Whiplash injuries mostly associate with motor vehicle collisions (MVC). Although, they can happen from anything that results in a sudden movement of the head. This can be from slip and fall injuries, carnival rides, sports-related injuries, and more. When associated with MVCs, the terms “acceleration/deceleration injury” or “whiplash-associated disorders (WAD)” are often applied. It depends on the direction of the collision. When the striking vehicle rear-ends the target vehicle, the term is “acceleration/deceleration injury”. WAD encompasses all scenarios and also includes the type and extent of the injury. The degree of injury includes four main categories. The least amount of injury is WAD I, and the worst soft tissue injury category is WAD III. Fractures are separate in the WAD IV category. The more severe the soft tissue injury (WAD III > WAD II > WAD I), the worse the prognosis.
Whiplash and MVC
We often wonder why the neck is so vulnerable to injury in an MVC. The simple answer is the head, which weighs about 12-15 pounds. The head supports the neck and not all necks have the same length, strength, and mass. This is the reason women are most vulnerable to the forces that occur in a WAD injury. Another reason whiplash injury can occur is the relatively “slow” speed at which we can voluntarily contract our muscles (>600 msec.) vs. relatively fast speed at which a typical rear-end collision takes to move the head on the neck during whiplash (~300 msec.)! Though the whiplash time duration will vary somewhat, depending on the speed of the collision, the angle of the seat back, the distance between the head and the headrest, the “springiness” of the seat back, the weight of the two vehicles, etc.
Here’s a typical breakdown of what takes place in a rear-end collision (within a 300-millisecond “typical” time frame):
Degree of Injury
The degree of injury is affected by all the items previously listed above and more. For example, if the headrest is more than two inches (~5 cm) away from the back of the head, and/or if “ramping” occurs and the head “misses” the headrest, hyper-extension can result and the soft tissues in the front of the neck can become over-stretched and/or the back of the neck can become over-compressed. Or if the rebound phase into flexion exceeds the tissue capacities, the back part of the neck can become over-stretched and the front part over-compressed.
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