Whiplash, neck pain and the muscles of the neck


Car accidents frequently result in whiplash type injuries, where the head and neck are violently thrown forward and then back again upon impact, injuring the soft tissues of the neck.

Although vertebrae and disk injuries do occur often in this kind of a scenario, sometimes nothing obvious comes up on imaging tests, and the patient is left with neck pain without a concrete reason as to why. In other situations, the accident victim may feel surprisingly okay immediately post accident, and then a few weeks to months later may develop neck pain. In this scenario it may be harder to prove to insurance companies that the neck pain is actually a result of the car accident, even though there is a very understandable explanation for this pain pattern.

Our spine is meant to have three curves in it, one at the neck (cervical spine), another in the opposite direction over the ribs (thoracic spine), and finally another arch in the low back or lumbar spine. Just as having spinal curves that are too exaggerated can create painful problems, so can having segments of the spine that have straightened out. Whiplash-type scenarios frequently result in a straightening of the cervical spine in the neck. This makes the accident victim far more susceptible to developing disk herniations in the cervical spine, which can impact both upper body and lower body function.

After a violent whiplash, the muscles of the neck are severely traumatized. The head weighs between 12 to 20 pounds, depending on the size of the individual, and when the head is tossed forwards and then backwards with such force, and the muscles of the neck are unable to control the speed with which this heavy weight is being thrown around, the muscles become injured. The muscles frequently go into spasm and over time, tighten up, resulting in not only inadequate movement, but also compression through the vertebrae, squashing disks and narrowing the spaces through which nerves and blood vessels travel. When the deepest anterior neck muscles (longis colli and longis capitus) tighten up, they will pull the cervical spine straight. It may take a few weeks post trauma for the neck to straighten, but if this is not treated, the whiplash victim may eventually have disk problems, and potentially radiating pain into the arms, or TMJ (jaw) issues. Because the deep neck muscles also play a proprioceptive role in determining our position in space, injury to these tissues can be implicated in dizziness as well. (Of course, the cranium gets a major shake-up in a whiplash as well, so in my opinion it is important to examine and correct the position of the cranial bones as well.)

People frequently seek treatment from massage therapists that do an excellent job of releasing the muscles of the posterior neck, but unfortunately only a few massage therapists also treat the anterior muscles of the neck, which are just as badly injured, and also in desperate need of treatment. Massage therapists need to have training on how to move the trachea (breathing pipe) over, and how to avoid the carotid artery (blood vessel to the brain) to get right down onto the anterior surface of the cervical spine to release these muscles. Whiplash victims that complain of difficulty swallowing, dry mouth, dizziness, headaches, or a permanent tickle or lump in their throat, or whose posterior neck pain does not resolve once the posterior muscles are released, may need to get their longis capitus and longis colli treated as well. Certainly anyone who has lost the curvature in their cervical spine (obvious on X-Ray) should seek out someone who is able to release these muscles in order to restore the normal curve to the spine.

The superficial anterior neck muscles are also very important to treat in whiplash cases, as many of these muscles also attach to the jaw, and are involved in talking, swallowing, and can affect the function of the jaw, potentially creating TMJ problems. If the whiplash was at an angle, tension right to left in the neck muscles may be different, causing the floating bone in our neck (the hyoid bone, located at the fold in the neck) to be pulled in one direction or the other. Imbalances in the digastric, infra and supra hyoid muscles can also impact swallowing and jaw function, not to mention potentially impeding thyroid function. So, if you have suffered a whiplash, do make sure that as part of your treatment, you seek out someone that can release ALL the muscles of your neck, including the ones in the front.

Furthermore, for a more complete recovery, a motor-control based exercise program geared to learning how to recruit the neck muscles in the right order would be helpful, so that the outer neck muscles like the upper traps, levator scapula and scalenes learn to relax when they are not needed, reducing the likelihood of the muscle spasm coming back.

I am pleased to announce that I just passed my Paul St. John Integrated Somatic Therapy test, so I am official with respect to being able to treat these muscles, along with any other pain issues you may have. I have been providing personalized corrective exercise programs for over ten years now, so I can provide the complete package – both structural integration (massage) and exercise. So if you are in the Vancouver area, and would like me to help you, please do contact me by replying to this email. It would be my honour.

If you want to search for other posts by title or by topic, go to www.wellnesstips.ca.

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Travell, Janet G MD and Simons, David G MD Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual (2-Volume Set) Lippincott, Williams & Wilkins, Baltimore, 1999.

McKenzie, Robin and May, Stephen Cervical and Thoracic Spine: Mechanical Diagnosis and Therapy (2-Volume Set) Spinal Publications, New Zealand LTD, Raumati Beach NZ, 2006.

Clark, Randall & Jones, Tracy Neuro ALP 1 Manual Neurosomatic Educators Inc. 2007.

Elliott JM et al. Characterization of acute and chronic whiplash-associated disorders. J Orthop Sports Phys Ther. 2009 May;39(5):312-23.

Pleguezuelos Cobo E et al. Postural control disorders in initial phases of whiplash. Med Clin (Barc). 2009 May 2;132(16):616-20. Epub 2009 Apr 22.

Armstrong B et al. Head and neck position sense. Sports Med. 2008;38(2):101-17.

Jull GA et al. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008 Sep;31(7):525-33.

Falla DL, Jull GA, Hodges PW. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine. 2004 Oct 1;29(19):2108-14.

O’Shaughnessy T. Craniomandibular/temporomandibular/cervical implications of a forced hyper-extension/hyper-flexion episode (i.e., whiplash). Funct Orthod. 1994 Mar-Apr;11(2):5-10, 12.

Copyright 2009 Vreni Gurd

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  1. christylsouders said,

    February 8, 2013 @ 7:56 pm

    Hello this is exactly what i am suffering from and am having a hard time finding help I live in lancaster pa thankyou for your wisdom

  2. Vreni said,

    February 9, 2013 @ 9:19 pm

    Anyone? I don’t know anyone there …

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