You get into a car accident and end up with neck pain. You seek medical care and you are told it is whiplash. You may get chiropractic care, physical therapy and/or take medications all under the diagnosis of whiplash. It may or may not help. Why? Because there is a problem with this diagnosis: Whiplash is merely mechanism of injury. It describes the fact that upon impact, your head was jerked forward and back. That is all it means. It doesn’t attempt to define the tissue in distress that is eliciting your pain. It is not a diagnosis.
Think about it…if you tripped and fell and bruised your knee, you wouldn’t say that your wound was a trip, right?
Note: If you’re currently suffering from a whiplash-related injury and you just want relief, scroll down for my healing protocol. Keep reading if you want to first understand why most conventional whiplash treatments fail.
For most people, experiencing whiplash leads to pain…and the pain leads to diagnostic testing. The MRI discovers a herniated disc, a pinched nerve, a compression fracture or some other structural variation and the doctor asserts that it is the cause of the new pain. This is known as correlative theory…and what I call junk science. It is the very same logic that says that if I open my front door just as the sun rises I can now say opening the front door causes the sun to rise. It creates a connection between two events simply because they occur at the same time.
Most likely, it is not the car accident that initiated the herniated disc or other abnormality. It was there long before. So many people have these abnormalities (90% of people over the age of 60 with no back pain have bulging or degenerative discs!) that it’s no wonder they are identified whenever an MRI is performed. So the assumption that whiplash leads to herniated discs, pinched nerves or any other type of structural variation is simply invalid.
Why whiplash pain persists: The typical treatment after a car accident is based on the “fact” that a structural variation developed due to the whiplash. If the structural variation existed before the whiplash, treating it won’t do anything to address the new pain.
SO…WHAT DOES HAPPEN WITH WHIPLASH?
The most-common tissue that is affected by the quick, jerky motions of whiplash is muscle. Muscle has a certain tone to it. If it is forced to stretch excessively in a quick manner, the tone in the muscle will try to prohibit the stretching. This can lead the muscle to strain and pain.
In the neck region, the muscles that support the head attach from the skull and top of the cervical spine to the shoulder blades. If these muscles are quickly stretched they could strain and elicit pain at the neck and between the shoulder blades. This type of muscular deficit does not show up on diagnostic tests so conventional practitioners won’t treat it. It will continue to elicit pain…and could lead to chronic pain.
A pre-existing muscle imbalance can make a whiplash-related injury worse. Many people have developed a forward-shoulder posture. This is where the person has a rounded upper back and his/her head hangs forward excessively in front of the spine. This altered posture results from a muscle imbalance between the pecs (chest muscles), anterior deltoids (shoulder) and biceps versus the muscles between the shoulder blades, posterior deltoids and triceps.
The muscles in the front of the body have a tendency to shorten because they are stronger. Once they shorten, they pull the shoulders forward causing the shoulder blades to move outward away from the spine. This overstretches the muscles between the shoulder blades, including the muscles that support the head. and they become susceptible to straining. The mechanism of whiplash causes the quick stretch that leads these muscles to finally strain and emit pain.
If the improper posture and muscle imbalance that leads to this were corrected before the whiplash, a lot of the resultant pain would be tamped down. In fact, some people would not experience any pain in the event of whiplash.
When I have treated patients with a diagnosis of whiplash, I focused on correcting the muscle imbalance that leads to the improper posture. And this, indeed, resolves the pain at the neck and between the shoulder blades.
If you present with forward shoulder posture with a forward leaning head, I urge you to address the issue now and potentially save yourself a lot of pain down the line.
EXERCISES TO RELIEVE (OR PREVENT) THE PAIN FROM WHIPLASH
You need to strengthen the rhomboids/midtrapezius (muscles in the upper back between the shoulder blades), lower trapezius (“trap”), posterior deltoids (muscles in the back of the shoulders), rotator cuff (muscles that stabilize the shoulders) and triceps (muscles in the backs of the upper arms).
For each exercise, perform three sets of 10 repetitions with a minute rest in between each set. Perform the series three times a week with a day of rest between. Resistance should be progressed to eventually get the muscles strong enough to perform all functional tasks without straining and eliciting symptoms.
1. Lat Pulldown (interscapular muscles: midtraps and rhomboids):
Tie a knot in the center of a resistance band and secure it in place at the top of a closed door. Sit in a sturdy chair facing the door and lean back with an angle at the hip of about 30 degrees. Reach up for the ends of the band so that the start position begins with the arms nearly straight and the elbows just unlocked. Pull the band down keeping your arms wide and bringing the elbows just below shoulder height and slightly behind the line of the shoulders. At this point, you should feel the shoulder blades squeeze together (the elbows will barely reach behind the line of the shoulders if performing this exercise correctly). Then return to the start position. Important: If the elbows start to drop so they are lower than the shoulders, you are using the incorrect muscles to perform the exercise.
2. Lower Trap Exercise (lower trapezius muscle):
Sit in a sturdy chair with a back and lean back slightly—about 10 degrees. This posture will prevent the resistance from pulling you forward. Step on one end of the resistance band to secure it and hold the other end in your working hand. Start with your arm halfway between pointing straight forward and pointing straight to the side, with your hand at shoulder height and your elbow just unlocked. Begin to raise the resistance until the arm reaches about 130 to 140 degrees (about the height of the ear). Then return to the start position at shoulder height.
3. Posterior Deltoid Exercise:
Stand with your feet more than shoulder width apart, knees slightly bent, and your butt pushed behind you. Your weight should be mostly on your heels. Step evenly on the band and hold the ends in front of your thighs with your palms facing in and your elbows unlocked. Begin to move the resistance out to your sides from the shoulders like a pendulum. Go out until you feel the shoulder blades start to move inward (about 60 degrees), and then return to the beginning position.
4. External Rotation Exercise (rotator cuff)
You can do this exercise using a dumbbell or resistance band. With the elbow supported at the end of a surface so that the elbow is just below shoulder height, the elbow should be maintained at a 90-degree angle through the whole motion. The elbow of the arm performing the exercise should be in a line with both shoulders (if the elbow is in front of this line, the rotator cuff will have difficulty performing the exercise). The start position is with the forearm facing about 20 degrees below parallel. The resistance is pulled upward until the forearm is facing about 20 degrees above parallel. Then return to the start position. Careful: This is an exercise where people want to go through too much range of motion. If excessive range of motion is performed, there is a chance of straining the rotator cuff.
5. One-Arm Triceps Extensions Exercise. This exercise is done sitting in a chair. If you are using a resistance band, secure one end at the top of a closed door and sit with your back to the door. If you are using a hand weight, hold it over your head, with your arm straight up and your elbow close to your head. Bend your elbow and lower the weight just behind your neck, then raise it back up. Repeat with the other arm.
I have treated patients who had pain for years after a car accident and they continued to say the cause of their pain was whiplash. If you continue with this thought process the odds of resolving your pain diminishes because you are focused on the mechanism that led to your pain. Unless you identify the tissue in distress eliciting the pain and treat that tissue, it will continue to elicit pain indefinitely. Remember: Whiplash is not diagnosis, it is a mechanism.
Click here to buy Mitchell Yass’s books, The Yass Method for Pain-Free Movement: A Guide to Easing through Your Day without Aches and Pains, or check out his website.