What Physical Therapy Is

I lived in a city with infinitely more cars, but I never remember seeing as many accidents as I have since moving to Jacksonville over 2 years ago.  Getting into an accident is scary and knowing what stress and motion occurs at the neck in a collision is even scarier.  The seatbelt and does a great job at keeping or body in place, but the 10-12 lb head pulls the neck and gets thrashed about.  My purpose of talking about this is not to get you paranoid, but to explain why even a small rear end accident can cause neck discomfort and what you can do about it after it occurs.

When you are sitting still and a car behind you impacts your car and pushes it forward the initial reaction is neck extension.  Your head will continue backwards until it either reaches the end of its ability to stretch or it hits the headrest; hopefully it’s the headrest.  Forceful extension causes stretching of front neck flexors and anterior longitudinal ligament.  If the stretching reaches its maximal length before the head hits the headrest, tearing and injury occur.  The nerves that exit and enter the neck can also get injured with this forceful extension and cause some of the more confusing and debilitating symptoms of whiplash injury such as headache, vertigo, ringing in the ears, and pain and tingling in the hands and arms.  Nerve injuries can be very fickle because they do not have same elastic properties of muscle and ligaments and do not respond well to injury. 

Once the head hits the headrest it ricochets forward- the whiplash phenomenon.  This motion is checked by the tissue being stretched all the way or impact of the face into the airbag (hopefully) or the something more unforgiving such as the steering wheel or windshield.  The back of the neck has its own muscles and ligaments, but also joints with their own set of tissues that support them.  The nerves can also be injured with this motion as well.  Through all of this the discs between the vertebrae that we hear so much about are absorbing shearing forces and if they are weak or the force is too great they can become injured as well. 

The end result is an extremely stiff and sore neck.  You would have the combination of muscle strain, ligament sprains, nerve irritation, and possibly bulging discs.  EMT’s will usually put a collar on your neck and take you to the ER for x-rays and this is done as a precaution to make sure a bone in the neck did not fracture or there was not a severe injury to the nerves.  If you get into an accident and are up walking around before the ambulance arrives it is still a good idea to lie down on the back board and go to the hospital if they recommend it; always error on the side of caution. 

The next day is usually worse as with most musculoskeletal injuries.  The inflammatory response has had a chance to set in and the body’s protective mechanisms are telling you it needs to rest.  At this point it is good to seek professional help to safely and effectively guide you through the healing process.  Some people will be better within a few days, but others it may take weeks.  By seeking quality care immediately after the accident you can prevent the pain from becoming chronic.