Recovering from Auto Injuries
Auto collisions are a serious public health issue around the world. Each year millions of people are injured in crashes that result in pain, lost time at work, and stress at home. Over the last few years, scientists have studied the nature of Auto injuries in great detail and their findings have made it easier for us to understand how these injuries occur and allow us to diagnose the exact cause of the patient's pain and treat Auto injury cases more effectively.In this video we will describe the anatomy of the human neck, explain how injury occurs during Auto collisions, and show how we can help pinpoint the cause of your pain and create an effective treatment program that will get you back on the road to health.
The human neck is an incredibly complex structure of muscles and tendons, blood vessels, nerves, bones, and ligaments. Any of these anatomical structures can be injured in an auto collision depending on the severity of the crash. The spine is made up of individual vertebrae that are designed to support our heads and protect the spinal cord. The vertebrae are separated by flexible discs that act as shock absorbers and thin fibrous bands of tissue that hold bones together in the spine. These ligaments act as straps to hold the vertebrae together and limit motion. The muscles attached to the bones of the spine, head, and ribs can all be affected. The vault of the neck is made up of many muscles and these muscles serve three purposes:
- They stabilize the spine and allow us to keep our heads up right.
- They allow us to move our heads.
- They protect the network of nerves and blood vessels that travel to the head and arms.
The human body is a vertical structure and can easily absorb the force of gravity and everyday activities because of its design. The spine can handle moderate amounts of compressive force. Move from side to side, or from front to back, however in an accident and it's a different story, since the vertebrae of the neck allows a wide range of motion they provide very little protection from horizontal. The muscles of the neck are there to keep our heads upright so they are very poor at resisting rapid movement from the rear or side. Therefore, the only anatomical structures protecting the Integrity of the spinal column from rear-end collisions are the ligaments that hold the vertebrae together and it is in the ligaments of the spine where the most serious whiplash injuries occur.
Let's look at the biomechanics of rear-end collisions to see why these injuries are unique studies on the biomechanics. Rear-end collision tests have been conducted since the 1950s it was in those crash tests that researchers first discovered the basic motion of a rear end collision. First the occupant starts out in a normal position, then as the car is rapidly accelerated the car seat pushes the occupants body forward as the head remains stationary until the rapidly moving torso against the shoulders further causing the head to extend violently backwards next after the hair extends backwards it begins to rebound forward. At first researchers thought that injuries from these types of collisions are caused by hyperextension -that is the head and neck were thrown backwards beyond the normal range of motion. Research in the 1970s and 1980s found, however, that in low-speed collisions the head did not move beyond this normal range. How then could injury occur in these patients without hyperextension? Researchers in Japan first discovered the answer to this question when they designed a test to analyze the motion of an occupant using video x-rays. They subjected the occupants to low-speed collisions and then carefully analyzed the motion of the cervical vertebrae. Their Discovery has dramatically changed how we understand auto injuries.
To understand how injuries can occur in a low speed collision we first need to understand normal spinal motion. This video fluoroscopy footage shows normal motion of the neck. As we see during flexion and extension, each vertebrae contributes to the overall movement resulting in smooth regular curving of the spine. Smooth motion of the spine is made possible by the facet joints on each individual vertebrae. As you can see, the facet joints are angled backwards during normal range of motion. Until 1996 researchers assumed that the spine move the same way during a rear end collision as it did during normal activities. Whiplash motion was seen as normal position before the impact extension backwards rebound motion forward and then back to normal. The Japanese researchers found a completely different type of motion. Here's what they found: in the normal position then as the seat back is accelerated forward the torso moves with it creating a straightening of the spine at the same time the occupant is sliding up the seat causing an upward motion. It remains stationary as the seat continues to push the torso forward. This creates a rocket and viola differential motion between the upper and lower cervical spine. The Japanese researchers found that at this critical point the lower cervical spine bends dramatically while the rest of us remains straight. In fact they found that in these joints with rounded bending the joint extends past the normal physiological range of motion.
Dozens of studies since 1996 have reproduced these findings and have added even more inside a group of us researchers studied in detail the motion of the facet joints they found that during the rapid bending phase the fastest tests were pinched and that the articular ligaments were stretched beyond their normal range of motion.
Ligament injuries can be very serious. Knee injuries are a good example. When the knee is moved beyond its physiological range the ligaments can be stretched or torn. The pain is severe and sometimes require surgical treatment. The ligaments of the spine are just as susceptible to damage. Detecting a minor tear or stretching of ligaments of the neck is much more difficult, however. Injured ligaments usually don't show up on x-rays, CT, or MRI scans. Orthopedic or neurological tests are often negative for these types of injuries. We know these injuries exist, however since the scientific studies show that ligament injuries do indeed occur from low-speed collisions. As we've seen in this video, auto collisions can cause injury to the ligaments of the neck. These ligament injuries can result in pain and loss of function. Our office uses a variety of state-of-the-art tools to objectively measure your body's response to the collision and pinpoint the area of injury. Once we've determine the exact cause of your pain we can develop a treatment plan that will get you back on the road.