Whiplash


Canadian Physiotherapy Association

It is estimated that there are more than 100,000 whiplash cases in Canada each year. Most occur from vehicle collisions, but whiplash can also result from sport or work injuries.

The term “Whiplash” refers to the nature of an injury, whereby sudden force is applied to your body, resulting in a rapid forward/backward motion of your head on your neck.  There are several soft tissues of the neck and upper spine that can be stretched by this sudden motion, with effects ranging from local pain and stiffness in your neck; through to numbness, tingling, sleep or concentration problems; in addition to some anxiety about driving that can be part of the experience.

Recent studies indicate that most recovery will occur within the first 6 weeks following the injury, although 20-50% of people will continue to experience some ongoing problems that don’t resolve quickly. These issues could include ongoing pain or stiffness that interferes with your daily activity.  An evaluation by a Physiotherapist is a great way to determine whether you are likely to recover in a timely manner, or if some formal rehabilitation may be needed to help improve your chances of smooth recovery.

Do I need to wear a neck collar?

This question is best left to your Physiotherapist, and should be addressed on an individual basis.  In general, the current thinking suggests most people don’t require a collar and early movement in a comfortable range helps recovery.  However, some people may benefit from occasional collar use for certain tasks, such as prolonged desk work or sleeping.  Your Physiotherapist can advise you of the pros and cons of collar use to allow you to make an informed decision.

The recovery process

Some mild pain, stiffness, neck tenderness and a little driving anxiety are all normal reactions after a motor vehicle collision. However, if these are severe (for example, pain at rest that you would rate as greater than 6/10) or last more than a week following your injury, you should see a Physiotherapist for an assessment.  Talk to your Physiotherapist about any concerns you may have. Expect the therapist to provide you with some education and teach you some exercises, movements or postures to help you recover. Your involvement in the recovery process is essential to increase your chances of a full recovery.

You can help yourself by performing frequent ‘good neck health’ practices. These could include postural awareness, for example: sitting tall, with your head squarely between your shoulders (not jutted forward), and your shoulders held slightly back and relaxed.  Position your work surface so that you can maintain this posture. Adjust your seat height and keyboard position where necessary to reduce strain on your neck. Perhaps more important than having a good posture while you sit is changing your position frequently throughout the day. Changes in posture could be as simple as setting a timer that reminds you to look away from the screen and move your neck through a comfortable range.

Physiotherapy can help

Physiotherapists support an active approach to the treatment of neck pain. Once the injury has been assessed to ensure there is no serious injury like a fracture or ligament tear, exercises may be prescribed to help you regain movement, strength, and ability to perform activities that are important to you. In addition, physiotherapists may assist with short-term pain relief through manual therapy, ice and / or heat applications and relaxation techniques. Education about neck pain, what to expect during your recovery, and how you can manage your neck pain are additional components of the physiotherapy rehabilitation program.

It is common for people who have experienced a neck injury to feel occasional pain or stiffness, even several years later.  It is therefore wise to make ‘good neck health’ practices a part of your daily routine.  While you do not need to constantly sit ‘perfectly’ straight, becoming aware of your postures, especially sustained postures that either increase or decrease your pain, and setting timers to remind you to move every hour or so is an example of such practice.  Sleep can sometimes be difficult with neck pain, so finding a mattress and pillow that you find comfortable may be a worthy investment.  Many stores will allow you to ‘test drive’ pillows and mattresses, so you may want to take advantage of that, to find one that works for you.

Below are some suggestions for ‘good neck health’ that you may wish to try.  If you find any of these cause you discomfort, then stop and consult your Physiotherapist who can perform a formal assessment and offer you a personalized rehabilitation program.

Stretching

  • Gently tuck your chin in towards your chest and rotate your head toward one shoulder until you feel a gentle stretch in the neck muscles on the opposite side of your neck. Hold 10 to 15 counts and then relax. Do 5 – 10 repetitions on each side.
  • Gently tuck your chin in towards your chest until you feel a gentle stretch in the muscles along the back of your neck. Hold 10 counts and then relax. Do 5 -10 repetitions.
  • Keeping your mouth closed, slowly tilt your head back until you feel a gentle stretch in the muscles along the front of your neck. You may wish to support your neck by clasping your hands behind your head during this exercise. Hold for 10 counts and then use your hands to help you back to the starting position. Do 5 -10 repetitions.
  • Keeping your head in line with your shoulders and nose pointing forward, slowly bend your neck to the side until you feel a gentle stretch along the opposite side of your neck. Hold 10 counts and then relax. Do 5 -10 repetitions on each side.

Strengthening

  • Tuck your chin and moderately push your head back against your hands or the floor (if lying on your back). Hold for 3-5 counts. Do 10-20 repetitions.
  • Place your hand on the side of your head. Tuck your chin in and push your head to the side, against your hand, matching forces so that neither your head nor hand actually move. Hold 3-5 counts. Do 10-20 repetitions.

Acknowledgments to: Dave Walton, Ashley Smith, Geoff Schneider and Jordan Miller

Find a Physiotherapist

The Canadian Physiotherapy Association (CPA) represents physiotherapists, physiotherapist assistants and physiotherapist students across Canada. CPA members are rehabilitation professionals dedicated to the health, mobility and fitness of Canadians. Physiotherapists are primary health care professionals who combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability. More than 20,000 registered physiotherapists work in Canada, in private clinics, general and rehabilitation hospitals, community health centres, residential care and assisted-living facilities, home visit agencies, workplaces, and schools.

Find a physiotherapist near you

The CPA presents its educational references as a public service and for informational purposes only.
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership.