“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.