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Massage Today
October, 2007, Vol. 07, Issue 10


By Ben Benjamin, PhD

Question: The term whiplash refers to a specific injury to the neck. True or False?

Answer: False.

The term whiplash refers not to one particular injury but to a violent forward/backward or lateral motion of the head, which usually causes multiple neck injuries.

Whiplash most often is the result of a motor vehicle accident - usually, but not always, a rear-end collision. It also can be caused by a forceful collision in various sports including football, basketball, soccer and baseball.

To test for muscle strains, perform the following resisted tests:
Resisted rotation demonstrated. - Copyright – Stock Photo / Register Mark Figure 1: Resisted rotation: Pain indicates injury to the sternocleidomastoids. Resisted side flexion demonstrated. - Copyright – Stock Photo / Register Mark Figure 2: Resisted side flexion: Pain indicates injury to the scalenes.
Resisted flexion Demonstrated. - Copyright – Stock Photo / Register Mark Figure 3: Resisted flexion: Pain indicates injury to the sternocleidomastoids.
Resisted extension demonstrated. - Copyright – Stock Photo / Register Mark Figure 4: Resisted extension: Pain indicates injury to the posterior scalenes, suboccipitals and/or erector spinae.

When whiplash occurs, the result could be a concussion, headache, nerve-root compression or torn muscles in the anterior and/or posterior aspects of the neck. The most common lasting results of whiplash are ligament sprains in the cervical area. As many as 18 different cervical ligaments might be affected. Depending on the nature of the injury, pain may be immediate or could begin days or even several weeks later.

Severe cervical injuries are most frequent at the C5 level, the segment of the neck where the most movement occurs. (As a rule, the area that allows the greatest amount of movement is the one most vulnerable to injury.) It's also common for high-impact car accidents to cause injuries to the C7 intertransverse ligament, especially if the head was thrust into extension because a head rest was not properly in place.

Accurate assessment is key to planning a course of treatment. In any case of whiplash, it is essential to have the client see a physician first. In addition to soft-tissue injuries, whiplash often causes a concussion and sometimes a nerve- root compression. Only a doctor can diagnose these conditions.

If the muscles are injured, they can be treated gently soon after the accident. If the ligaments are sprained, massage and friction therapy can safely be applied by a skilled orthopedic massage practitioner after 72 hours.

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