“The Truth About Low Speed Auto Accidents…”

   Thousands of automobile collisions occur everyday. And every day thousands are injured.  Researchers note that the majority of accident injury claims occur at relatively low speeds of about 12 mph.

   This causes tremendous disputes between injured parties and the insurance companies that are responsible for compensating them fro their injuries. To insurers, there really is no speed at which they want to admit and injury could occur. For economic reasons they try to dismiss whiplash in its entirety as if it doesn’t exist.

   Thanks to recent irrefutable research studies proving the existence and exact mechanism of whiplash injuries, insurers are hard pressed to try the “whiplash is a hoax” defense nearly as much as in the past.

    A more recent tactic is to claim the speed of the collision is too low to cause injury. The defense often relies on their insured’s reports of how fast they were going when they ran into the back of the other party—obviously biased data. Other times photographs of the vehicle damage is used to show a low speed. Often, the photographs are shown to an Accident Reconstructionist who by merely looking at photographic damage renders an opinion on how fast the vehicles were traveling. They will even go so far to make statements such as “the evidence suggests there was insufficient force to cause human bodily injury…” This would be laughable if it didn’t cause so many problems for injured victims.

    Here are but a few facts concerning motor vehicle injuries and their relationship to speed with supporting scientific evidence.

    Three different studies (Panjabi, Panjabi and Cholewicki and Kaneoka) proved the mechanism by which the neck is injured by a rear impact force. [1], [2], [3] The studies involved simulating a rear impact collision ot live human test subjects and recording the results with cineradiography (high speed motion x-rays). The researchers found that the neck was injured by deforming into an “S- shaped” configuration. All three of these studies found that this physical event occurred at speeds as low as 2.5 mph.  

    The radiographically proven human threshold for injury in a rear impact collision therefore is 2.5 mph. Other authors have disputed these figures and some insurance company sponsored studies have found the threshold to be closer to 5 mph.
 

   For the sake of argument, let’s stipulate that the 5 mph threshold is correct. It still means that a collision of only 5 mph can cause damage to the neck.

     Freeman et. al. in Spine, Vol. 23, Number 9, 1998, p. 1046 shows the damage thresholds for many cars. This is the minimum speed required to cause the car to show visible signs of damage. The smallest, lightest vehicle listed was the 1980 Toyota Tercel, which required a collision of 8.1 mph to become damaged. On the other end of the spectrum was the 1989 Chevrolet Citation, which required 12.7 mph. A Ford F-250 pick up required 11.7 mph.

    Cars built today are equipped with rear bumpers designed not to show any damage below 5 mph. In an attempt to reduce repair costs shouldered by insurance companies, crash standards were adopted to mandate rear bumpers must withstand  a 5 mph collision into a fixed barrier (wall, pole, etc) without any visible evidence of damage.  It should be noted that this standard involves testing of “vehicle to barrier” crashes not “vehicle to vehicle” testing.

    In “vehicle to vehicle” crashes where the bumpers line up well, it takes considerably more force to cause visible bumper damage than a 5 mph collision. Some tests have shown that cars could be crashed repeatedly at 20 mph and not show outer damage. In a “vehicle to vehicle” crash it is estimated that the minimum speed to cause visible damage is approximately 15 mph.
 

   Another consideration is that while a bumper may look undamaged from the outside after a collision, inside under the skin, the foam or plastic may be crushed or cracked. This is not seen from the outside, so photographs would make it appear as if no damage was sustained. Still further, the bumper may appear intact, but on unibody vehicles, the unibody may be bent or deformed by a collision. This may not be apparent and some auto repair facilities may miss it. 
 

   So what does this mean? It means that if you are rear-ended and your bumper is cracked, dented, or misplaced at all, your collision involved speeds in excess of 15 mph.  That’s 3 times the human threshold for injury if we use the 5 mph figure. In reality, the proven threshold is only 2.5 mph, so a collision of 15 mph is 6 times the threshold for injury.
 

   Now let’s say your vehicle sustained no visible damage, but your neck hurts after the collision. Does that mean you weren’t really injured? No. It means that the vehicle’s threshold for damage was not exceeded. The impact could have been 10 mph. Too low for bumper damage, but still 4 times the threshold for human injury.

    In a low speed collision, the kinetic forces that are transferred from the other vehicle into your vehicle are not dampened or bled off by your bumper. Instead, the force is transmitted through the vehicle, into your seat and to your neck resulting in injury. If your body or neck are jolted or jerked by the impact, an injury could occur.

    Another aspect to consider is if your vehicle is moved forward by the impact. An average car weighs close to 4,000 lbs. Let’s say you are hit from behind and your car is pushed forward a few feet, but shows no signs of bumper damage. Is it possible to be hurt? Yes, of course. The force required to move a stationary 4,000 lb object is tremendous. Can you walk up to a car sitting at a red light with its brakes on and shove it forward even an inch? Not likely. A collision that is strong enough to propel a car forward by even inches is plenty enough force to cause a whiplash injury.   

    So, as you have now learned, there really shouldn’t be any dispute on whether a low speed collision can cause injuries. It has been scientifically proven by several studies. It is also a fact that the speed required to cause bodily injury is quite low, a scant 2.5 mph. It has also been shown that any accident that causes damage to the rear bumper is likely to cause injuries and even in accidents where there is no outward physical damage to the vehicle, there may still be sufficient forces involved to cause bodily injuries.        

     For a Free report entitled, “What You SHould now If You’ve Been In vovled in an Auto Accidnet,” go to DrMarks.com.                                 
                          
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References

Panjabi MM, Grauer JN (1997): “Whiplash produces a S-shape curvature of the neck with hyperextension at lower levels. ” Spine 22 (21): 2489-94.

Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.

Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770

Characteristics of Specific Automobile Bumpers in Low Velocity Impacts, SAE 940916

“One Simple Thing to Avoid Whiplash…”

Thousands of automobile collisions occur everyday. Most of them occur within a short distance from home, occur at relatively low speeds of about 12 mph and often involve very little vehicle damage.[1] These accidents account for an astonishing number of chronic headache and neck pain sufferers each year.

Contrary to what insurance insiders might want you to believe, thousands upon thousands of American motorists suffer chronic neck and back injuries as the result of auto collisions each year. A group of prestigious medical researchers found that between 25 and 40% of auto collision victims will suffer long term pain, stiffness and other symptoms as direct result of their accident [2]. These chronic cases are said to be due to damage to the facet joints and/or discs in the neck. These are serious injuries with serious consequences.

Three different studies Panjabi [3], Panjabi and Cholewicki [4] and Kaneoka et al. [5] proved the mechanism by which the neck is injured by a rear impact force. The studies involved simulating a rear impact collision to live human test subjects and recording the results with cineradiography (high speed motion x-rays). The researchers found that the neck was injured by deforming into an “S- shaped” configuration. All three of these studies found that this physical event occurred at speeds as low as 2.5 mph.

The data from these three studies have changed the world of auto crash mechanics. A definitive mechanism was uncovered as the root cause of whiplash-type injuries. Treating physicians now understand how these injuries occur and can apply various treatments to help victims recover. But due to the nature of these injuries and despite good medical care, many of these cases will become chronic and never completely go away.

Since chronic whiplash injuries often become permanent, physicians who treat these injuries should focus on preventing them from occurring in the first place. Medical science has revealed many aggravating factors that increase the likelihood of suffering a whiplash injury. If more public awareness was focused on these factors we might see fewer cases of whiplash and chronic whiplash sufferers.

This article is the first in a series of articles that attempts to inform the public on steps to take to avoid becoming a crash statistic. This first item is probably the most important and is a single action that can be taken that can eliminate most cases of low speed whiplash.

The single most important thing you can do to prevent whiplash especially in low speed collisions is to sell your car and buy a different one. I’m only partly joking here. Let me explain.

Rear impact whiplash injuries occur when your vehicle is struck by another is pushed or jolted forward. Since your butt is on the seat and the seat is bolted to the floor of the car, your body is essentially connected to the vehicle. If it moves forward, your body moves forward. Are you with me so far?
So again, when your car is pushed forward by a rear impact, your body also moves forward–except for your head. Your head, which is fairly heavy and is balancing atop a relatively thin neck, is not resting against anything. Nothing is holding it in place like the rest of your body. So when your body is suddenly jolted forward, there is a moment in time when your body is moving forward, but your head remains in the same place. This separation of your head and body causes your neck to deform resulting in stretching and tearing of muscles, ligaments, tendons, discs and/or joint surfaces.

So how can you avoid whiplash? You can prevent it from properly positioning your seat’s head restraint [6]. You know that thing on top of your seat that you go out of your way to push back so it doesn’t mess up your hair? Well that thing is there to prevent your head from snapping back and suffering whiplash. The problem is 99% of cars on the road have head restraints that don’t work. They’re designed for looks instead of function because consumers don’t know any better.

Now that we know that airbags can save lives, we all want them in our cars. Since we’ve been educated about ABS brakes, we demand our cars have them. These things make driving safer so why would we want a car without them? Well tell me, when you bought your most recent vehicle did you look at the head restraint system? Did you demand that your vehicle be equipped with an active whiplash deterrent head restraint? That’s okay. Nobody else does either. And even if you did ask for it, only Volvo, Saab, Infiniti, Lexus, Nissan, Porsche and Toyota offer them, and only on limited models.

Volvo and Saab equip all of their models with active restraint systems. (Swedish = safe) Each is a little different, but both effectively work to minimize whiplash. These dynamic systems achieve this by first making the head restraint adjustable enough to actually sit where it should be to do any good. Namely, the head restraint should be within about 2 inches of your head and the top of the restraint should be above the top of your head. Whiplash research has found that if your head is more than 4 inches away form the head restraint at impact you are much more likely to be injured. Similarly, if the head restraint sits too low it cannot protect you because on impact your neck actually elongates and your head rises. If the restraint is too low your head misses the restraint and it does no good. If the restraint is too, it actually acts as a fulcrum and can make your injury more severe!

Second, these dynamic systems actually minimize the differential movement between your torso and your head. Using specially designed seat backs or actual lever systems like in the Saab, the torso is supported and allowed to flex back slightly to stay in alignment with the head reducing shear stress on the neck. The head restraint in the Saab is connected to a lever in the seat back and moves forward on increased loading to catch the head.

So how effective are these active head restraint systems? In the Journal Trauma in 2001, a study concluded that Saab’s version known as SAHR, reduced the risk for whiplash by a whopping 75%.[7] A later study which received actual real life crash data input from several major auto insurance companies found whiplash injuries were reduced by 43% in women and 31% in men using Saab’s SAHR system.

These dynamic seat restraints are simple mechanical systems that add very little to the cost of a vehicle, but offer tremendous gains in safety. They really should be offered on ALL vehicles just like airbags and ABS. Auto manufacturers would be preventing thousands of injuries each year and saving the American economy a tremendous amount in lost labor due to accidents.

So the one single thing you can do to prevent whiplash is to properly adjust your head restraint. Make sure when you are sitting that the head restraint is within 4 inches of your head, the closer the better. Adjust the height so that the top of the restraint is slightly above the top of your head. Some cars will not allow enough adjustment to do this. Get it as close as you can. Any improvement will reduce risk of injury.

Can’t get it close enough? Time for a new car! Hey it’s for safety after all.

In the next article, I will explain what to do in that split second when it becomes clear you are going to be hit…this tip can prevent a lot of injuries.

For a Free Report entitled “What You Should Know If You’ve Been Involved in an Auto Accident,” go to DrMarks.com

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References

[1] Chapline JF, Ferguson SA, Lillis RP, Lund AK, Williams AF. Neck pain and head restraint position relative to the driver’s head in rear-end collisions. Accident Analysis and Prevention 32:287-297, 2000

[2] Barnsley, Lord, Bogduk, Whiplash Injury Clinical Review, Pain 58, 1994, pp. 283-307

[3] Panjabi MM, Grauer JN (1997): “Whiplash produces a S-shape curvature of the neck with hyperextension at lower levels. ” Spine 22 (21): 2489-94.

[4] Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.

[5] Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770

[6] John R Brault, MS, Jeffrey B Wheeler, MS, Gunter P Siegmund, BASc, Elaine J Brault, MS, PT Clinical Response of Human Subjects to Rear-End Automobile Collisions. Arch Phys Med Rehabil Vol 79, January 1998

[7] Journal of Trauma-Injury Infection & Critical Care. 51(5):959-969, November 2001. Viano, David C. Dr med, PhD; Olsen, Stefan BS

“The Problem with Whiplash…”

Everyday hundreds of auto accidents occur and the occupants are injured. Fortunately, the majority of these injury victims do not suffer fatal injuries. That’s the good news. The bad news is, most of the occupants suffer injuries that they may not be aware of or are mistreated by other doctors.

The “Problem with Whiplash” is that very few people truly understand it.

Well meaning emergency room physicians, general medical doctors and even many chiropractors do not fully appreciate the extent of injury suffered by these patients. A recent survey found that a significant percentage of family practice and orthopedic physicians question the validity of whiplash. [i]

Worse yet, these doctors cannot prove to the insurance companies, lawyers and juries that the injuries are real. The end result is that whiplash victims are given short shrift in terms of poor documentation, inadequate treatment, and low compensation for their injuries.

The first thing to realize about whiplash type injuries is that they are real. The current medical literature is filled with objective research validating this type of injury. [ii] Further, the research indicates that injuries can occur at surprisingly slow speeds and sometimes even without much car damage. [iii]
Next, whiplash injuries can remain hidden for weeks, months, and even years before telltale symptoms emerge. [iv]

Another fact to realize about whiplash is that it is serious. Even minor accidents can cause significant changes in the delicate nerves, ligaments, muscles and discs of the neck. At the onset, the problems may seem minor, but given enough time without proper care, the spine will dysfunction. Eventually arthritis occurs and the end result is permanent neurologic damage and loss of overall health.

Worse than arthritis, many whiplash accidents can result in mild forms of brain injury known as “post concussion syndrome” or “traumatic brain injury”. This is more prevalent in side impact collisions, but can occur in rear or front-end accidents as well. These concussive injuries often result without hitting the head. Still other researchers have linked Alzheimer’s disease and chronic fibromyalgia with whiplash type injuries. Whiplash is indeed a serious health problem.

Whiplash must be treated. Contrary to what most insurance company reps will claim, these injuries do not simply go away on their own. But not all treatments work. Hard medical evidence suggests that certain types of treatment are far superior at treating this problem. [iv]

A study by Woodward, Cook, Gargan and Bannister [v] found 93% of the patients studied under chiropractic care for chronic whiplash injuries had improved. They further stated “…no conventional (medical) treatment has proven to be effective in these established chronic cases.”

Without understanding these basic truths about whiplash, the general population is at the mercy of the insurance industry. The insurance companies know the facts and they spend millions of dollars each year to hide them. They use high-powered attorneys to fight claims and intimidate people.

If you have been injured in an auto accident it is important to remember whiplash is real, it can be serious and it must be treated properly. The key to successfully treating whiplash injuries is to find a medical provider who specializes in this area and that has a long track record helping accident victims recover from their injuries. The specialist must also be able to document your injuries precisely and communicate effectively with your attorney, the insurance company and in court if necessary.

For a Free E-Seminar “The Truth About Whiplash” and a Free Report entitled “What You Should Know If You’ve Been Involved in an Auto Accident,” go to DrMarks.com

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References:

[i] Evans RW, Evans RJ, Sharp MJ. The physician survey on post concussion and whiplash syndromes. Headache. 1994;34:268-274.

[ii] Barnsley, Lord, Bogduk, Whiplash Injury Clinical Review, Pain 58, 1994, pp. 283-307

[iii] Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770

[iv] Smith J. (1993). “The Physics, Biomechanics and Statistics of Automobile Rear Impact Collisions.” Trial Talk: 10-14.

[v] Woodward, Cook, Gargan and Bannister (1996). “Chiropractic treatment of chronic ‘whiplash’.” Injury 27(9): 643-5.

“Get Off the Couch and Back Onto the Green…”

Jack had it. Tiger has had it. Freddie is constantly battling it. Many of the elite of golf have had it.

The “it” is low back pain.

While very few recreational golfers have much in common with these legends, low back pain is the one thing shared by golfers of all skill levels.

Low back pain is reported to be the most common ailment affecting working age adults in the U.S., second only to the common cold. An astonishing 80% of Americans over the age of 30 will suffer at least 1 week of debilitating back pain during their lifetime.

Amongst the nations 30 million golfers, back pain is even more prevalent.

Golf and back pain go hand in hand. Many people, even golfers themselves, do not realize what a physically demanding sport golf really is. The amount of strain placed on the lower back joints, discs and muscles is tremendous.

Overstretching and straining muscles that are cold and tight cause many injuries. Golf can be rough on the back, but it is made even worse by golfers not stretching or warming up before or during a round.

Often overlooked is the fact that on public courses players take a shot and then wait around quite awhile before their next swing. This slow play causes the muscles to cool off and tighten up. Your next swing is with tight muscles making injuries more likely. Walking rather than riding a golf cart can help prevent this, but many courses do not allow walking.

The most serious problems for golfers include disc bulges, degeneration and herniation.

Symptoms of back pain that radiates to the buttocks, thighs or legs are very serious. These symptoms often mean that the cushions between the spinal bones of the low back have deteriorated or are bulging outwards into the nerves.

Once this occurs, it’s definitely time to seek specialized help. Severe back pain and sciatica (leg pain caused by disc material irritating the sciatic nerve) can come and go and is often helped by chiropractic manipulation, acupuncture or physical therapy. But common questions to doctors specializing in back pain among golfers are: What about the cases that do not respond well to these treatments? And what can be done about the cases that seem to go away only to return a month of two later?

Moderate to severe back and/or leg pain caused by deteriorating discs that fails to improve with non-invasive procedures or often reappear, were often thought to require surgery. But today physicians realize that surgery has its place in treating these resistant cases, but only as a last resort.

Searching the medical literature you will soon find that the most common type of back surgery (discectomy) has at most a 50% success rate and that at 12 months post-surgery surgery patients are no better off than non-surgically treated patients.

Additionally, patients undergoing surgery are prone to additional surgeries later on. Second surgeries are usually fusions where two or more spinal bones or vertebrae are in various fashions tied or bolted together. These surgeries have even less impressive success rates.

The good news for golfers with severe back or leg pain is that advances in medical computer technology have lead to a promising new treatment called “non-surgical spinal decompression.” This new treatment for disc problems that cause back pain and sciatica has been clinically shown to relieve pain and can actually reduce the size of disc herniations. All without the risk and potential side effects of surgery.

But golfers with back pain need to know that not everyone is a candidate for spinal decompression and expertise among providers varies greatly. Before embarking on a non-surgical decompression course, talk to an expert who perform the procedure and have an evaluation done. Only a health specialist that provides this treatment can tell you whether or not it has potential for you.

Free Golfer’s Guide to Severe Back, Disc and Sciatica Pain can be found at http://www.painlessgolf.com.