Tulsa Spine and Rehab

Whiplash, to most of us it’s an injury that movie doctors and lawyers chase after. But whiplash is real and brings with it serious issues for your mobility. To get the straight scoop we turn to Doctor Sean Riley. Doctor Riley, thanks for being here.

Hey there, Charlie.

So tell us, Doctor Riley, what is whiplash?

So… whiplash, like you had mentioned, we associate it to some form of trauma, like I was in a car accident unfortunately and I was diagnosed with a whiplash injury. I was a football player and diagnosed with some type of a whiplash injury. So typically whiplash is going to be associated with some type of acute situation or trauma, a traumatic event. Essentially when the head is forced back into hyper extension, where it goes backwards, and then conversely it goes forwards into hyper flexion. For instance if you were in a car accident and you were hit from behind your head will snap backwards and then go forwards. Secondary to that movement pattern you potentially could create damage to ligaments.

And…just a quick anatomy lesson, Charlie. Ligaments are the tissues that connect bone to bone. Many times, I’m sure growing up playing sports many of us have had an ankle sprain where we damage the ligaments in our ankle, or we roll an ankle, and we put a lot of stress on that tissue. So there’s damage to the ligament. Just quickly, tendonitis, tendon is what connects muscle to bone. But for this purpose, we’re talking about the ligament bone to bone.

And so there’s trauma to that tissue. The problem with ligament issues, Charlie, ligaments are almost avascular. What that means is that they have limited blood supply. So bone and muscle, for instance, have a fair amount of blood supply. Unfortunately if you were to ever break a bone, or if you were to ever damage muscle, the healing process is relatively predictable because there’s a fair amount of blood supply to that tissue. With blood supply to the tissue it promotes healing. So think about getting all the good stuff in, all the good stuff in there to repair the tissue, and the waste products out. When you damage the ligament, that’s why these darn things can take so long to heal because they don’t have a ton of blood supply. So the healing process can sometimes be all over the board. So these sprain strain injuries, these whiplash type injuries can be very, very uncomfortable.

And hard to pinpoint I assume? Is that why it’s so rife with fraud?

Well, I just think that it gets sadly, it gets lumped into one thing. You see these whiplash clinics and that’s essentially that they treat a lot of accident type patients, and can somewhat potentially be labeled as maybe just an accident type clinic, chasing these accident types of cases. Unfortunately, it’s a reality, and we see a lot of whiplash type injuries not only in accident patients, but a lot of the athletes that we treat. They can be painful. A lot of times obviously the patient will experience moderate to severe neck pain, they’ll present with decreased range of motion, they’ll have limitations in mobility, different types of things like that.

It not only is quite uncomfortable, it can affect their day to day type activity. And so it’s important we understand what we’re dealing with, the severity of the sprain, and the appropriate treatment recommendations.

We’re speaking with Doctor Sean Riley, with Tulsa Spine and Rehab. It’s an integrated clinic providing chiropractic and physical therapy, massage therapy, internal medicine, and yoga. Doctor Riley is giving us the tour of what the reality of whiplash is. Now because it is so hard to really pinpoint, Doctor Riley, I imagine the treatment of it has to be equally difficult.

Absolutely. So like you had mentioned, you need to handle it carefully. So obviously there’s damage to the tissue, so there’s possibly hyper mobility, which means excess of motion to that tissue. We want to handle it like a sprain-strain injury, we want to use ice and rest, and allow that tissue a chance to repair. I’m not a big fan early on in these sprain type cases to mobilize or manipulate that joint. It’s a little counter productive in that if we want to stabilize the tissue and allow it a chance to heal, we don’t want to get in there and continue to move and over … Unfortunately we’ve seen on the television, patients wearing the soft collars. In some circumstances those are necessary because essentially we’re wanting to limit how much movement your neck has, so we’re wanting to brace and stabilize. So ice, rest, those are types of treatments early on to allow that tissue, give it a chance to heal.

From there what we want to do is progress into some form of active care or rehab to reestablish range of motion, reestablish normal function, those types of things. If not, many times, Charlie, if left untreated, the patient may develop a new norm for example. For instance let’s say they’re only able to rotate to 30 to 40 degrees to the right and normal range of motion is 80 to 90 degrees. Well over time you develop adhesions, scar tissue formation and those types of things where you’ll have that limitation to range of motion. I think it’s important that we handle it a couple different ways. Obviously early on we want to allow the tissue to heal, but when safe and ready to go, then we want to progress more into active care focusing on range of motion, strengthening of stabilizing structures, and at some point possibly manipulation, not necessarily to the injured joint, but maybe above and below that injury.

How can you know when you’ve reached that point where you’re ready to go from the rest and recuperation to the rehab?