Tag Archives: whiplash

This Common Car Crash Injury Leads To Bigger Problems

Sub failure Injuries

Whiplash Is Not A Diagnosis

Not a week goes by that a patient doesn’t come in and tell me that he/she has or had whiplash.  Whiplash is not an injury, it’s a mechanism of injury.  Saying you have whiplash would be like saying you have “fell on my back” or “slip and fall”.

So now that we understand that whiplash is not an injury, lets talk about one of the most common injuries whiplash can cause…Subfailure Injuries.

Subfailur Ligament Injuries

Ligaments are fiberous connective tissue that hold bony joints together.  They attach from bone-to-bone with the purpose of stabilizing joints and allowing them to move within their normal range of motion.  Unlike other connective tissue, such as muscles, they are not very elastic and do not stretch very well.  This is critical to understanding how these tissue get injured in car crashes.

Ligament Instabilities Defined

“The loss of the ability of the spine under physicologic loads to maintain relationships between vertebrae in such a way there is neither damage nor subsequent irritation to the spinal cord or nerve roots, and, in addition, there is not development of icapacitating deformity or pain due to structural changes.”

White AA, Panjabi MM:  The problem of clinical instability in the human spine:  a system approach.  Clinical Biomechanics of the Spine.  1978:192

The adult cervical spine is unstable when:

  1. a)  All the anterior or all the posterior elements are destroyed or unable to function.
  2. b)  More than 3.5mm horizontal displacement of one vertebra in relation to an adjacent vertebrae measured on lateral x-rays.
  3. c)  More than 11º or rotation difference to that of either adjacent vertebra measured on lateral cervical neutral or flexion-extension x-rays.
  4. d)  Cervical kyphosis.

Future Health Problems

Joint instabilities resulting from ligament injuries causes not only increased pain but may also lead to additional health problems including: disc derangement, degenerative changes, increased pain, nerve entrapment and spinal cored compression.

Proper Diagnosis Leads To Proper Treatment

Special evaluation of joint instabilities needs to be considered when determining the most appropriate treatment.  Frequently joint instabilities will not be detectable on neutral lateral and anterior x-rays, cervical flexion/extension and open mouth lateral bending films should be taken to determine the true integrity of the spinal ligaments.  If injuries to the lumbar spine are suspected; flexion/extension and lateral bending films of the lumbar spine are recommended.  Think about an athlete with a torn ACL; the knee and supporting ligaments may appear fine in the neutral position but when the knee is put under stress with pushing or pulling the lower leg, pain is created because the injured ligaments are stressed. Similarly many injures in the spine will only present themselves when the spine is stressed in flexion/extension or lateral bending.

Special consideration needs to be considered with treating injuries with instabilities because improper treatments and irritate and potentially make the instabilities worse.

To learn more about Square ONE visit www.squareonehealth.com

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Commonly Missed Car Accident Injuries | Fort Collins Auto Injury Doctor

Commonly Missed and Misunderstood Injuries Caused by Motor Vehicle Collisions

Diagnosing and treating injures related to traumas such as those from a motor vehicle injures requires an advanced understanding of the biomechanics of the spine.  Dr Chris Gubbels of Square ONE specializes in biomechanics and advanced spine correction.

Both the normal shape and function of the spine can be altered in a MVC.  A normal health cervical spine has reversed C-shaped curve


Normal Curve Reversed Curve
                   Normal Curve                                                                                               Reversed Curve

called a lordosis.  Additionally each vertebra has a normal amount of movement within each joint.  Just like an athlete injuring joint after an impact or sudden change in direction, similar types of injuries can happen in the spine after a whiplash injury.

Sudden impacts such as those from front or rear end impacts can causes the spinal joints to move beyond their normal limits causing damage to connective tissues, boney structures and other soft tissues.  These injuries frequently cause alteration in both form and function of the cervical spine.

Instabilities Caused By Whiplash
Instabilities Caused By Whiplash

A normal health cervical spine has a lordotic shaped curve of about 30º – 45º.  This curve is needed for spinal stability.  One study looking at 500 individuals found 82% of those that had been in a MVC had a loss of the normal curve.  Additionally, many times connective tissues can be stretched or torn called ligament subfailure injuries.  Just like when an athlete tears a ligament in his/her knee, this causes instability in the spinal joints allowing them to move beyond their normal limits.   These injuries are frequently undetected, undiagnosed and often not properly treated by providers.

A loss or reversal of the normal cervical curve can cause additional injuries and health problems if left uncorrected including: degenerative disc disease, bone spur formation, compression of the spinal cord, decreased muscle strength, poor surgical outcomes and even decreased blood flow to the brain.

Insurance provider frequently try to limit patient visits and group soft tissues into muscle spasms.  Ligamentous tissue may take 12-18 months to heal and sometimes may never fully return to normal (2). Croft guidelines estimate ligament injuries may take 56 weeks or more and up to 76 or more visits for full recovery, every case is different.

Anyone involved in a motor vehicle collision should be evaluated by a health care professional that specializes in diagnosing and treating injures related to traumatic events.  Many injures may not cause symptoms of for weeks to months after the initial event and healing for some injures is frequently beyond just symptom relief.

Dr Chris Gubbels D.C. of Square ONE specialized in spinal biomechanics and diagnosing and treating injuries caused by traumas such as those from motor vehicle collisions.  We train with world leading experts and stay up-to-date on current research and treatments.

              BEFORE TREATMENT                         AFTER TREATMENT

  • Ligament subfailure injuries lead to muscle dysfunction.   Panjabie Fysioterapeuten nr. 10 octorber 2007
  • Injury and Repair of the Musculoskeletal Soft Tissue. American Academy of Othropaedic Surgeons. Woo S, Buckwalter JA
  • Kellett J. Acute soft tissue injuries – a review of the literature. Med Sci Sports Exerc. 1986 Oct; 18(5):489-500

To schedule a FREE consultation call 970-207-4463.  To learn more about Square ONE click here.

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