Whiplash, Neck Pain and Soft Collars-should you use them?
Scenario: you have a car accident, you have whiplash, you have neck pain, you go to the doctor and he recommends pain killers and a soft collar to be worn for the next month. What is wrong with this picture? Everything.
It used to be common practice for doctors to prescribe the use of soft collars for a month, 2 months or more based on the premise that protecting the area will allow the area to heal and therefore make you better. Unfortunately, this thought process is wrong. The use of a soft collar should be minimal at most. If you leave your neck in a soft collar for an extended length of time your neck can get worse not better. The same applies to all of your joints. Any of you who have had perhaps a sprained ankle for example will know that a physiotherapist will ask you to start moving it as soon as possible in a pain free range of movement. If it is still too sore you will be asked to do isotonic exercises( putting load on the tendons and ligaments without the actual joint moving) to make the structures heal more quickly. You want to have a strong and flexible repair and that is exactly why you should start a stretching and strengthening program as soon as the inflammatory phase has finished.(normally within the first 2-3 days)
Your neck ladies and gentlemen is no different. If you leave your neck static, bound up in a collar, muscles and other soft tissues atrophy (waste away) and the joints stiffen. The same is with your sprained ankle, lock it up with tape for a month and you will come out of that tape MUCH WORSE than the person who got their joint and soft tissues moving almost straight after their injury.
In a nutshell, if you have neck pain you need to get it moving as soon as possible (as pain permits). Here are some related studies showing what the medical community now knows:
From netdoctor.co.uk on ‘What Causes Whiplash?’
“Research has shown that whiplash patients who rest for several weeks and wear a soft collar actually recover more slowly than those who try to follow a normal routine.”
And from patient.co.uk in ‘Whiplash Neck Strain’:
“In the past, some people have worn a neck collar for long periods after a whiplash sprain, and have been reluctant to move their neck. Studies have shown that you are more likely to make a quicker recovery if you do regular neck exercises, and keep your neck active rather than resting it for long periods in a collar.”
And from ‘The Enigma of Whiplash Injury’ by W.F Young:
“Mealy and associates, in a prospective randomized trial comparing use of a soft cervical collar and analgesic medications with a regimen of active therapy, found that the group treated actively had significant improvement in both neck pain and mobility compared with the group treated with a soft collar.”
The American Academy of Orthopedic surgeon’s reports:
“In the past, whiplash injuries were often treated with immobilization in a cervical collar. However, the current trend is to encourage early movement, rather than immobilization. The soft collar may be used for a short term and on an intermittent basis.”
“In a third prospective randomized study… Patients encouraged to remain at their normal level of activity had a better outcome than patients treated with immobilization and time off from work.”
Once again, it’s vitally important to get your joints(s) moving as soon as possible after the initial inflammatory phase to encourage proper scar tissue formation, decrease your healing time and have a strong and flexible joint to allow you to get back to your full range of activities and enjoy life to the fullest.
Stretching- Here is one of the worst to do
Which exercises should you do for a pinched nerve
The stretch you should not do for Neck and Shoulder pain
The Best pillows-What the Studies Say
Neck Exercises-The best and Worst to do and Why
Read Morewhiplash-how to decrease your risk by 40%
WHIPLASH
What you need to know about it
As more and more people drive cars these days we also inevitably are seeing an increase in car accidents. Whiplash is a common injury and females are 2 times more at risk than males and they are also more likely to develop long term symptoms. It is not well known why this is the case but it is thought that males have stronger neck muscles than females which may help and also because women tend to sit slightly more forward in their seat. When sitting further forward the head travels further before it hits the headrest. Another interesting fact is that drivers tend to have more serious neck injuries than the passengers. This is thought to be because the passengers tend to sit back in more of a reclined position with their heads against the headrests.
Now I have mentioned the head rests a couple or times in regards to whiplash injury but lets take a closer look at these things that we tend to think of as luxury items. I guess it’s because of their names which make us think of them as nothing more than something to rest our heads against. However, they are so much more than that.
How to decrease your risk of whiplash by 40%
When a rear collision occurs the head is thrust backward and into extension of forces up to 12G. A head rest or better termed, head restraint is designed to reduce that rearward motion of the head greatly decreasing your chances of a whiplash injury. With rear end collisions being so common it’s perhaps one of the most important safety features you have in your car.
It should be at head height that means your center of your head should meet the center of the head restraint. You should check yours the next time you decide to go for a drive and spend the time to position it correctly. It’s too late after a crash occurs. A head restraint that is too low allows the head to propel back and OVER it. You also don’t want your head too far forward. It should be no more than 4 finger widths from the head restraint. If you can’t do this comfortably you may want to invest in a car head support for better protection against neck injuries. Research has shown you will decrease your chance of neck injury by 40% with a correctly positioned headrest.
The National Highway Traffic Safety Administration (NHTSA) told automakers the head restraints in their passenger vehicles will have to extend higher and fit closer to the backs of people’s heads. For the first time, the new standard addresses the back set. Head restraints will have to be within about 2 inches behind the head.
Also, if you know your going to get hit try to decrease your risk of injury. If you have your head or body turned during a collision it can greatly increase your chances of a significant injury. Keep your eyes on the road and your head straight. If you know you’re going to get hit, then reduce the distance between your head and the head restraint by moving your head back. The car neck pillow reduces the headrest distance and increases your level of safety.
What to do if you know a car is going to hit you from behind
Crashes involving whiplash neck injuries happen at lightning-fast speeds, but if you have time to prepare: Put your head and your neck all the way back so that you’re in contact with the seat back and the properly adjusted head restraint. Straight-arm the steering wheel and get a good grip. If you are stopped, put your foot on the brake as hard as you can. Look straight ahead, not in the rearview mirror – don’t have your head turned at all. Put your neck back slightly so your eyes are looking level up at about the top of the windshield. Scrunch your shoulders up toward your ears and then brace.
I hope you never have to be involved in a car collision but at the very least I hope this will help you if something does happen. Happy motoring!
Stretching- Here is one of the worst to do
Which exercises should you do for a pinched nerve
The stretch you should not do for Neck and Shoulder pain
The Best pillows-What the Studies Say
Neck Exercises-The best and Worst to do and Why
Read MoreMore on Whip Lash
Here is a terrific article from consumer reports.org in relation to head restraints and whiplash related injuries. I urge you to read this to make sure that you and your family are well protected in the event of a collision. I would also advise you to look at the head supports that you can buy at the bottom of this page if your car does not already have decent head restraints.
Many cars don’t protect against whiplash injuries
How to save your neck in a rear-end crash
A rear-end crash occurs every 17 seconds in the U.S. But a surprising number of vehicles offer inadequate protection from the whiplash injuries that can result, according to crash-test data and our own analysis.
Many whiplash injuries could be minimized or prevented altogether with better head restraints and seatbacks, especially for backseat passengers. Yet the problem gets relatively little attention. Automakers are inconsistent in providing effective head restraints in all seating positions. And auto-safety advocates tend to focus on other concerns, largely because “rear-enders” are rarely life-threatening.
A new federal requirement that takes effect for 2009 passenger vehicles should help, but it doesn’t go far enough.
To compound the problem, even if their cars have adequate restraints, most people don’t know how to properly position them or don’t take the time to do it, leaving themselves more vulnerable to serious injury.
This report will tell you what to look for, what to avoid, and how to protect yourself from neck injuries.
Most cars fall short
Neck injuries are the most commonly reported type of crash-related injury. Whiplash refers to the rapid snapping back of a person’s head during a collision, which hyperextends the neck and damages nerves and ligaments, often resulting in chronic symptoms such as persistent pain and lack of mobility. It can occur at crash speeds as low as 10 mph.
Lisa Salisbury is a recent victim. In October 2006, Salisbury, 39, an art director, was driving on a rural highway in Stamford, Conn., when she stopped her 2002 Subaru Legacy wagon for workers who had blocked off one lane. The driver behind her, however, didn’t stop.
“I felt something pop in my neck,” Salisbury recalls. “My head snapped back and then forward when I bounced off the seatback. My shoulder belt actually frayed.” X-rays showed she had fractured parts of two vertebrae and severed a ligament. “My doctor told me the bones would heal by themselves but that I’m likely to develop arthritis there. Now, seven months later, I get agonizing headaches whenever it’s about to rain.”
Salisbury is not alone. According to the Insurance Institute for Highway Safety (IIHS), which is funded by auto insurers, roughly 2 million whiplash claims are filed every year. An estimated 200,000 of those are serious enough to cause long-term medical problems. Taller people are most susceptible, medical experts say.
IIHS crash tests suggest why injuries are prevalent. The IIHS is the only organization that conducts dynamic tests of front seats and head restraints, and makes rear-crash-protection ratings available to the public. Of the approximately 175 vehicles for which the institute now has overall ratings, only about one-third are rated Good or Acceptable. Nearly a third are rated Marginal, and more than a third are rated Poor.
Since 1969, the government has mandated that all passenger cars have head restraints on outboard front seats. But IIHS tests, which simulate a stationary vehicle being rear-ended by a vehicle of the same weight at 20 mph, have found that even head restraints that are properly positioned don’t necessarily provide good protection.
“Most of the time what you’ll find is the seatback is too stiff,” explains David Viano, a former General Motors safety engineer and seat designer. “Ideally, the top part of the seatback, where your shoulders hit it, should be soft and pliable. If you can’t sink into the seat, you rebound off of it during the crash, and that can cause the injury.”
Another variable is that performance can vary from one seat option to another. For instance, the BMW 5 Series with base or “sport” seats is rated poorly by the IIHS, but with “comfort” seats it’s acceptable.
Ideally, the seat/head-restraint combination should be designed so that your torso, neck, and head move in the same plane. That means your head and shoulders should stay in about the same position relative to each other as they would in a natural sitting position.
“Not everyone has the same posture,” says Matthew P. Reed, an associate research scientist at the University of Michigan’s Transportation Research Institute. “So it’s a balancing act for the carmakers: If the backset is too great, the restraint loses effectiveness. But if the restraint is so close that it interferes with a person’s preferred head position, then consumers complain about it, or even remove it.”
Dan Jarvis, a Ford safety spokesman, says automakers are improving. “Now that manufacturers know and understand the test criteria,” he says, “they can build for that, and you’ll see improved ratings.”
Because rear crashes are rarely fatal and because the IIHS tests are relatively new, Consumer Reports does not currently use them as a prerequisite for recommending a vehicle. We are examining how to weigh rear-crash protection compared with protection for front and side crashes, which are more lethal.
More problems in the rear
The rear seat in many vehicles is still the Wild West of rear-crash protection. Consumer Reports auto-test engineers evaluate rear-seat head restraints on every vehicle we test. We’ve found that many outboard seats use integral restraints, which often are little more than bumps on the top of the seatback. Many vehicles also lack head restraints for the center-rear position, which isn’t required by the U.S. government. In Europe, it is required.
We measure the height of the head restraints and make sure they can stay fixed at least 29.5 inches above the seat cushion. If a restraint isn’t high enough to be effective in preventing whiplash, we note that in our monthly auto tests. Of the 2007 vehicles we’ve recently tested, only a little more than half have restraints in the rear outboard positions that are tall enough without adjustment. Only half have any restraints in the rear-center position.
More vehicles are being made with effective, adjustable head restraints in all rear positions. But those can create another problem, making it difficult for the driver to see out the rear windows. To address that, many restraints can be pushed down into a recess in the seatback or can fold out of the way when the rear seat is unoccupied. We prefer the type that folds forward into the seating area, as in Volvos, because they force rear passengers to put them up before they can get comfortable.
Good positioning is critical
Whatever car you drive, you’ll get the maximum whiplash protection from a head restraint that’s properly positioned. To work well, the top of the restraint should reach at least as high as the top of your ears and be relatively close—3 inches or less—to the back of your head.
Adjustable restraints are the most common type. They can be raised or lowered to the proper height, and many can be tilted toward or away from the head. But they’re only effective if occupants take the time to adjust them properly. Many people don’t, which increases their risk of serious injury.
Progressive Insurance found in a 2002 survey that 40 percent of drivers did not adjust their head restraint when driving a newly purchased vehicle, and 57 percent didn’t adjust them after someone else had driven their vehicle. Only 14 percent of drivers knew the optimal positioning of a head restraint. In 2003, the IIHS did an observational survey in Washington, D.C., and Charlottes ville, Va., that revealed that about 56 percent of male drivers and 24 percent of female drivers had head restraints positioned too low.
Some automakers have introduced “active” head restraints, which automatically move up and forward to catch a person’s head in a rear crash. Those are usually effective, but there’s no guarantee. In the latest IIHS tests, two-thirds of the 37 vehicles that had them received a Good or Acceptable score. The other third were Marginal or Poor. “This underscores that it’s not just the head restraint but the seat architecture that determines what’s going to happen,” says Adrian Lund, president of the IIHS.
Next steps in head restraints
In 2005 the federal government upgraded the head-restraint rule, which becomes mandatory with 2009 passenger vehicles built on or after Sept. 1, 2008. That rule, Federal Motor Vehicle Safety Standard 202, specifies that front outboard head restraints have to reach a minimum height of 29.5 inches upward from an occupant’s hip and must be able to be set within 2.2 inches behind a seated person’s head. Currently, the government specifies a height of 27.5 inches with no backset requirement.
“New regulation brings the height requirement into line with European standards,” says David Zuby, IIHS senior vice president. He says that additional provisions in the rule “should make our head restraints even better than what the Europeans require.”
While the law is a step forward, Consumers Union, the nonprofit publisher of Consumer Reports, believes it still falls short. For instance, it doesn’t require vehicles to have rear-seat head restraints. It mandates only that if the manufacturer puts them in outboard positions, the restraints have to meet the new height requirement. CU would like to see backset specifications for rear restraints and restraint requirements for the rear-center position. If the government won’t require it, CU urges automakers to take the initiative themselves.
Related Links:
What to do if a car is going to crash into you from behind
Neck Exercises-The Best and Worst to do and why
Stretching- Here is one of the worst to do
Which exercises should you do for a pinched nerve
The stretch you should not do for Neck and Shoulder pain
Read MoreWhiplash, Neck Pain Exercises and Cervical Collars
Mark Perren-Jones from The Haven Spa and Health Clinic
The self-adjusting frame designed to support the back
and the neck. | Source GB Patent, GB1852-1064 | Date 1852 …
You will be glad to know its no longer recommended
I happened to walk into my local pharmacy the other day and noticed the pharmacist wearing a cervical collar for her neck. This prompted me to write on the latest knowledge about the use of the cervical collar. It used to be prescribed by Doctors very often for minor neck strains to rest the area and protect it from further injury. However, it has been found like all other areas that have been strained that it is actually worse for the area; it slows down your recovery time and weakens (atrophies) the soft tissues from lack of use. You get better slower!
It’s the same for all of your injuries, you need to get the joint(s) moving as soon as possible in a controlled manner to help your injury heal faster, be stronger and greatly decrease your risk of re-injury. Remember, the number one reason for injuries not to heal properly is from a lack of appropriate exercise. The neck is no different. But I want to be clear that the exercises must be in a controlled manner so that more tissue damage does not occur. For more on treating your own injuries and knowing which are the best rehab exercises for each keep watching this space for my upcoming e-book and DVDs soon to be released.
The American Academy of Orthopaedic surgeons in their article on Whiplash wrote:
“In the past, whiplash injuries were often treated with immobilization in a cervical collar. However, the current trend is to encourage early movement, rather than immobilization. The soft collar may be used for a short term and on an intermittent basis.”
In Jan. 2005 netdoctor.co.uk wrote in their article on ‘What Causes Whiplash?’
“Research has shown that whiplash patients who rest for several weeks and wear a soft collar actually recover more slowly than those who try to follow a normal routine.”
Another article from patient.co.uk in April 2005 also states in their article ‘Whiplash Neck Strain’:
“In the past, some people have worn a neck collar for long periods after a whiplash sprain, and have been reluctant to move their neck. Studies have shown that you are more likely to make a quicker recovery if you do regular neck exercises, and keep your neck active rather than resting it for long periods in a collar.”
And if you still weren’t convinced, here is another from ‘The Enigma of Whiplash Injury’ by W.F Young:
“Mealy and associates, in a prospective randomized trial comparing use of a soft cervical collar and analgesic medications with a regimen of active therapy, found that the group treated actively had significant improvement in both neck pain and mobility compared with the group treated with a soft collar.”
“In a third prospective randomized study… Patients encouraged to remain at their normal level of activity had a better outcome than patients treated with immobilization and time off from work.”
Once again, it’s vitally important to get your joints(s) moving as soon as possible after the initial inflammatory phase to encourage proper scar tissue formation, decrease your healing time and have a strong and flexible joint to allow you to get back to your full range of activities and enjoy life to the fullest. Also, if you do happen to injure yourself please use ice for the first 48 hours NOT heat. For more on this see my article when to use ice and heat
Read MoreWhat is Whiplash?
Mark Perren-Jones From The Haven Spa and Health Clinic
Many of you have heard about whiplash but what exactly is it. Here is a definition from major whiplash review that took place in 1995.
“Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck. It may result from rear-end or side impact motor vehicle collisions, but can also occur during diving or other mishaps. The impact may result in bony or soft tissue injuries (whiplash injury) which in turn may lead to a variety of clinical manifestations. (Whiplash associated disorders or WAD).”
Put simply, when a car hits you from behind you are propelled forward and your neck is thrust backward forcefully into extension and then is thrown into flexion. Your head can be forced into extension as high as 12G and into flexion as high as 16G! Most commonly injured are the joints, discs and ligaments.
Having said this, there’s still some controversy whether WAD is a myth or not. There are certain groups of people who do not believe in whiplash syndrome. Their argument is that his is more a problem where there are likely compensations to be gained from insurance companies.
They argue that there is no evidence of injuries when animals are put through whiplash injuries except with exceptional force, also that some studies demonstrate that no injuries have occurred on people using sophisticated imaging studies, the complete lack of neck pain in people who are in smash up derbies and who crash cars for fun, and also the huge variations in symptoms in different cultures which appears to reflect legal determinants rather than the rate of accidents. Much of this is based on a study in Lithuania is often quoted regarding their theory “where there s little knowledge or expectation of the potential of a whiplash injury to lead to chronic symptoms, and where involvement of insurance companies, litigation and even therapeutic community is rare there is no increased prevalence of chronic neck pain after a rear end collision, when compared with the background risk of chronic neck pain in uninjured control subjects”
In 1999 however, Freeman et al produced a review to challenge the authors who do not believe in whiplash syndrome. He said that “there is NO epidemiological or scientific basis for the following ideas:”
* whiplash injuries do not lead to chronic pain
* chronic pain is psychogenic
* the risk of chronic neck pain among acutely injured whiplash victims is the same as the prevalence of chronic neck pain in the general population.
Related Links:
Neck Exercises-The Best and Worst to do and why
Stretching- Here is one of the worst to do
Which exercises should you do for a pinched nerve
The stretch you should not do for Neck and Shoulder pain
Read MoreAbout Me
Mark Perren-Jones has worked throughout the world’s health spas and health clinics. He did the majority of his study (7 years) in Australia and has treated thousands of clients over the past 20 years with all sorts of neck and back problems. He has studied acupuncture, massage, joint manipulation and mobilization, kinesiology, reflexology, Thai massage, Bowen technique and many other modalities to understand which therapies gets the best therapeutic results and which don’t for particular neck and back problems.
With his 20 years of clinical experience, years of diligent study and research Mark has put together this site so that you can benefit directly from his work. You will be taught not only how to treat your own pain but as importantly what causes your pain in the first place. With the knowledge you gain to remove the causes of your neck and back pain, means you will not have to suffer anymore. 
I have my new DVD out now which will show you in my easy 3 step approach how to alleviate your own neck pain.
Neck pain and especially stiff necks are not difficult to treat once you know how ( ie.remove the major causes of your neck pain and stiffness.)
I will show you how simple it is to treat your neck pain & stiffness both quickly and easily.