People use the word whiplash to describe an injury after a car crash. The problem with the term is that many people believe whiplash is a short-term problem that will go away in a few weeks to a few months. The truth, however, is that whiplash injuries are multidimensional, complex, and can cause problems for a small number of people for the rest of their lives.
Let’s Define a Whiplash so We Are on the Same Page
The typical scenario in which a whiplash happens is quick acceleration followed by deceleration of the neck. We usually see this mechanism in a rear-end collision.
Imagine this, you are stopped at a traffic light on 441 in Leesburg. When your vehicle is stopped – both you and your vehicle are stationary (fixed in one position). The car behind you crashes into your back bumper. This energy causes your vehicle to move forward, however, because the force is transferred through the vehicle, your body and neck are still stationary. This initial movement is the ACCELERATION. Your car’s acceleration causes your neck to move back towards or over the headrest. Your neck is moving in extension. (if you want to feel extension, lift your chin and look at the ceiling. This is extension).
The next thing that happens once your neck extends, is the body starts to catch up with the car, and your neck is forced forward. This is the DECELERATION phase. In this phase your neck goes into flexion. (If you want to feel flexion, take your chin to your chest. This is flexion).
This is where the term whiplash comes from. First, your head is whipped back and then it rebounds and goes forward. Think of the animal trainer at the circus, bringing to whip backwards and then forwards. Besides whiplash some people will call this injury a hyperextension – hyperflexion injury. Another common term is a cervical (neck) strain- sprain. Part of the issue with whiplash injuries is that it goes by so many names.
Symptoms Associated with Whiplash Injuries
Part of the bias against Whiplash injuries after an accident is that the symptoms can vary. Here is an initial list of Whiplash Associated Injuries. In the next section, we will explain why a car crash victim can experience each of these symptoms.
- Neck pain and stiffness
- Jaw pain
- Upper extremity (arm) pain, numbness, tingling
- Burning in the upper back
- Mid-back pain
- Low back pain
- Ringing in the ears (tinnitus)
- Vision changes
- A variety of other symptoms
Why can a Whiplash cause such a variety of symptoms?
We are so glad that you asked that question. In order to understand why different people can experience different problems after a car accident, we have to discuss the major body systems and anatomy involved.
First, we need to define the term neuromuscular skeletal system. For our purposes, we are talking about muscles, nerves and bones, which protect the nervous system.
The Anatomy Involved in a Whiplash Injury
The job of the bones, the skeletal system is to provide structure, support and protection.
The skull is there to protect the precious brain. The skull sits on the top of the spine.
The vertebrae are odd shaped bones in the neck. There are seven of them and they are usually labeled C1-C7. Only the first two vertebrae in the neck get their own names – The ATLAS (C1) and THE AXIS (C2). If you think about it for a moment, you can probably figure out why these two vertebrae get their names. Remember, what ATLAS did in Greek mythology? Every picture of Atlas shows him holding up the celestial heavens. This is exactly what the ATLAS in the neck does. It holds up our head. The AXIS also describes what it does in the neck. A majority of our rotation (looking over one’s shoulder) happens because of the shape of the AXIS (C2).
The vertebrae are designed to protect the precious spinal cord, which is the reason they are shaped so oddly. Each vertebra has a whole in the center, allowing the spinal cord to travel from the brain down to the end. The vertebrae also have holes on the sides, which allow nerves to exit the spinal canal. The vertebrae also have to be able to move, so we can look up, look down, and look around. This requires each vertebra to have weird angles, and they have to work with the vertebrae above and below. If one of the vertebra acts up and doesn’t play nicely with its neighbor on top or on the bottom, we can have problems. Okay, so that’s a general overview of the bones. Now, to the “neuro” part of neuromuscular skeletal system.
The Nerves Involved in Whiplash Injuries
I like to describe the nervous system as coming in three flavors, just like ice cream: vanilla, chocolate, and strawberry. In the nervous system, we have the central nervous system (CNS), the peripheral nervous system (PNS), and the autonomic nervous system (ANS). For the purpose of our discussion, we are only going to discuss chocolate and vanilla.
The Central Nervous System (CNS)
The central nervous system is made up of the brain and spinal cord. The brain has many parts like the cortex, cerebellum, and brain stem. It is best to analogize the CNS as a super highway. Take I-75 or the Turnpike for example. Imagine northbound I-75. It has a bunch of lanes that takes information from the body and brings it to the main control (brain). Generally, this is the sensory or afferent part of the CNS. Southbound I-75 takes information from the brain and delivers it to the specific part of the body. Generally, this is the efferent or motor system.
At the bottom of the brain, before it leaves the big hole in our heads (foramen magnum), there is the brain stem. The brainstem is the starting point for a number of cranial nerves. Why is this important? Because, cranial nerves can be the answer to some of the weird symptoms that folks may experience after a Whiplash injury.
The next part of the CNS is the spinal cord. The spinal cord starts at the bottom of the brain stem after the nervous system leaves the foramen magnum and stops in the upper lower back. The spinal cord is the way the brain and the body communicate. If there is a problem in the spinal cord, the communication stops. Think of a paraplegic or quadriplegic.
The Peripheral Nervous System (PNS)
Using our highway analogy, the peripheral nervous system is like the exits and entrances on I-75. Follow me for a moment. Say you touch a feather with your index finger. The nerve in your index finger will send a signal up your hand, into your arm, past your shoulder, into your neck, enter I-75 at the spinal cord and travel up to the brain. Next, we will look at the muscular part of neuromuscular skeletal system
The Muscular Part of the Neuromuscular Skeletal System
In order to fully explain the neuromuscular skeletal system, I am going to expand the muscular system to include other stuff, connective tissues, like cartilage, tendons, ligaments.
In order to allow movement in the spine, we have look at discs. In the neck there are discs between the vertebrae except for the upper one. The discs are the shock absorbers of the spine. They are made of concentric rings of cartilage, called the annulus. In the center is a fluid material, called the nucleus pulposis. The discs are really good at handling axial forces (up and down). The discs are not so good at handling torsional (twisting) forces.
Ligaments are another part of connective tissue. They attach from bone to bone. The ligaments job is check or restrict motion, and keep the bones aligned with one another. In the neck we have a bunch of ligaments. At each vertebral level, where the vertebrae come together to form the joint (facet joint), the joint is covered with ligamentous material and that is called the capsule. Ligaments are pretty good at their job; however, they don’t heal very well because they don’t have a great blood supply, which is why if you look in an anatomy book – ligaments will usually look white.
A tendons job is to connect a muscle or a bunch of muscles to bone.
We all know what muscles are. When muscles contract they usually cause some type of movement or restrict movement.
This concludes a brief overview of the anatomy of the neuromuscular skeletal system. You can see that there are a lot of players that can be injured in a Whiplash. This can range from bones, nerves, ligaments, tendons and muscles. Depending on the tissue injured, and the location of the injury, the car accident victim’s complaints, symptoms and recovery can be different.
If you have any questions about a Florida whiplash injury claim, contact our office today.