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RESOLVING WHIPLASH INJURIES PART 5 – Exercises to Support Whiplash Injury Treatments

Updated: 4 days ago


Exercise is a critical component in rehabilitating WAD injuries. There is strong evidence that exercise combined with manual therapy (manipulation or mobilization) has a substantial effect on reducing pain and increasing range of motion after a WAD. (29, 30, 31, 32)


Initially, as much as possible, exercises should be performed within a pain free range-of-motion. This helps to ensure that no abnormal neurological motor responses are developed (central sensitization), and the necessary tissue repair can occur. It is very important to remember that injured tissue needs time to remodel, but without the right exercise program, the possibility of re-injury and on-going pain is also very high.


The type of exercises that are prescribed will vary based on each patient’s needs, and the severity of the injury. In addition, specific recommendations for the patients Activities of Daily Living (ADL) such as using ice or heat, sleeping positions, and other recommendations can speed the healing process.


Tip: Check out my blog “Ice or Heat – Which Should I Use?” and my video “Back Pain and Your Activates of Daily Living”.

Exercise Examples for Whiplash Associated Disorders (WAD)

The following videos are examples of the type of exercises we often prescribe to our patients. (The actual exercises we would prescribe would vary depending on patient injuries. In general terms, we would first focus on improving mobility, then introduce strengthening exercises, then introduce functional exercises with a focus on balance and proprioception. In addition low-intensity aerobic exercise can help to speed the rehabilitation process.


Caution: These videos are for demonstration purposes only and should not be taken as recommendations for a specific case.


MOBILITY AND FLEXIBILITY EXERCISES


Neck Stretching - PNF - Kinetic Health: PNF (Proprioceptive Neuromuscular Facilitation) is a type of stretching that to increases flexibility and mobility, and increases overall range of motion. PNF is a progressive stretch technique involving muscle contraction and relaxation.

In this video we go through the four key motions of the neck and show you how to increase your mobility. (55)


Self Myofascial Release of the GB20 - Acupuncture Point Self-myofascial release of an acupuncture point known as gallbladder 20 (GB20 - Fengchi) can be very effective for relieving tension headaches, neck pain, and shoulder pain. GB 20 is located on the nape, just below the occiput, in the depression between the upper portion of sternocleidomastoid muscle and trapezius muscle. (52,53)



Myofascial Release of the Suboccipital Muscles - In this video we show you a great way to release trigger points at the base of your skull, in the Suboccipital region. The suboccipital muscles are extremely important since they contain very high concentrations of muscle spindle fibres. (Muscle spindles are the part of your nervous system that provide postural information to the central nervous system.) (54,55)


6-Effective - TMJ Exercises: The following video shows you how to perform 6 exercises for Temporomandibular Joint Dysfunction. These are some of the same exercises that we prescribe to our patients after we perform Motion Specific Release - MSR TMJ procedures. (53)





5 - Great Daily Shoulder Mobilization Exercises: You can perform these exercises throughout your day for best results. These exercises can make a huge difference in your posture, especially if you have been sitting for a long period of time. (56)






STRENGTHENING EXERCISES


Important: All neck injuries requires the advice and attention of a trained professional. So check with your practitioner before starting this phase of treatment.


6 - Isometric Neck Exercises: Isometric exercises are a gentle way to gently strengthen the muscles of the neck. These exercises are a great starting point for strengthening after an injury. (55)







L's Shoulder & Upper Back Strengthening - These are great exercises for strengthening the shoulders and upper back after a WAD. (56)









NERVE FLOSSING EXERCISES


Peripheral nerve entrapment is a common occurrence in whiplash injuries.The following link takes you to our Nerve Flossing Playlist (14 Nerve Flossing Exercises), covering multiple sections of the body from the spine to the upper and lower extremity. (52,53,54)






CONCLUSION

Whiplash Associated Disorders are complex injuries. In order to achieve optimal results in treating and resolving these injuries, patients must consider several important factors:


  1. Select a practitioner who possesses a good understanding of Whiplash Injury Bio-mechanics. This is important, not just from the perspective of resolving the injury, but for addressing the litigation process. Though most case are resolved before a case goes to court, practitioners may be called to testify to give their opinions on the injury and its long-term ramifications. Make sure you have qualified and well educated practitioners on your team.

  2. A complete examination that includes a comprehensive history, orthopedic and neurological assessment, and necessary imaging is essential. All aspects of examination must be thoroughly documented, including a subjective pain assessment and a neck disability index. From a medical legal perspective documentation is critical.

  3. Best results are achieved by using a multidisciplinary approach. From an injury resolution perspective, a trained professional, should address both soft-tissue and joint injuries. Choose a skilled musculoskeletal practitioner (Chiropractor, Physiotherapist, Registered Massage Therapist) who has experience in addressing WAD. In addition to your manual musculoskeletal practitioner, pain management could also be a significant factor, since it is often difficult to receive therapy, do prescribed exercises, or even sleep when experiencing a high level of pain. This will require consultation with a medical practitioner. The appropriate medication can definitely be an asset in helping you to progress and achieve optimal results.

  4. Exercise is NOT optional, it is critical for a full recovery from a WAD. Special consideration should be given to the specific needs of each individual. Exercises prescribed should consider three primary stages: acute, recovery and functional rehabilitation and should include neuromuscular re-education. It is also essential that the patient has exercises that they can continue to use in a home exercise program.


WAD are complex, but can be addressed successfully if the right approach is taken. Make sure that you understand your options to achieve the best results possible.



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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