whiplash injury

Whiplash Injury Physiotherapy Mississauga

Whiplash injuries are considered to be “the most common non hospitalized injury resulting from a road traffic crash”. Whiplash is a relatively common injury that is often ignored or mistreated due to lack of understanding of the condition. Sudden neck strain is often just called whiplash. Although it’s usually associated with car accidents, any impact or blow that causes the head to jerk forward or backward can cause neck strain. The sudden force stretches and tears the muscles and tendons in neck. Neck strains are often confused with neck sprains. They’re a bit different. Neck strains are caused by damage to the muscle or the tendons, bands of tissue that connect muscles to bones. Neck sprains are caused by tearing of the ligaments, the tissues that connect the bones to each other. The causes, symptoms, and treatment of neck sprains and neck strains are usually the same. People who play contact sports like football are especially prone to neck strain. Failure to properly educate and treat patients with whiplash can lead to chronic psycho social symptoms including depression and anxiety.

Whiplash is most commonly caused by a motor vehicle accident in which the person is in a car that is not moving, and is struck by another vehicle from behind. It is commonly thought the rear impact causes the head and neck to be forced into hyperextended (backward) position as the seat pushes the person’s torso forward – and the unrestrained head and neck fall backwards. After a short delay the head and neck then recover and are thrown into a hyperflexed (forward) position. More recent studies have determined that after the rear impact the lower cervical vertebrae are forced into a position of hyperextension while the upper cervical vertebrae are in a hyperflexed position. It is thought that this abnormal motion causes damage to the soft tissues that hold the cervical vertebrae together (ligaments, facet capsules, muscles).

Types of whiplash injury


A mild case, which starts with a delay of symptoms by hours or to the next day, limited to pain in the neck without spasm, no loss of neck motion, minor radiating symptoms, and no localized tenderness. Full recovery is often in days to weeks. Going off work is not required.

Type 2

A moderate case, starts with instant pain, neck spasms, loss of neck motion, and moderate to severe radiating pain, but without physical evidence of a pinched nerve. Recovery may take weeks to months and is sometimes not complete.

A severe case, like type 2 but maybe worse. Here we also have evidence of a pinched nerve. Recovery is like type 2.

Type 3

A severe case, like type 2 but maybe worse. Here we also have evidence of a pinched nerve. Recovery is like type 2.

Symptoms of Whiplash and its Physiotherapy

Physiotherapy is preferred as the first line of treatment for the Whiplash Injuries. Your doctor may refer you to a physiotherapist or you might arrange an appointment yourself in the times of severe neck pain or spasm. Your physiotherapist may recommend exercises, modification in lifestyle, wide range of treatments and Hands On Manual Physiotherapy techniques. Our physiotherapist working at Curezone Physiotherapy Clinic in Mississauga makes sure to handle your Whiplash injuries with utmost care and provide the best treatment appropriately. Whiplash Injury is commonly associated with varied disturbances in motor, sensorimotor, and sensory functions and psychological distress.

The most common symptoms are sub-occipital headache and/or neck pain that is constant or motion-induced. There may be up to 48 hrs delay of symptom onset from the initial injury. The pain of whiplash is often hard to ignore. The other symptoms may include are Pain, decreased range of motion, and tightness in the neck. Pain when rocking the head from side to side or backward and forward. Pain or stiffness when moving the head to look over each shoulder.

Tenderness and headaches at the base of the skull that radiate towards the forehead. Sometimes, the pain of a neck strain is immediate. In other cases, it can take several hours or days before your neck begins to hurt. The blow that causes neck strain can sometimes cause a concussion, too. Since concussions can be serious, you need to see a doctor right away. You need emergency medical care if you have a headache that worsens or persists, have weakness or trouble talking, or are confused, dizzy, nauseous, excessively sleepy, or unconscious.

Whiplash Clinical Prediction Rule

A Clinical Prediction Rule (CPR) is a tool that helps to predict outcome, for example the possibility of a person to have moderate/severe pain and disability or have full recovery after a whiplash injury. According to Howell, chronic neck pain following a whiplash-type injury could be predicted with the use of the Neck Disability Index (NDI). She found correlations with pain, disability and driving task scores with whiplash associated disorder (WAD) patients.

Physiotherapy Treatment

  • Ice pack to reduce pain and swelling can be given immediately after injury.
  • Pharmacological treatment may include, Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin) or naproxen (Aleve), will help with pain and swelling.
  • The physiotherapy also depends on the injures, acute and chronic.

In acute injury, physiotherapy can be delayed due to multiple social, economic, and psychological factors such as depression, anxiety, expectations for recovery, and high psychological. Coping strategies such as diverting attention and increasing activity can contribute in positive outcomes. The most important goals of the interventions are reassuring the patient, modulating maladaptive cognition about the symptoms and injuries.

Physiotherapy is mostly useful in the chronic state as there is a difference between a patient suffering from acute whiplash and a patient suffering from chronic whiplash. There is a suggestion that the injury in combination with psychological factors may lead to chronic symptoms of injuries such as chronic pain or motor and sensory malfunctions. A multidisciplinary therapy with cognitive, behavioral therapy and physiotherapy, including neck exercises is effective in the management of patients with chronic neck pain.

Research has not found any clinical benefits from passive therapies such as ultrasound, hot/cold packs, acupuncture, massage, TENS, electro-stimulation, magnets, or laser therapy.

• Manual treatments such as neck mobilization, Soft tissue release, Sub occipital muscle release may be helpful along with active exercises and stretching.

• Vigorous or unskilled neck manipulation may re-injure the neck.

• Prolonged rest periods or use of a collar weakens tissues and slows recovery, and may actually cause the symptoms of whiplash.

• If some passive treatments are combined with an active physiotherapy program, it is probably the activation part that is helping.

• If a treatment is going to help, you should feel some improvement in days to weeks; if not, stop it and reassess your treatment options.

Our registered physiotherapist at Curezone physiotherapy, Mississauga near heartland will help you achieve your goals and have a painfree and healthy experience. Call us now to book an appointment or a 5 min free consultation @ 905 997 4333.