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Shaw Chiropractic
A Medical-Legal Newsletter for Personal Injury Attorneys
by Dr. Steven W. Shaw

PATHOMECHANICS OF WHIPLASH

There is a dilemma in the mechanism of the Cervical Acceleration-Deceleration Syndrome: Why (in many cases) is the damage to the vehicle not proportional to the injury experienced by the passengers? Recent research has demonstrated that high impact forces are transmitted directly to the passengers involved in low speed impacts. Vehicles are designed not to compress until the speed of impact exceeds 15-20 miles per hour. A 10 mile per hour impact can produce a total collapse of only 2.5 inches in the case of a rear end collision. This relative non-compressive force is then transmitted to the passenger with resultant high acceleration and deceleration forces. Therefore, the important question to ask is not, "What is the damage to the vehicle?" Rather, you should ascertain, "What was the change in acceleration induced to the victim's vehicle when it was struck?"

It is well known that it is the change in acceleration of the passengers which causes the injury due to shearing forces.
Some important information to obtain includes:

What were the road conditions?
Was the injured passenger using a shoulder-lap belt?
Was the vehicle moving or stopped upon impact?
Which seat was the injured passenger occupying?
Was the victim aware of the impending crash?
Did the victim brace before the crash?
Was the victim male or female?
What position was the headrest in?
Was the impact at an angle?

SOME COMMON AND OVERLOOKED CAUSALLY RELATED SYMPTOMS

It is not unusual for symptoms to occur which may not commonly be associated with the injuries sustained in a motor vehicle accident. If not asked about these, patients will often not associate them with the accident and consequently ignore the symptoms or not mention them to the attending physician. You may wish to ask your clients if they have experienced any of the following symptoms after their accident:

Muscle Pain
Paresthesia (Altered sensation or numbness)
Headache and Occipital Neuralgia
Pseudoangina
Eye and Vision Problems
Ear and Balance Problems
Dysphagia (Throat Problems)
Breathing Difficulties
Bad Dreams
Difficulty Concentrating
Forgetfulness
Digestive Problems.

IS PRE-EXISTING A PROBLEM?

Trauma imposed upon a spine that has pre-existing disc degenerative changes will find the soft tissue structures of the involved motor unit less capable of tolerating and dispersing the traumatic forces. Therefore, injury will be greater! However, even though there may be a pre-existing condition, if the accident causes additional medical impairment or damage, it is the accident which is responsible. Treatment should be directed toward bringing the patient as close to pre-injury status as possible.

Trauma imposed upon a normal spine is adequately managed by the elastic discs, the resilient ligaments, elastic capsule tissues, and openings for nerves and blood vessels as there is an innate margin of safety. Trauma to a degenerated spine finds less compressibility, less resilience, and narrowing of the foramen and therefore there is less of margin of safety.