What is whiplash and how is it treated?

Whiplash is an injury to the neck and back that results from a sudden force impact. It usually happens during a car accident, but the same whiplash syndrome could result from a sports injury, a fall, a bike accident and other sudden force impact. It is crucial to see your doctor and get tested for complications like injured discs, injured blood vessels and nerves, and head trauma. Getting your neck massaged or stretched when you might have a broken disc can possibly be fatal or paralyzing. After being evaluated by a physician, bodywork is one of the best suited treatments to help soft tissue heal and prevent further complications, limitations in mobility, and an increase in pain that can become chronic.

Although physicians sometimes refer to it as a neck hyperextension injury, many cases of whiplash are much more complicated, with involvement of shoulders, (upper, mid or low) back, the pelvis, hips, abdomen and side muscles - basically anything above the belt and usually but not always excluding the arms. It can include all types of soft tissue, not just muscles. Whiplash can show up immediately or it can creep up several days later.

Aside from neck pain, additional symptoms of whiplash may include:

• Neck stiffness
• Headache
• Dizziness
• Hoarseness and difficulty swallowing and/or chewing
• Paresthesia
• Shoulder, back or arm pain
• Back pain
• Mild to severe limitations in mobility

According to Ben Benjamin, Ph.D., the following resistance tests should be included when assessing whiplash:

• Pain upon resisted neck rotation indicates injury to the sternocleidomastoids.
• Pain upon resisted side flexion of the neck indicates injury to the scalenes.
• Pain upon resisted neck flexion indicates injury to the sternocleidomastoids.
• Pain upon resisted neck extension indicates injury to the posterior scalenes, suboccipitals and/or erector spinae.

Other orthopedic bodywork teachers of mine have implicated the longus colli muscle and anterior ligaments in many whiplash cases. Personally, I have also found the most under treated areas in whiplash are the obliques, QLs and other muscles of the abdomen and pelvis. Unfortunately, many doctors will write a prescription for treating neck pain or low back pain and the massage therapist will only work these areas. The problems is that not only may other areas have experienced direct trauma, but there is "fallout" and bracing of muscles that are not immediately in the prescribed areas. They have nonetheless tighten down to protect the body or compensate for the injury. That is partly why the patient never received full resolution of symptoms.

Another cause of treatment failure is that car accident injuries can be persistent. While I often feel much change happening during a session and a client, particularly a younger client, will feel much better after one or two sessions, the symptoms can come creeping back. Besides, failure to treat "fallout" areas, it is important to work with the neurological and emotional components of the injury. In other words, the brain becomes wired in an accident to go back to bracing the injury even if it now safe. Or there may be areas that are neurologically turned off for other reasons. Neuromuscular therapy and facilitated stretching can help, as well as neurokinetic therapy. Sometimes clients will begin to relive the accident as the injured areas are treated and the body tightens up. At this point it is important to work with the nervous system and introduce more calming techniques like craniosacral, light Swedish, and acupressure.

While a majority of people with whiplash improve within one month, symptoms sometimes persist longer. It is now widely believed that the sooner massage therapy is received, the quicker the person heals and the less likely they are to develop chronic pain and immobility. Some modalities that can be helpful immediately are gentle trigger point therapy or acupressure, swedish or lymph drainage, and gentle craniosacral. After a few days to a week, myofascial release, facilitated stretching, deep tissue, and neuromuscular therapy become more useful.

I see many clients that have exhausted their auto insurance settlement benefits and were not healed to their satisfaction. It is my goal always to get you to as close to your pre-accident state and return you normal functioning, avoiding larger problems down the line. Most of the time, I can get my clients to 90% and sometimes better than before. The success depends on several things: your age and current body state, the severity of the accident, confounding health and lifestyle factors, your ability to work on self healing outside the sessions, your pain tolerance, and how close together your sessions are (approximately one week or less apart).

Centered Bodywork
6637 SE Milwaukie Ave, Suite 202, Portland, OR 97202
415-410-4622