Managing Your Whiplash Pain – Part Three
The stages of whiplash management we have covered are: taking painkillers regularly; rest; keep active at a reduced level; pace and don''t overdo; intersperse periods of activity and resting. As the pain reduces all these things remain important but you can now beneficially introduce exercise to your management programme. Initial exercise may be best performed lying down to reduce the stresses on the anatomical structures of the neck due to gravity, with a pillow under the neck in supine. Gently rotating the neck to one side is the first thing to try, moving until the pain begins to be felt or to worsen slightly. Five movements each side may be enough to start with.
If the pain is severe then regular, perhaps hourly, repetition of these rotation movements might be enough to get things started. Once the exercises can be done in sitting this is useful as it is a more functional position. Rotations can be continued with increasing range and gentle forwards and backwards movements of the neck too. All simple neck exercises should be done separately, in other words the movement should be done in one direction and then the neck returned to the neutral position, avoiding moving the neck from side to side or front to back.
As the movements get better additional exercises can be introduced, with a new exercise always started gently, such as side bending of the neck, moving the ear towards the shoulder, and retraction which is a tucking in movement of the head to give oneself double chins. Maintaining a regular regime of exercise every day is difficult but may be very important in returning the neck towards normal as soon as possible and preventing the possibility of the development of chronic neck pain. Additional exercises suggested by the physiotherapist will include shoulder ranges of movement such as lifting the arm above the head, putting the arm behind the back and putting the arm behind the neck with the elbow out.
The physio will also include shoulder girdle exercises such as shoulder shrugging, rotating the shoulders backwards and forwards and bracing the shoulders back so the shoulder blades get close together at the back. Exercise of all the areas around the neck is useful to put normal mechanical inputs into the nervous system which helps to normalise the pain responses.
Author: Jonathan Blood-Smyth