Before starting any exercise routine you should check in with your physician to be sure it is safe to exercise. This blog post describes some red flags that are important to address prior to starting an exercise routine for your neck. If you think you are experiencing a red flag, call your doctor. These exercises are to address an acute injury or an injury that happened recently.
What is whiplash?
Whiplash is an injury that can occur to the neck anytime the head is forcefully moved forward and back. This quick change in direction to the head can cause strain to the muscles and joints of the neck. The term whiplash is often associated with injury after a car accident, but people can get whiplash from falls or sports injuries.
Common symptoms of whiplash
Symptoms of whiplash often come on hours to days after the trauma.
Symptoms can include:
- Neck pain
- Loss of range of motion of the neck
- Radiating pain into one or both arms
- Headache
- Dizziness or feeling foggy
What are some things to see a doctor about after a car accident?
Some symptoms can be indicative of something more serious going on and should be reviewed by your doctor. In physical therapy these are called red flags.
- Immediate onset of symptoms with the trauma, instead of symptoms that start hours or even days later, can be a red flag.
- Complete loss of range of motion of the neck in most directions
- Sudden onset of severe headache
- Numbness or tingling in your arms or legs or face
- 5Ds And 3Ns are red flags that should not be ignored
- Diplopia – double vision
- Dizziness – vertigo, lightheadedness
- Drop Attacks – a sudden fall that is not associated with a loss of consciousness and not caused by a stimulus (like tripping)
- Disarthria – slurred speech
- Disphagia – difficulty swallowing
- Ataxia – loss of coordination that will often present as difficulty walking because of balance problems
- Nausea – queasy sensation, often with the urge to vomit
- Numbness – especially in the face
- Nystagmus – uncontrollable eye movements that will sometimes affect vision or balance
If you are experiencing some of these red flag symptoms following a car accident you may still be appropriate for physical therapy, but you should check in with your physician before starting an exercise program.
Do I need a neck brace?
The answer is probably not. In most cases people do better when they gradually return to their regular activity. Studies show that people who return to early motion have decreased pain, improved motion, and fewer lost days of work when compared to those who are immobilized using a soft collar. Therefore soft collars should not be recommended. However, if it has been determined that you have a confirmed ligament tear or a fracture of a cervical vertebra a neck brace is clearly indicated.
Three Exercises for Whiplash Injury Immediately After a Car Accident
1: Range of Motion
Work on gentle pain free range of motion. Start slow. Turn the head from side to side, stop before the point of pain. You may notice motion is limited more to one side or another, just continue to turn head within pain-free range of motion. Try 5-10 repetitions 3 or more times a day. You can also practice looking up and down
2: Gentle Activity – Walking
Light walking is a good way to increase blood flow to healing tissues. The arm swing and natural rotational movement that walking creates through the spine is another way to work on easing back into activity. Start easy with this, it is not a fitness walk, you should not be carrying items or holding the dog leash. Start with 10 minutes of walking and repeat a few times throughout the day, if comfortable. If you cannot get outside it is acceptable to walk around the house.
3: Chin Tuck
The chin tuck exercise targets a stabilizing muscle in the neck called the longus coli. This exercise is to be performed with a towel roll behind the neck while lying down. You may also need a towel or pillow under your head. Your face should be parallel to the ceiling when you start. Imagine an axis of motion at the position of your ears. Make a nodding “yes” motion by bringing your chin toward your voice box. Your head should not lift and the muscles in the front of the neck should stay relaxed. You can place one hand across the front of the neck to monitor the muscles.
Start with a 3-5 second hold for up to 10 repetitions. Work toward 10 repetitions of a 10 second hold. Exercise can be done up to 2 times a day. If you are noticing increased symptoms with this exercise, stop
What should I avoid?
Avoid bracing the neck with a soft collar. Be careful with heavy lifting, strenuous activity and exercise that make your symptoms worse. Avoid sitting for prolonged periods with bad posture.
In general, you should start to gradually return to your regular activities. You may need to scale these activities, making them easier at first and then increasing the load or intensity. Listen to your body.
When will I feel better?
For a lot of people with mild symptoms and minimal disruption to activity whiplash will improve within several weeks. But early activation is key, which means returning to your regular activities. You may experience ups and downs in your recovery, but symptoms should typically be getting better with time. Most improvement is made in the first 6-12 weeks after an accident.
When should I seek Physical Therapy?
There is certainly a recovery window. The first 6-12 weeks after an accident can be an important time to initiate physical therapy, especially if you are struggling to return to regular activities. See a PT if you are having a hard time lifting, carrying, bending, sitting for work, turning your head, or returning to sports and recreation.
The physical therapists at the Whiplash Injury Treatment Center at Union Physical Therapy are trained to evaluate your injury. They use hands on techniques to decrease pain and improve range of motion. They are experts in prescribing exercises to improve strength and endurance to the muscles around the neck and shoulders. Your therapist will work with you to establish specific goals for your treatment plan to get you back to doing the things you want to do.
About the author: Amanda Benson, PT, DPT, CMPT, OCS has been treating patients in the Seattle area since 2005. She has advanced training in manual therapy and in orthopedics. Amanda is one of the founding members of the Whiplash Injury Treatment Center.