Whiplash, or “Whiplash Associated Disorders” (WAD), results from a sudden jarring motion, often from a car crash that occurs too fast for someone to voluntarily “brace” themselves. This is because the whole “whiplash cycle” is over within 300msec, and we cannot contract a muscle faster than 700-800 msec. Other injury factors include: the type and angle of the crash, the size of the involved vehicles, the speed, the absorption of the crash by crushing metal (or lack thereof), the size of the person (and gender), angle of the seat back and it’s “stiffness,” the position of the head rest, and the slipperiness of the road. ALL these factors (and more) help determine whether an injury occurs as well as the degree of injury!
There is so much published about neck pain resulting from whiplash that it’s confusing (to say the least) about which exercises are best for the whiplash patient. Rather, each patient needs to be assessed and managed based on their unique situation.
In regards to neck pain, an exercise program must have three goals: Stretching, Strengthening, and Stabilizing. All three goals work towards a common purpose: To restore function. Initially, when pain factors are high, patients perform active movement within reasonable pain boundaries to improve their cervical range of motion. Once movement is fairly well tolerated, it's time to focus on strengthening exercises.
There are certain muscles that can “hide” behind larger, stronger muscles and are more difficult to isolate, and therefore, very often remain weak — even sometimes in spite of strengthening exercises. One VERY important muscle group is called the deep neck flexors, which “hide behind” the stronger, more superficial neck flexing muscle called the sternocleidomastoid (SCM). To “trick” the SCM into NOT contracting (so we can engage and exercise the deep neck flexors), we drop the chin to the chest without flexing the head forwards (like the downward motion when nodding “yes”). Try it! You should feel “the pull” or a stretch in the muscles in the back of your neck. This is referred to as “craniocervical flexion” but we’ll call it a “chin tuck.”
PROCEDURE 1: Perform the above “chin tuck” by lying on your back, chin tuck, and press your neck down into the bench or floor, hold for three-to-five seconds and then release the chin tuck SLOWLY (two times slower than the initial downward movement). If you can’t get your neck to flatten out, repeat this with a small rolled up towel placed behind the neck. Start with three-to-five repetitions and gradually increase the reps and sets. To make this more “portable” so you can do this during the day, see Procedure 2.
PROCEDURE 2: In a seated or standing position, place your finger tips behind your neck and push your neck into your fingers gradually increasing the pressure as you apply the “chin tuck.” Do this slowly, applying gradual pressure INTO your finger tips and then (MOST IMPORTANTLY), release the pressure SLOWLY (again, two times slower than the initial “push”). Repeat three-to-five times for one session and do multiple sessions during the day. SET THE TIMER on your cell phone for two or three hrs to REMIND you to do these multiple times a day!
Next month, we will address the deep neck extensors, as well as other deep muscles!
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