What are some common musculoskeletal injuries from an auto accident?
Whiplash is a common injury that results from an auto accident and involves the cervical spine. The cervical spine is the part of the spine that supports the head and neck and is surrounded and protected by ligaments, muscles and tendons. A whiplash injury involves a rapid acceleration and deceleration movement of the neck and often resultant sprain of the cervical ligaments and strain of the cervical muscles and tendons. This type of injury can result in significant neck pain as well as headaches.
2. Lumbar sprain/strain
The lumbar spine is the part of the spine that supports the lower back. The associated ligaments, muscles and tendons can also undergo sprain or strain with an auto accident. Depending on the intensity and severity of the car accident, the jarring movements of the body and impact of an air bag and seat belt can affect the lumbar spine and cause low back pain and/or tightness.
3. Disc herniations or discogenic pain
There are several different degrees of a intervertebral disc herniations, and they happen most often in the lumbar and cervical spine and less commonly in the thoracic spine. A thorough examination is required when there is thought to be a disc herniation, as sometimes a referral to another specialist is needed. This is especially in the event of worsening neurological signs such as weakness in the extremities, loss of bowel or bladder function or numbness in the “saddle area”
(specific to a lumbosacral disc herniation). Many times though, a disc herniation or disc “bulge” can be managed conservatively with spinal and extraspinal adjustments, soft tissue therapy and specific repetitive movements and exercises. When a disc herniates or “bulges,” it moves backwards towards the spaces where the spinal cord and nerve roots are located. That backwards movement can cause direct compression or also swelling, inflammation and irritation around those nerve roots. This results in a specific distribution of pain and other symptoms in a certain pattern. Its very important to be examined after a car accident for potential discogenic injury.
4. Extremity injuries and/or bruises
Some common extremities that can become injured as a result of an auto accident include the knee, hip, shoulder, wrist and ankle. The knee can be injured from compression as the foot is planted on the brake or against the floor of the car upon impact. A very similar mechanism of injury can occur with the hip. The shoulder can become compressed and damage to the posterior capsule can occur if the hand is gripped onto the steering wheel upon impact. The wrist and ankle can be twisted, bruised or compressed as well.
How can chiropractors help?
1. Spinal manipulation
Spinal manipulation is an extremely effective treatment for improvement of movement restrictions in any area of the spine, as well as for relaxation of the spinal musculature. Chiropractors receive the highest level of training in spinal manipulation and can provide a very effective treatment in combination with the modalities described below.
2. Extremity manipulation
Extremity manipulation involves improving the joint movement of the extremities rather than the spine. This is another effective treatment injuries related to an auto accident, especially those involving an extremity.
3. Soft tissue manipulation
Soft tissue manipulation describes work to the muscles, tendons and ligaments of a given area. This can involve use of the chiropractors hands or a tool, often a metal instrument, to break up myofascial adhesions and bring blood flow to the area to stimulate the healing process.
4. Dry Needling
Dry needling has two main treatment uses: trigger points and blood flow for healing. With treatment of trigger points, we find “tight spots” in muscles that can contribute to pain and dysfunction. We then insert very thin needles into those trigger points and twist them slightly to wrap up the covering of the muscle. The process re-orients the covering of the muscle and results in the muscle relaxing and removal of the trigger point. For the goal of increasing blood flow with dry needling, we simply insert a certain amount of needles into the area that we want to increase blood flow. This process restarts the inflammatory process and brings a bunch of blood to the area for healing. Dry needling can result in slight soreness but nothing that should last more than a day or two. The process overall involves very little pain when done efficiently.
5. Therapeutic exercises
Therapeutic exercises performed and prescribed have two main goals: activate deep phasic stabilization muscles that are commonly inactive or weak, and to neurologically relax or “shut down” muscles that are chronically tight and hold tension. There is no more effective method of achieving this than through Dynamic Neuromuscular Stabilization (DNS) exercises. DNS consists of protocols based on the teachings and treatment programs of Dr. Pavel Kolar and Dr. Karel Lewit, the father of manual medicine. The exercises and positions are derived from developmental kinesiology, the way we develop in the first year of life. By using these positions that the body has been in the past, and in fact developed through, we can essentially hit “control-alt-delete” on the brain and re-train movement patterns and joint stabilization. The goal is to put the body back in these developmental positions to optimize joint position and activate all the right muscles around those joints. There is also an emphasis on diaphragmatic respiration (“belly breathing”) and creating intra-abdominal pressure (IAP) for core and pelvic floor stability. Rather, these concepts are actually the building blocks for each of the developmental positions. The goal is to teach the brain how to activate the proper stereotype of movement and stabilization. The combination of joint manipulation and DNS exercises is extremely powerful for the overall function of the nervous, muscular and skeletal systems.
6. Pulse wave ultrasound therapy
Pulse wave ultrasound therapy is a highly effective treatment method: high-energy sound waves are introduced into the painful areas of the body. It is one of the most advanced and highly effective noninvasive treatment methods cleared by the FDA. The treatment works by helping to improve the regenerative potential, enhancing blood circulation to regenerate damaged tissue.
7. Pulsed electromagnetic field therapy (PEMF)
PEMF is a reparative technique to treat acute and chronic musculoskeletal injuries, especially bone injuries, fractures and tendon or ligament injuries. Some specific conditions that have shown success include but aren’t limited to hip and shoulder impingement, AC joint sprain, MCL/LCL sprains, chondromalacia patella, shin splints, stress fractures, bicipital tendonitis, Achilles tendonitis, tendonopathies and whiplash associated disorders. PEMF uses directed pulsed magnetic fields through injured tissue which is believed to stimulate cellular repair. PEMF has been shown to reduce pain and inflammation, accelerate repair of bone and soft tissue and to relax muscles.
Dr. Forrest Allen is a chiropractic physician at Pro Chiropractic in Bozeman and Belgrade that specializes in treating athletes, but also anyone in the general public. If you or someone you know has been involved in an auto accident in Bozeman or Belgrade, give our office a call and we will get you on the schedule. We pride ourselves in thorough examinations and patient education of specific diagnoses, treatments and improvement of your function.