A common injury from a motor vehicle accident, whiplash is a neck sprain resulting from the sudden forces typical of a car crash. After being evaluated by a physician, bodywork is one of the most recruited modalities to help this soft tissue injury heal. When applied carefully and skillfully, massage therapists can help clients with whiplash find relief and avoid a resulting chronic neck problem.
Although physicians sometimes refer to it as a neck hyperextension injury, whiplash is a fairly accurate mechanical description of how the neck injury occurred. Bending first towards and then away from the point of impact, whiplash is the consequence of the head moving in a whip-like motion. As the head moves rapidly in one direction, the muscles in the neck receive the message to contract. The momentum of the head can cause strain or sprain to the muscles and ligaments in the neck as the head reaches the end of its movement. Whether the head whips forward and backward or laterally, whiplash usually causes multiple neck injuries.
Evidence of whiplash can surface immediately following the neck’s whip-like injury, or it can creep up several days after. Aside from neck pain, additional symptoms of whiplash may include:
- Neck stiffness
- Hoarseness and difficulty swallowing and/or chewing
- Shoulder, back or arm pain
A client who has neck pain following a motor vehicle accident must first be seen by a physician to rule out serious injury. In addition to soft tissue damage, doctors must determine if the whiplash has caused a concussion or nerve-root compression. Once massage therapy is deemed safe, bodyworkers must assess the injured musculature involved to formulate a treatment plan. In addition to taking a detailed history of the accident, muscle resistance testing can help the bodyworker pinpoint the muscles most in need of release.
According to Ben Benjamin, Ph.D., the following resistance tests should be included when assessing whiplash:
- Pain upon resisted neck rotation indicates injury to the sternocleidomastoids.
- Pain upon resisted side flexion of the neck indicates injury to the scalenes.
- Pain upon resisted neck flexion indicates injury to the sternocleidomastoids.
- Pain upon resisted neck extension indicates injury to the posterior scalenes, suboccipitals and/or erector spinae.
While a majority of people with whiplash improve within one month, symptoms sometimes persist longer. Most therapists agree that the sooner massage therapy is received, the quicker the person heals and the less likely they are to develop chronic neck pain. In general, any massage that relaxes the affected muscles will help relieve the pain and discomfort of whiplash. However, these three specific approaches are particularly therapeutic:
- Myofascial Release – Myofascial release techniques can free restricted neck muscle and fascia to help restore fluidity, thus relieving the stiffness of whiplash. Additionally, myofascial unwinding can unlock dysfunctional fascial holding patterns established at the time of injury.
- Static Compression – Applying static compression to affected trigger points creates an influx of oxygen that relaxes the contracted musculature. Since myofascial trigger points often develop in the cervical muscles following a whiplash injury, this treatment prevents prolonged muscular dysfunction that can linger for months or years after the initial trauma.
- Deep Tissue Massage – Once the superficial muscles are relaxed, deep tissue work can liberate contracted deep fascia, adhesions and scar tissue. Making sure to stay within the client’s pain tolerance level, deep tissue massage can free tissue that had tightened around local nerves.
Because of the neck’s delicacy, bodyworkers should always proceed cautiously with a whiplash injury. The following guidelines are intended to keep therapists mindful of the neck’s vulnerability:
- Since the anterior neck muscles are often injured in whiplash, be careful to avoid pressing on the nearby carotid artery.
- Wait until a few days after the accident before administering massage therapy so that the initial healing process is uninterrupted.
- A physician should always be consulted to determine if there is a fracture, concussion or other disc problem before attempting any bodywork.
- Make sure your approach is gentle enough to not cause the client any further discomfort than what they are already experiencing.
As long as a massage therapist uses caution when working with whiplash, their efforts can play a major role in recovering from this common injury. Especially beneficial when doing myofascial release, static compression and deep tissue massage, bodyworkers have the tools to ease muscle pain, induce relaxation and unlock the tension created by a whiplash injury.
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