Author: Michael Greenspan

Whiplash is a specific kind of traumatic injury that harms the muscles and joints of the neck; while it can break a bone, such a fracture is a rare event. The tissues most injured in a whiplash collision are the neck muscles and joints of the neck: the places where bone meets bone.

Muscles cross over the joints, contracting in order to move the bones in relationship to each other. Much like a ligament, if a muscle is overextended because the joint is forced to move beyond a muscle’s full extension, the muscle becomes injured.  An injured muscle is called a ‘strain.’  It’s quite normal for a single injury to cause both a sprain and a strain in the ligament and muscle respectively.

Quite often, “landmine knots” called trigger points form in the front and back neck muscles, causing severe aches and pains, as well as referred pain into the eyes and head.

Joints are held together with connective tissues called ligaments. Ligaments hold the bones together, limiting the movement of each joint. When the joint is forced to move beyond the limits that the ligaments set, the ligaments are injured, resulting in a sprain. You may recognize this from the term ‘sprained ankle.’

Unlike most joints, wherein a muscle stretches across a single joint because it has only a single pair of bones within its range, the spine is a complex collection of small bones and muscles that stretch over many of the joints between those small bones.

Although whiplash injury can break (fracture) a bone, fractures from whiplash trauma are quite rare.

Notice, for example, that your elbow only moves in one direction. The neck, meanwhile, can turn left and right, tilt up and down, slide forwards and backwards, slide side to side, and even extend and contract a little bit. It’s the most flexible part of the body. The neck also holds up the dead weight that is the massive human skull and the brain it contains. All that, and the neck muscles and bones also protect the spinal cord that connects our brain to the rest of our body, allowing us to feel sensations and move.

This is all due to the incredibly powerful and well-engineered bones in our spine, called vertebrae. Each vertebrae has three individual joints rather than the one that most bones are allowed. The largest joint on each vertebrae is called the disc joint, because a disc of ligament-like tissue sits between it and the next vertebrae in the spine. The disc joints are the ‘shock absorbers’ of our bodies.

Then, each vertebrae has two joints at the back of the bone, called facet joints. The facet joints are where the muscles that control the movement of your neck and back are connected.

When you get whiplash, the muscles, disc and facet joints between your neck vertebrae get overextended in a forward-back direction. This results in several related conditions: ligament sprains, muscle strains, and in extreme cases, the discs between vertebrae can rupture or become herniated.

Whiplash injury research is both extensive and in-depth. Because whiplash is such a common legal battleground, there have been literally thousands of scientific and medical studies on every single aspect of whiplash.

For example, we’ve known for a couple of decades now that the primary sources of damage during a whiplash event is the overextension (‘inertial injury’) to the soft tissues (muscles, ligaments, fascia, and muscles) of the surrounding area and joints in your vertebrae.

By injecting the muscles and soft tissues of the neck with very localized anesthesia – thus numbing the neck one small section of tissue at a time – researchers studying whiplash have been able to determine precisely which muscles and tissues the pain is originating in. By using a powerful x-ray machine called a fluoroscope to precisely position anesthetic needles in the exact tissues they want to anesthetize, they can ensure that they don’t accidentally anesthetize the wrong tissues. When they make an injection that stops the patient’s pain, they’ve found the tissue that was responsible for the pain. By slowly working their way through the facet joints, the disc joints, the spinal muscles, the spinal nerves, the connective tissues, and other parts of the neck, they can establish in each case where the problem is.

The results have been very consistent across hundreds of patients: chronic whiplash pain is by far most commonly sourced in the muscles, trigger points, and  ligaments of the facet joints at the base of the neck, and secondly in the disc joints of the same vertebrae.

Whiplash-related headaches, however, come from “landmine knots” better known as trigger points in your neck and shoulder muscles. These trigger points refer pain directly into your head, behind your eyes, and base of skull causing you that aching tension throughout the day.  Whiplash-related headaches also come from ligaments of the facet joints in the upper part of the neck.

Whiplash Injury Healing Time

Injured muscles and soft tissues can take up to 12 months to heal completely even when given the most appropriate treatment. The average healing time for a well-treated whiplash injury (back to maximum movement with no pain) is seven months and one week – however, a meaningful amount of whiplash patients can take as long as two years to reach that point.

However, Neuromuscular Massage Therapy  is shown to greatly speed up recovery and pain relief, breaking the pain spasm cycle caused by the accident.

Numerous scientific and medical studies prove that the extent of damage to your vehicle is not a predictor of the extent of damage to your neck caused by a whiplash injury. In short, there’s no connection: you can find severe whiplash in the rider of a vehicle that suffered only a paint scratch, and you find a person with no whiplash damage who’s car has been totaled.

• Specifically, no correlation is found between vehicle damage and:
• The degree of whiplash injury
• The duration of treatment required for whiplash injury
• The severity of the symptoms of whiplash injury
• The probability of chronic pain caused by whiplash injury
• Or the probability of whiplash-related arthritis in the joints of the neck developing later.

Some vehicles are designed to collapse during an accident; others are made to resist collapse. All necks are designed with more or less the same standards of movement – so there’s a solid, engineering-based reason why no amount of correlation is found between vehicle damage and whiplash damage.

One of the most brilliant scientists that ever lived was undoubtedly Sir Isaac Newton – a physicist, astronomer, mathematician, theologian, and natural philosopher whose work has influenced many parts of our society. At age 43 – in 1647 – he published Principia Mathematica, which altered the history of science.

In his seminal book, Newton discusses three Laws of Motion – Laws which we’re able to easily use to explain the causes and effects of whiplash trauma and the injuries it causes. The First Law of Motion is the Law of Inertia. It says, quite simply, that an object that isn’t moving will remain motionless and that an object that is moving will keep moving in the same direction and speed – in both cases, unless some outside power intervenes to change things.

The larger and heavier and faster-moving an object, the greater the intervening power has to be in order to alter the motion. In the case of whiplash injuries, the object that’s moving is your head – a pretty hefty ball of mostly water, often moving forward at several dozen miles per hour while the vehicle (and, because of seat belts, the body) holding it up stop quite violently. The only force that can stop the head is the strength of the neck’s muscles and connective tissues.

Alternately, in the case of a rear-end collision, your car and body, which is held up by the seat back, lurches forward. Your neck flexes backward as your head doesn’t keep up. Then, because your car is heavy and holding your body in place with a seat belt, your car and body stops, but your head won’t. Your head plummets forward, again only stopped by your neck’s muscles and ligaments.

In either case, what happens is that, given a significant enough impact, the muscles and connective tissues of the neck tear and disjoin, causing severe damage we call ‘whiplash.’

For nearly a century, we’ve known that the best way to get injured muscle tissues to heal is to get them to move – early and often, though not necessarily to the extremes of their normal limits. In particular, treating whiplash injuries has been easiest when combining massage, mobilization and manipulation of the tissues. When the joints are mobilized, the muscles and connective tissues move – and if done by someone trained in therapeutic massage rehabilitation, they can be moved in a way that encourages them to heal correctly.

The classic response to an injury has long been traction – the immobilization of the area. However, we’ve known for decades that the best whiplash healing happens with controlled movement, not immobilization.

When we hurt our neck’s muscles and ligaments, one of the most common responses is ‘guarding posture’ – a change in the way we hold our head and move that keeps the pain from flaring up. The problem is that when the guarding posture is held for weeks (or months or years) at a time, it can cause a snowball of changes to the way we hold our torso, walk, carry things, and so on – changes that themselves cause pain and problems.

The best way to avoid being permanently stuck in guarding posture is to allow our neck’s muscles and ligaments to heal – which means moving them correctly. But moving them correctly is what we’re guarding against! It hurts!  That’s precisely why you need a skilled neuromuscular massage  therapist to loosen up the muscles and help you move them correctly without causing wincing pain.

According to the Annals of Internal Medicine, the benefits of massage therapy for neck pain treatment and whiplash have proven to be significantly superior to self-guided exercises and drugs (the so-called “conservative treatment” espoused by most primary care physicians.)

When treating chronic whiplash pain, science proves the benefits of massage therapy to be more effective than acupuncture, non-steroidal anti-inflammatory drugs, and traction. In addition, the group treated with massage therapy had no adverse reactions – the group taking drugs actually reported more adverse reactions than benefits. Massage therapy was the only one of the three groups that was still found to have benefited one year later.