whiplash

CAD- A.K.A. WHIPLASH

Avoid the Risk of Serious Injury; Adjust your Headrest High & Behind your head

What is CAD?

CAD is an acronym that stands for Cervical Acceleration Deceleration Trauma.   It is a more accurate term for what occurs to our neck in a motor vehicle accident.

In a rear impact collision, even at low speeds, the rear bumper is compressed and the target, or struck, vehicle is propelled forward.  The applied forces causes the following reaction:

1.      The torso is thrust into the seat, compressing and loading the seatback.

2.      The torso and head rises up in the seat (Ramping Effect).

3.      The head and neck come into contact with the headrest.

4.      A hyperextension of the neck occurs, and head and neck extension pushes down on the headrest (Hammer and Nail Effect), thereby accentuating cervical hyperextension.

5.      The hands can come free from the steering wheel, accentuating the rearward force into the seatback.

6.      Due to the forward forces and occupant inertia, the foot comes off the brake pedal, accentuating the forward thrust.

 

 Within milliseconds, the following sequence occurs:

1.      The stored energy in the seatback is released, causing forward propulsion of the torso. 

2.      The forward thrust of the torso and the lag time of the head causes a shearing in the neck joints.

3.      With the torso restrained by the seatbelts, the head then whips forward, causing a hyperflexion of the head and neck.

4.      The forward forces applied to the driver then cause a forceful reapplication of the brakes, which accentuates the deceleration and forward momentum of the occupants.

5.      Due to the elastic makeup of the bumper, the vehicle will have little or no visible damage at impacts of less then 8-12 mph.  Threshold for occupant injury is 5 mph.

 

Timing is everything!

Perhaps the single most important thing a person can do for a whiplash or CAD trauma is early intervention of conservative care.  It has been documented that scar tissue formation begins within three days of a CAD trauma.  Once formed, scar tissue becomes very difficult to control and is responsible for long-term chronic pain.

The second most important thing you can do for CAD trauma is to get appropriate care.  Specifically, this is care directed to reduce inflammation and scar tissue, and promote the re-building of strong healthy muscles, tendons and ligaments.  The process includes grading the severity of the trauma.  The type of treatment is then based on the stage of the injury.

1.       Stage one - Inflammatory.  During this stage, which usually lasts 48 to 72 hours, the primary treatment is with ice, ultrasound, electric muscle stimulation, and massage to reduce inflammation.  A cervical collar may also be necessary to prevent continued re-injury.  Vitamin supplementation is recommended to aid in the healing response.

2.      Stage two – Repair.  Depending on the severity of the injury, this stage can last as long as fourteen weeks after the injury.  Treatment during this stage, which should begin after two to three days, includes traction, controlled exercise and gentle manipulation.

3.      Stage three - Remodeling.  This stage of care could take upwards of a year or more to complete.  Treatment includes strengthening exercises, deep tissue massage, and manipulation to restore normal joint mobility.

 

Type of treatment

Cervical Pillow:  All grades and stages of CAD trauma should be supported with a cervical pillow.  It is advisable to avoid sleeping face down or on your back with too many pillows.

Cervical Collars:  Although long-term use of a collar is not compatible with a return of flexibility, the use of a collar for the first two to three days may be necessary.  Specific recommendations' regarding soft or rigid collars and when to stop varies depending on the injury and lifestyle.

Ice:  Should begin immediately and continue daily for three to four days.  After this, ice works well in conjunction with moist heat.

Ultrasound:  This is a deep cellular massage that reduces inflammation, and thereby accelerates the healing process.  Treatment should begin immediately, and be performed daily for the first four to seven days.  Continued treatment at a reduced frequency is necessary.

Electric Muscle Stimulation:  Stimulates muscle contraction to promote healing and prevent myofascial pain syndrome.

Traction:  Muscles and ligaments begin to heal after 48 hours.  Providing traction shortly after this process begins has been shown to promote healthy tissue regeneration.  This should begin by day three unless not tolerated by the patient.

Exercise:  Isometric exercise is equally important to improve muscle healing.  This should be begin by day three and continue through day twenty-one.  After that time, exercise should be directed to increase strength.

Specific Chiropractic Adjustments:  Perhaps the most important type of treatment for CAD trauma is Specific Chiropractic Adjustments, especially during the Repair and Remodeling phases of care.  Due to muscle spasm, the tightening of ligaments and scar tissue formation, the end result of CAD trauma is the loss of flexibility and motion between the joints of the spine.  In the treatment of these injuries, the goal and purpose of Specific Chiropractic Adjustment is to correct and restore this lost function of the spine. 

 

Frequency & duration

The frequency and duration of treatment is highly dependent on a number of factors, which include the severity of the trauma, delay in appropriate treatment, pre-existing conditions, and compliance with treatment recommendations.

It should be noted that the degree of vehicle damage is not always proportional to the severity of the CAD trauma.  In fact, it is fairly common to experience significant injury with little or no vehicle damage.  Low speed rear impact collisions (LOSRIC) have perplexed insurance companies, doctors and patients for many years.  However, referring to the sequence of events that occurs in a rear impact collision, it is easy to see how forces are transferred to the neck.

 

Nutritional supplements

Physical and emotional stress increases the need for certain vitamins.  Additionally, many drugs and alcohol increases the need for vitamin B6.  Supplementing with B1, B6, B12 and folic acid can help prevent long-term muscle pain.  However, the blood levels of B12 and folic acid should be determined before hand.  Vitamin C and iron are important for tissue regeneration, as is zinc.

 

cad certification

Dr. Holst has received advanced certification in the care and treatment of CAD trauma, which he re-news regularly.

In addition to keeping abreast of the most effective treatment methods, we are able to accurately document the risk factors that contribute to the injury of CAD trauma.

If you know someone who has been injured in a motor vehicle accident, be a friend . . . Tell them we can help them.  Be sure they call us today at (845) 344-0444.  Barbara will be sure to get them in to see us the same day.