Each year approximately 3 million people suffer a whiplash injury. About half experience some chronic problems, and about 10% become permanently disabled. The costs associated with whiplash annually are a staggering 43 billion in the US alone. What is whiplash? Whiplash is described in the literature as an injury to the neck, specifically your cervical spine, and/or supporting soft tissues resulting from a motor vehicle trauma. The classification of Whiplash-Associated Disorders (WAD), or Cervical Acceleration-Deceleration Syndrome (CAD), which has been applied for over two decades, states that temporomandibular joint (TMJ) pain can occur after whiplash trauma. Temporomandibular disorders (TMDs) is a broader term embracing both muscles and TMJs. A systematic review of TMD pain pointed to an increase in its prevalence and incidence after whiplash trauma.
This particular study, A 15-year follow-up of temporomandibular joint symptoms and magnetic resonance imaging ﬁndings in whiplash patients: a prospective, controlled study by Hanna Salé, DDS, Ph.D., Fredrik Bryndahl, DDS, Ph.D., and Annika Isberg, DDS, PhDc, 2014., aimed to determine the incidence, prevalence, and progression of temporomandibular joint (TMJ) magnetic resonance (MR) imaging ﬁndings and symptoms in patients over 15 years after whiplash trauma, compared with control participants. Sixty consecutive patients were enrolled directly after whiplash trauma. The study protocol included TMJ MR imaging at inception and 15 years later, as well as a questionnaire and interview at inception, at 1-year follow-up, and at 15-year follow-up. Fifty-seven patients (95%) participated in all three examinations (85% for MR imaging). Fifty matched control participants were examined. The prevalence of TMJ symptoms was signiﬁcantly higher in patients compared with control participants at inception (44% vs. 20%, P ¼ .0055) and remained signiﬁcantly higher throughout the study period. The prevalence of disk displacement did not differ signiﬁcantly between groups either at inception (63% vs. 53%) or at 15-year follow-up (63% vs. 55%).
This prospective 15-year follow-up found that MR imaging ﬁndings of TMJ disorder were as prevalent in patients exposed to whiplash trauma as in control participants, whereas a significantly higher prevalence of TMJ symptoms was found in patients compared with control participants. This finding and previously reported impairment of jaw function after whiplash trauma point to a need for including a clinical examination of TMJs and related muscles in routine medical examinations of patients with symptoms after whiplash trauma.
So it remains important to evaluate and screen the orofacial area and temporomandibular joints in all your whiplash related clients, post-concussion, as well as slip and fall clients.
While there is much to write about on the topic and stress the importance of seeking quality physical therapy treatment for this, I wanted to focus on a couple of key Auto Safety Facts to help ensure you not only survive a crash but hopefully significantly reduce the severity of suffering a whiplash injury.
ALWAYS wear your seat belt and shoulder harness when riding in a vehicle. Many fatal crashes occur at relatively low speeds, and you double the chances you will survive a crash by wearing your seat belts. Your best bet in reducing your risk of a fatal crash is your seat belt. Here are the facts:
SAFETY DEVICE EFFECTIVENESS
Airbags alone 12%
Seat Belt Alone 42%
Airbag + Seat Belt 47%
- The belt should cross your shoulder and rest on your hips and pelvis
- Pregnant women should place restraint belts over and under the abdomen.
With seat belt restraints you will stay in your seat and away from the car’s interior parts!
Without seat belt restraints as your car stops abruptly, your body will keep moving at collision speed!
Only 25% of us correctly adjust our head restraints. This is the SINGLE most important way to prevent whiplash injury. Position the head restraint as close to the head as possible. It should be level with the top of the head.
Is your head restraint positioned correctly?
The proper position is to adjust the head restraint such that it is about 5cm (2 inches) from the back of your head. Closer head restraints are twice as effective at preventing injuries as those set too far back. Closer means that your head will have less distance to build up speed and load the neck during an impact.
This poorly adjusted head restraint is set both too low and too far from the back of the head. This leaves the head and neck unsupported in the event of a rear-end collision.
This correctly positioned head restraint is set at the proper height for this individual and is about 2in (or less) away from the back of the head. This will provide significantly better protection for the head and neck in a rear-end collision than a poorly adjusted head restraint.
What to do if you’re about to be hit from the rear:
- Sit fully back against seat and head restraint.
- Shrug shoulders firmly to limit neck motion.
- Look straight ahead with head back slightly.
- If stopped already, apply brake firmly.
- If the driver, place hands flat against the steering wheel.
Airbags can also cause injuries. Some bags come out at speeds of up to 200 mph. Under normal conditions, the airbag is fully inflated just before the occupants contact it. In the event of a crash, it is important to keep your hands AWAY from the airbag module cover to avoid injury such as broken hands and/or wrists.
A smaller person, whose chest or sternum is WITHIN 10 inches or less of the steering wheel, is at risk of being struck by the airbag. Injuries can be serious or fatal. Some cars have adjustable brake and accelerator pedals to allow shorter drivers to adjust their seats farther back.
I hope that this information, (as there is more), provided ensures the safety of you and your loved ones. Included are some very helpful sites. It is very important to review the guidelines to follow so your children are safe as well when using child restraint safety systems: http://www.nhtsa.gov/Safety/CPS
Having personally completed a comprehensive (and really the only one of its kind) Whiplash Injury Biomechanics and Traumatology Program with the Spine Research Institute of San Diego several years ago, this incredibly valuable information can save your life and the ones you love! Thanks to Dr. Arthur Croft for sharing his passion, expertise and knowledge!
Michael Karegeannes PT/MHSc/LAT/MTC/CFC/CCTT/CMTPT
Owner of Freedom Physical Therapy Services