What is it?

Whiplash results from the head being suddenly jerked backwards and forwards. It can result in injury to bones or soft tissues in the upper body which are collectively referred to as Whiplash-Associated Disorders.

How does this happen?

Whiplash-Associated Disorders most commonly occur after a road traffic accident where the car you are travelling in is rear-ended. They can also occur from sports, diving and other activities.

What are the symptoms?

Other symptoms which can also occur include:

• Restricted movement of the neck
• Stiffness in the upper body
• Pain around your jaw
• Fatigue
• Tingling, pins and needles or numbness in the arm
• Muscle spasms

 

How is it diagnosed?

Whiplash-Associated Disorders are diagnosed by an assessment from a healthcare provider (e.g. Doctor, Registered Physiotherapist etc). This assessment typically starts with some questions about how this injury occurred, your symptoms and your past medical history. You may be asked to fill out a questionnaire to give your healthcare provider further insight into how this injury is affecting different areas of your life. 

 

A physical exam will then be carried out during which you will be asked to perform simple movements like looking to the left/right. Your healthcare provider will carry out certain tests to check what structures are involved. You may be sent for an x-ray to rule out bony injury. It is rare that a MRI or CT scan will be required. 

 

After all of this your injury will be classified depending on the severity of it and the structures involved. Whiplash-Associated Disorders are graded from 0 - IV, with 0 being the least severe and IV being the most severe. Typically in clinical practice we mostly see grade I - II. 

 

What treatment will I need & how long will it take to recover?

Research shows that the earlier you attend a healthcare provider after your injury and the earlier you start a treatment programme the better your recovery will be.

Initial treatment may involve medication to help reduce pain levels.

Evidence-based guidelines recommend starting gentle movement exercises as soon as possible which will help reduce pain and improve your function.

The video "Neck Pain" in the Masterclass Section will take you through tips and strategies on managing neck discomfort, while keeping yourself moving. The "Neck Stretching" video goes through some gentle movement exercises.

 

 

Treatment for the majority of people will consist of exercise. Studies have shown that Whiplash-Associated Disorders respond best to:

• Movement or mobility exercises for the neck, upper back and shoulders.
• Strengthening of the upper back, mid-back and neck.

The Niggly Neck Rehab Series is a progressive series of classes which includes all of these exercises. It is suitable for Whiplash-Associated Disorders (> 6 months previous).

 

 

The most important piece of advice for a quick recovery is to keep moving!!! Research shows that if we move as normal and go about our daily lives as normal (within pain limits) that it aids a speedy recovery. 

 

Recovery time frames vary as there are many factors involved. Approximately 50% of people recover within one year. For a more severe injury it can take up to three years to see full resolution.

 

TAKE HOME MESSAGE:

Keep moving, stay active and return to work as soon as possible to promote a smooth and swift recovery!

 

Information sourced from:

Pastakia, K., & Kumar, S. (2011). Acute whiplash associated disorders (WAD). Open access emergency medicine : OAEM, 3, 29–32. 

National Institute for Health and Care Excellence (NICE) (2018). Neck Pain - Whiplash Injury.

 

Physiotherapist-led Pilates, also known as Clinical or Rehabilitative Pilates, is an amended form of traditional Pilates, taught by a Physiotherapist. It consists of numerous rehabilitation principles and can assist in the management of chronic conditions, spinal pain, rehabilitation from injury and prevention of further injury. It is a low impact form of exercise which means it does not stress any joints, making it suitable for all ages and capabilities.

A commonly held belief is that Physiotherapist-led Pilates is just core strengthening - it is so much more than that!! It is a mixture of strengthening exercises, balancing exercises, stretching and mobility exercises. Physiotherapist-led Pilates combines the principles of more traditional Pilates with the Physiotherapist’s knowledge and expertise to adapt exercises, ensuring they are suitable for those with injuries or painful conditions. Often this will comprise of different options or variations of an exercise to make sure you are doing the most appropriate exercise for your body. Typically Physiotherapist-led Pilates is at a slower pace than traditional Pilates to ensure you can keep up and perform the exercise in a safe yet effective manner. 

Recovering from injuries:

Previous recommendations for injuries used to be an initial rest period. We now know that “rest is rust” and so this recommendation has been changed to relative rest. This may mean temporarily stopping a higher impact form of exercise (e.g. running, walking or gym classes) however you still need to keep your joints mobile and your muscles strong to rehab effectively. Physiotherapist-led Pilates can be a great rehabilitation tool, achieving the relative rest your body needs to heal, while also keeping you mobile and strong without aggravation of your injury.

Low back pain:

For those experiencing lower back pain exercise is a key recommendation in the management of this. In recent systematic reviews exercise has been shown to be beneficial in the management of low back pain and in particular exercise involving strengthening and flexibility, both of which Physiotherapist-led Pilates involves.

Persistent pain:

Persistent or chronic pain is a condition in its own right that for many years has gone underdiagnosed, under-reported and poorly managed. Recent guidelines for the management of chronic pain include exercise as a key component. Commonly when you suffer with pain there is fear associated with exercising. For many this fear stems from an anticipation that exercise will make the pain worse. Studies in this area show that endorphins released when exercising can help improve pain. If we do not exercise we lose mobility, bone and muscle strength, reduce our balance and overall increase our risk of falls/injury. This disuse or deconditioning further negatively affects the quality of life and increases the disability associated with chronic pain. There are many forms of exercise available, finding one that suits you and most importantly that you enjoy is key! If you are looking to start exercising again and apprehensive to do so, Physiotherapist-led Pilates can be a good place to begin as it is slow-paced, low impact and run by a healthcare professional.

So whether you have a short-term injury, long term back pain or chronic pain condition or just want to exercise at a slow safe pace Physiotherapist-led Pilates is suitable for all!

Low back pain is the largest cause of disability worldwide and it makes up most of what I see in clinical practice. So for those of you who suffer from low back pain (if you are reading this I imagine you have experienced it!) know that you are not on your own with it. Low back pain affects up to 84% of people at some point in their lives. Unfortunately for 11% of males and 16% of females low back pain ends up being long-term.

It is important to point out that not all low back pain is the same. The majority of cases (95%) of low back pain have no known cause (what we would call non-specific low back pain). If you have seen healthcare professionals or had different tests done only to be told there’s nothing to be found you are not alone. Scans like x-rays or MRIs are actually only recommended if serious pathology is suspected, which make up 1-4% of cases.

When searching the internet for ways to manage low back pain (hello Dr Google!) it can be challenging to find reliable information. To help with this, there are a few best-practice evidence-based clinical guidelines which I will summarise here, namely:

• The National Institute for Health and Care Excellence (NICE)
• Scottish Intercollegiate Guidelines Network (SIGN). 

The key takeaways from these are:

1. Get exercise

One of the main recommendations In both of these guidelines is that exercise should form the basis of all treatments for low back pain. Further treatment is only recommended in addition to exercise.

2. Get advice

While exercising is important, it is also important that you get advice to make sure that it is the exercise most suited to your needs.

3. Type of Exercise

It has been shown that unloaded exercises like pilates, yoga or tai chi are as helpful as resistance exercises. Interestingly however, walking alone is not an effective form of exercise to manage low back pain. Pilates has been shown to be better than minimal intervention and a number of high-quality clinical trials recommend stabilisation exercises, which are included in pilates, for those with long-term low back pain. 

4. Provision of Exercise Videos

These guidelines also report that the provision of exercises videos improves the performance accuracy of the exercises. 

5. Keep at it!

Exercise performed for more than twelve weeks, in particular, has shown significant reduction in pain intensity and the effect this pain has on the individual’s quality of life. 

So, incase you can’t see the point I have been attempting to make with this blog(!), low back pain is a massive problem globally with a huge impact on the individuals experiencing it. There is strong evidence for the use of exercise in the treatment of low back pain and it is recommended in best-practice clinical guidelines.

The take home message: get exercising!!!

Remember: an assessment by a healthcare professional is always recommended before commencing exercising, particularly if you have medical issues or pain.