5 exercises for whiplash that cannot be missing in your protocol

What is a whiplash and how does it appear?

The term “Cervical Whiplash Syndrome” (SLC) or Whiplash is used to describe injury to one or more elements of the neck region, which can occur when inertial forces are applied to the head. This denomination is reserved for those cases in which no signs of cervical spine injury can be seen on radiological examinations and in the absence of signs of nerve root injury. Then it is a diagnosis of exclusion that must be made once other more serious injuries have been ruled out. (Combalia Aleu A et al., 2001)

Cases of patients with CRS are quite frequent, being one of the most prevalent musculoskeletal disorders. And although its etiology varies depending on the country, we believe it is relevant to mention the data in Spain: it is estimated that each year more than 25,000 cases of whiplash occur in our country, in a proportion of 1/1000 patients per year, being 98%. of the same produced in traffic accidents (Gómez-Conesa A et al., 2005).

From our experience with mutuals, it is also important to mention the socio-economic impact of this injury as it is one of the most common causes of sick leave. A leave of absence whose duration will depend on both the injury and the characteristics of the patient and which can range from 15 to 90 days.

Why does it produce pain and what is its injury mechanism?

In other words, in some way, the most common way for this whiplash syndrome to appear is after a traffic accident, at which time it would be normal for the head to be subjected to the aforementioned inertial forces. But why does whiplash cause pain and how does the injury occur?

Trying not to be too technical, let’s analyze what happens during a claim:

At the moment the vehicle impacts, the trunk and shoulders of the injured person continue to be subjected to acceleration from the car seat. The head, on which no force acts, remains static in space, which causes it to be thrown and a forced extension of the neck occurs while the shoulders move forward.

After extension, the inertia of the head is overcome by acceleration, forcing the neck into forced flexion. Most studies on accelerations from a rear-end impact in a car assume that the victim’s head is in the anatomical forward-facing position, which is not applicable in most traffic accidents.

Thus, if the head is in a slight rotation, the impact would further force this rotation before extension occurred. This fact has important consequences, since the rotation of the cervical spine places most of the structures (interapophyseal joints, intervertebral disc and ligaments) in a situation more susceptible to injury.

What are the most common symptoms?

The symptoms of CRS are different depending on the patient but could be grouped into the following groups:

NECK PAIN

Neck pain is the most common symptom of CRS. It usually refers to the neck region and patients perceive it as dull and that it increases with movements. It is associated with contracture and limited mobility.

It may radiate to the head, shoulders, upper extremities, or interscapular region and involve nervous-type nociception.

HEADACHES

There is a fairly clear “cervical and headache” relationship in musculoskeletal pathologies that affect the neck region.

In the case of SLC, it is usually suboccipital or occipital, with radiation to the temporal or orbital region. Although it is assumed that the origin of the headache is cervical, other causes should be considered, such as intracranial hemorrhage and other associated injuries.

PARESTHESIA

The tingling sensation and the ulnar nerve symptoms, as well as the numbness of the hands, can be associated with the weakness of muscle groups, alterations in reflexes and abnormalities in the exploration of sensitivity, and can be attributed to compression of the roots. nervous and should be studied.

One of the most plausible theories is that the paresthesias may be due to a thoracic “gorge syndrome” caused by compression of the most inferior trunks of the brachial plexus as they pass between the anterior scalene and the middle scalene, above the clavicle.

DIZZY

Various studies describe the presence of sensations of imbalance or vertigo, in association with other auditory or vestibular symptoms (if you remember, we already discussed this topic in our interview with Laura Flix).

Evidence indicates that symptomatic patients frequently have objective abnormalities of vestibular function on ENG tests, suggesting a central or peripheral lesion.

Treatment for SLC: telerehabilitation as a tool

Whiplash treatment involves the prescription of orthoses and medication (anti-inflammatories and muscle relaxants, etc.), manual physiotherapy and therapeutic exercise. But since in TRAK we take exercise treatment as our flag, we will talk about this one above all:

Most clinical guidelines highlight the key role of exercise for the treatment of acute phase whiplash. The evidence shows that the majority of patients who perform specific neck exercises see their pain reduced 3 months after starting the intervention (Rebbeck T, 2017).

One of the biggest complications presented by the treatment of this type of pathology is the kinesiophobia (fear of movement) that patients present, who tend not to perform the exercises that the professional prescribes. That is why the introduction of a telerehabilitation tool like ours increases the effectiveness of the treatment and accompanies the patient in his rehabilitation, encouraging him to complete his treatment.