Whiplash (neck strain)

Whiplash injury occurs when there is sudden flexion or extention of the neck, usually when the athlete is struck from behind during contact sports, and the head is rapidly thrown both forward and backward. Soft tissues of the neck including intervertebral discs, ligaments, cervical muscles and nerve roots may be injured, producing neck pain, stiffness and loss of mobility.

The hips, back and trunk are the first body segments and joints to experience movement during a whiplash. Forward motion in these structures is accompanied by upward motion, which acts to compress the cervical spine. This combined motion causes the head to move backward into extension, producing tension where the lower cervical segment extends and th upper cervical segment flexes. With this movement of the cervical vertebrae, the anterior structures are separated and posterior components including facet joints are severely compressed.

Cause of injury

Tackle from behind, e.g. football. Sharp collision with another athlete or piece of equipment. Blow to the head, e.g. boxing.

Signs and symptoms

Pain and stiffness in the neck, shoulder or between shoulder blades. Ringing in the ears or blurred vision. Irritability and fatigue.

Complications if left unattended

Left untreated, whiplash injury can produce chronic symptoms of pain, inflexibility and loss of movement, along with the continuation or worsening of associated symptoms of fatigue, sleep loss, memory and concentration loss and depression. Symptoms may also suggest more serious injury to the spinal vertebrae with potentially serious consequences.

Immediate treatment

The RICER regimen. Immobilization with a cervical collar

Rehabilitation and prevention

The neck will usually be immobilized with some form of brace, though early movement is usually encouraged to prevent stiffening. Low-impact strength and flexibility training and rehabilitation should follow complete healing of the tendons, discs and ligaments. Risk of whiplash may be minimized with protective gear as well as a thorough warm-up routine, though prevention in rough contact sports may not be guaranteed.

Benefits of massage for whiplash

In addition to  massage, specific bodywork methods ease acute whiplash discomfort and help prevent chronic fallout. For example, myofascial approaches restore fluidity to the fascia–normally a slippery tissue that surrounds all the moving parts inside the body–allowing freer movement of muscles and ligaments. Friction-based massage helps break up scar tissue and relieve stiffness. Trigger point therapy works by releasing tension held in tight knots of muscle. And any type of bodywork that stimulates circulation helps ease and prevent headaches.


Long-term prognosis

The long-term prognosis for most whiplash injuries is good, given adequate care, though symptoms may persist and the neck may be prone to re-injury.

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