain. Many clinical studies have investigated this issue. Unfortunately, while there will always be people willing to attempt to mislead the system for personal gain, nevertheless, whiplash is a real condition with real symptoms.

What causes whiplash? Whiplash is most commonly caused by a motor vehicle accident in which the car the person is riding in is not moving, and is struck from a vehicle from behind without notice. It is commonly thought the rear impact causes the head and neck to be forced into hyperextension as the seat pushes the person's torso forward - and the unrestrained head and neck fall backwards. After a short delay the head and neck then recover and are thrown into a hyperflexed position. More recent studies investigating high-speed cameras and sophisticated crash dummies have determined that after the rear impact the lower cervical vertebrae (lower bones in the neck) are forced into a position of hyperextension while the upper cervical vertebrae (upper bones in the neck) are in a hyperflexed position. This leads to an abnormal S-shape in the cervical spine after the rear impact that is different from the normal motion. It is thought that this abnormal motion causes damage to the soft tissues that hold the cervical vertebrae together (ligaments, facet capsules, muscles). Whiplash neck sprains are common. About 2 in 3 people

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involved in car accidents develop neck pain (with or without other injuries). Many people are surprised with the onset of neck pain following even minor accidents some hours following the accident. It is important to note that even minor car bumps can cause enough whipping of the neck to cause symptoms. Less commonly, whiplash can result from everyday mishaps such as jolting your neck when you trip of fall.

Whiplash: early intervention to prevent chronic whiplash WAD (Whiplash-Associated Disorder) is a misunderstood and painful problem. Around a third of road accidents result in a whiplash injury and tens of thousands of Australians experience it each year at great costs. Early, active physiotherapy intervention, combined with education and psychological support, can help prevent acute whiplash developing into a chronic injury. Leading physiotherapy researchers in Queensland have determined that a patient’s condition three months after initial injury is a stronger predictor of longer-term outcome than the severity of the injury itself. Symptoms (including

Physio Professionals Michelle Peauril Iona MacInnes Andrew Crew

Physiotherapy

pain, dizziness and restricted neck movement) evident 3 to 6 months post -injury are likely to lead to a chronic condition of whiplash. Early, active intervention is critical. One study reports that pain intensity and sick leave are significantly reduced if patients receive active intervention (frequent active cervical rotation with assessment and treatment), and that long term recovery of total cervical ROM is reliant on the active intervention being received soon after injury. Overseas trials have also found a multi-modal physiotherapy approach combining postural training, manual technique and psychological support delivers greater benefits to patients than using physical agents only. Patients with WAD being treated using a multi-modal approach were found to return to work sooner and reported greater and longer lasting benefits of their treatment. Australian research on the benefits of a multi-modal physiotherapy program is being undertaken at the University of Queensland’s world leading neck pain and whiplash research unit. The physiotherapist’s in our physio professionals practice demonstrate a

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depth of knowledge, clinical judgment in their practice of physiotherapy techniques to relieve pain resulting from whiplash injuries, and provide effective treatment to restore movement and function. Being patient-focused practitioners, we invert quality time during consultations to ensure patients understand the benefits, risks and alternatives to proposed treatment. We are also provide advice to encourage selfmanagement and build patient confidence to cope with their injury.

We can help As highly trained health professionals, our physiotherapists regularly work with medical and other health professionals in a multidisciplinary approach to patient care. We welcome the opportunity to work in partnership with you to deliver the highest quality and most effective physiotherapy services as part of a treatment plan for your patients with acute and chronic WAD.