BCP Whiplash

Question 1

What is the definition of Whiplash?

Answer 1

An acceleration and deceleration mechanism of the neck.

Question 2

Does whiplash only happen at high speeds?

Answer 2

• no, they can also happen at lower speeds.

Question 3

What structures could be injured during whiplash?

Answer 3

• bone structures
• ligaments of the spine
• intervertebral disc
• muscular pain (spasms)

Question 4

What are the 4 grades of whiplash?

Answer 4

0 - no pain or complaints
1 - Neck pain/stiff, no physical signs
2 - Neck pain/stiff, loss ROM, Tenderness
3 - Neck pain/stiff, loss ROM, Tenderness, neurological
4 - Neck pain/stiff, loss ROM, Tenderness, fracture/disslocstion

Question 5

What is the average time for an episode of whiplash?

Answer 5

6-12 weeks. If longer could be down to the tissues involved (ligaments taking longer than spammed muscle)

Question 6

What risk factors of whiplash turning from acute to chronic?

Answer 6

• Depression
• sense of injustice
• OCD

Question 7

What are high risk factors of whiplash? (Red flags)

Answer 7

• high impact/speed mechanism
• Cervical Radiculopathy
• Over 65
• spinal stiffness
• Spinal tenderness

Question 8

What signs would indicate the patient might have a poor prognosis for recovery from whiplash?

Answer 8

• high self reported pain (VAS)
• Neural symptoms
• pain/ sensitivity on distal/unrelated structures
• Poor pain efficacy
• Negative mindset

Question 9

How would we carry out a neurological test for suspected whiplash?

Answer 9

• neck ROM to see if we get neuropathic signs
• Spurlings
• ULNTT
• skin sensation test (Dermatome)

Question 10

Why would we use education in rehab for whiplash

Answer 10

• let people know that despite the level of pain it is very unlikely they have any serious structural issues.
• Explain to them what has happened muscular and relate it to other injuries that we socially don’t see as bad such as ankle sprain

Question 11

Should we push into pain with whiplash pain when doing exercises.?

Answer 11

When the pain is high it is likely not beneficial, when the pain is low or has been chronic in nature, it’s beneficial.

Question 12

Is manual therapy good for whiplash?

Answer 12

• there is no evidence
• light massage and mobilisations will give limited relief.
• distractions give immediate relief but are not long lasting