An Anatomical Exploration Of Whiplash
Whiplash injury is so common that we all probably know someone who has experienced it or have experienced it ourselves. But despite how commonly it occurs, doctors and researchers are still puzzling over exactly what happens anatomically and biomechanically during this situation. In this article, I share what research has found about what happens during whiplash and which structures and tissues in the body are most often impacted.
What Is Whiplash?
Whiplash is caused by a sudden impact that forces the head, cervical spine, and torso through a series of movements outside of what our bodies can physiologically tolerate. Specifically, the pelvis and torso are thrown rapidly forward, the head is thrown backward relative to the torso and shoulders, then forward again. This action takes the regions of the cervical spine into abrupt, strong hyperextension, then back into flexion. There is a moment during which the cervical spine is thrown into an S-shape created by hyperextension of the lower cervical vertebrae and flexion of the upper cervical vertebrae.
The quick back and forth “whipping” series of actions, as well as the movement of the vertebrae beyond what we can physiologically support, creates compression and shear forces on the cervical spine. The specific position of our body, especially our head and neck, at the moment of impact, can influence the specific injuries we experience.
When does whiplash occur?
Whiplash most often happens in automobile collisions, either from behind or from the side. However, it can also happen in other acute accidents like contact sports when there is sufficient abrupt force from behind, as in a collision between two players in football or rugby. It has also been reported from other activities where a similar force is present, like a fall from a horse, a diving accident, or a skiing accident.
In order to study this complex set of actions and resulting injuries, researchers have conducted simulations using both computer modeling and crash test dummies, examined human cadavers, and conducted animal testing. However, the complexity of each individual situation and of modeling the human body in that situation have made studying this situation difficult. For that reason, researchers are still identifying exactly what happens during a whiplash situation.
What kind of injuries are experienced after whiplash?
Many different structures in our body can be involved in the injury, depending on the amount of force during the collision and the position of the person. Specific symptoms and injuries are extremely varied, from mild injuries that heal on their own in a few weeks to significant injuries that linger with chronic injury-associated issues.
Stiffness and sensations after a whiplash generally center around the neck. However, depending on the severity of the impact and the position of the person, other structures in the body may also be affected.
Structures and tissues affected could include:
- Muscles, especially the sternocleidomastoid, splenius capitis, semispinalis capitis, and upper trapezius muscles
- Spinal ligaments, especially the anterior longitudinal ligament
- Cervical vertebrae, especially the facet joints, facet capsular ligaments, and the intervertebral discs
- Thoracic vertebrae
- Ribs and shoulders
- Vertebral artery
- Nerves and nerve roots, especially the dorsal root ganglia
- In more severe cases, whiplash injuries can include bone fractures
- Other tissues and structures specific to injury circumstances
Symptoms
Like the specific structures and tissues affected by whiplash, the symptoms are variable depending on the specific situation. Variables like how much force was present at impact, the position of the person at impact, and the existing health of the person influence the body of symptoms that they may experience.
Common symptoms include:
- Pain and stiffness of affected structures, particularly the neck, but can extend to other areas of the spine and back
- Altered muscle recruitment in the neck and other affected structures
- Dizziness
- Numbness in arm/hand
- Headache
- Vision issues
- Mental focus difficulties, memory, concentration issues, etc.
The potentially traumatic nature of a whiplash experience can also result in changes to the central nervous system, including hypersensitivity to pain and other stimuli, and psychological distress.
Dealing with whiplash
Whiplash treatment is usually divided into acute and chronic types. Individuals may recover from acute, short-term symptoms within 2-3 weeks after impact. However, many individuals also experience chronic symptoms after a collision or impact that caused whiplash. Because the specific types of injuries are extremely variable, treatments are as well.
Additionally, diagnosing what structures and tissues are injured as a result of a whiplash is difficult. One reason it’s difficult to be certain which tissues and structures were injured is that many areas of abnormal tissue don’t show up on common types of imaging diagnostics. Additionally, it’s difficult to know which physiological cervical issues stemmed from the injury and which were pre-existing. And that also makes treatment plans difficult. A full assessment from an experienced medical professional is important for creating a treatment plan to address chronic whiplash-related symptoms.
Conclusion
Whiplash occurs when we experience a sudden impact with sufficient force to throw our head and neck into a series of hyperextension and hyperflexion movements that are more than our bodies can physiologically tolerate. The particular structures and tissues affected vary according to the specific situation. Similarly, the symptoms and treatments are variable. Consult an experienced medical professional to develop a treatment plan.