In many cases, recovery from Whiplash Associated Disorders (WAD) can occur quite quickly, especially with a program that includes conservative care, combined with recommendations on activities of daily living (ADL), and an individualized program of exercise. (29) WAD symptoms can be persistent leading to chronic problems. Early implementation of treatment can make a huge difference in whether or not WAD becomes a chronic condition.
With whiplash injuries, research has shown that 15% to 40% of individuals who have whiplash injuries can develop chronic neck pain. Early intervention can often help you avoid becoming one of these statistics. (16, 29)
What Type of Treatment is Most Effective?
Manual therapy should begin as soon as possible, after a complete physical examination (orthopedic and neurological testing) and appropriate imaging has been taken to identify fractures. Research consistently shows that manual therapy is effective for decreasing pain and improving function. (42)
The selected therapy should address both soft tissue and joint injuries. Since pain is often a significant factor during the initial stages of treatment, I recommend taking a multidisciplinary approach in which the musculoskeletal practitioner provides Conservative Care, while the medical doctor prescribes the appropriate medication for dealing with acute pain and inflammation.
Tip: Research has shown that a soft neck collar (cervical collar) does NOT improve treatment outcomes. In fact, it could lead to a delayed return to activities. (41)
ADDRESSING SOFT TISSUE RESTRICTIONS
IN THE CERVICAL SPINE
The following videos demonstrate some of the soft-tissue procedures we commonly use to treat patients who suffer from Whiplash Associated Disorders (WAD). We have found these procedures to be especially effective when they are combined with joint manipulation/mobilization techniques and a functional exercise program. For the best results, soft-tissue restrictions must be assessed and treated for the kinetic chains of the entire shoulder, neck, and jaw. The following videos are examples of Motion Specific Release (MSR) procedures we would commonly use to address soft-tissue restrictions.
Releasing the Anterior Cervical Spine - MSR: In this MSR Anterior Cervical Release protocol, we focus on some of the structures of the anterior cervical spine. This MSR (Motion Specific Release) protocol is designed to be combined with the MSR Posterior Cervical Spine protocol, MSR Shoulder protocols, TMJ protocols and with osseous manipulation/mobilization of the cervical, and thoracic spine, as well as the upper extremity joints. (53)
Posterior Cervical Release - Part 1 In addition to addressing localized areas of pain, it is also important to consider the broader kinetic chain and address any myofascial or joint restrictions in these areas. Remember, it is not effective to treat any anatomical structure in isolation, all structures are interconnected, and therefore, all related or affected structures must also be treated. (53)
The MSR Ten‐Point TMJ Protocol - Part 1: Jaw problems (TMD) are commonly seen in WAD. (34,35,36)TMD problems often cause jaw pain, headaches, earaches, facial pain, vision problems, eye pain, balance issues, tinnitus, throat and neck pain, dizziness, and a multitude of other symptoms. In Part One of this two-part video series, we focus on using external procedures to address the soft-tissue structures of the jaw which are causing temporomandibular dysfunction. (52,53)
ADDRESSING JOINT RESTRICTIONS
In addition to removing soft-tissue restrictions, it is equally important to remove osseous joint restrictions in the cervical spine. Without the removal of these osseous restrictions, Many patients never see a resolution of their WAD symptoms. Joint restrictions in the cervical spine can be released, by a certified practitioner, with either Neck Adjustments or through Neck Mobilization.
The Power of Chiropractic Adjustments
Chiropractic adjustments are powerful tools. Research shows when patients who suffer from neck or back pain receive Chiropractic care, then they do much better as compared to patients who do not. They are out of pain sooner and recover much faster. In this video, Dr. Abelson demonstrates some of the procedures we use to address joint restrictions throughout the body.
Neck Adjustment Verses Neck Mobilization – Which one is for me?
The practitioner should always determine if neck adjustments are appropriate for the patient’s specific case. For patients who would prefer NOT to have their neck manipulated, we offer a safe, effective alternative using Neck Mobilization to release restrictions in the neck area (cervical region).
Although Neck Manipulation is a great tool for removing joint restrictions, cervical manipulation is not always appropriate for many of our patients. For example, we do NOT manipulate the necks, of patients over a certain age, patients with severe osteoarthritis or osteoporosis, patients with certain autoimmune conditions such as Rheumatoid Arthritis, or various other conditions.
Cervical Joint Mobilization - MSR: In this video, I demonstrate examples of Cervical Joint Mobilization, which we also teach to other practitioners during our Motion Specific Release (MSR) courses. (53)
Caution: These MSR Protocols should only be performed by certified MSR practitioners, and are not for practice by the general public. The videos we provide are strictly for demonstration purposes!
Part Five: In Part Five of “Resolving Whiplash Injuries”, I will review the importance of using exercise for WAD treatments and provide examples of appropriate exercises.
Note: All references are at the end of RESOLVING WHIPLASH INJURIES Part 5
DR. BRIAN ABELSON DC.
Dr. Abelson believes in running an Evidence Based Practice (EBP). EBP's strive to adhere to the best research evidence available, while combining their clinical expertise with the specific values of each patient.
Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publication which will be available later this year.
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