Whiplash

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Julie

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I have a client who was in a car accident several weeks ago. He has a pretty tough case of whiplash, and I've been working with him for about six weeks. While we've seen progress, I'm not sure it is as much as should be. I know whiplash is tough.....but I'm just not sure it is supposed to be *this* tough.

The low back issues seem to have made the most progress. His rib pain is gone, but the neck issues remain. He isn't in much pain anymore, but has some nasty trigger points yet. Both masseters have huge TP's. His symptoms are mainly on the left side - headaches caused by TP's in upper traps, suboccipitals, SCM, scalenes and masseter. He also still has TP's in the left subclavicular and both longus colli. I seem to have worked out the TPs in the suprahyoids, digastric and pterygoids, but don't understand why the others are not responding as well.

Any ideas? He is going to PT, also, and he says they do mostly the same things I am doing. How long is there generally need for treatment after an MVA?
 


It can be a very looooooonnnnnnggggg time... I went to PT, Chiro, now MT for my whiplash, I go every 2 weeks, and have in depth work on just my neck and my back. My accident was December 2005, I am feeling better, but if I don't go for my massage I have issues, I really wish I could get in there once a week, but that is just too expensive. I almost feel as if once the damage is done, it is done...
 


Thank you - that is both encouraging and discouraging. I want to HELP him! But I also want to know that I am being helpful, even if the results are not what I want to see just yet. Six weeks doesn't mean I'm worthless and just collecting pay because he is in pain, kwim? He sees enough benefit to keep doing this, or rather, he knows how much better he feels when his massages are regular than how he feels if he misses one.

I am wondering, though, if he should get some chiropractic treatment in conjunction with massage.
 


yeah, long time up to two years, dont rule out strength training-very important to the recovery. Trp's in all those muscles really? Are you sure trp's or over stretched damaged muscles?
 


Don't compromise your treatment by sending him to a chiro...it is a soft tissue injury and that is what you are best at not the chiropractor.
 


OffIce said:
Don't compromise your treatment by sending him to a chiro...it is a soft tissue injury and that is what you are best at not the chiropractor.

I can't imagine how chiropractic care could compromise my work with the soft tissue. The chiro would not be trying to deal with the soft tissue, but checking for misalignments and realigning, if need be. Aren't the two therapies complementary?
 


Rose of Sharon said:
I can't imagine how chiropractic care could compromise my work with the soft tissue. The chiro would not be trying to deal with the soft tissue, but checking for misalignments and realigning, if need be. Aren't the two therapies complementary?

I was thinking the same thing.
 


You know that with TMJ, you have to work with the 3 P's..psoas, piriformis and pterhowdoyouspellgoids. Likely too the pelvis is unbalanced with either a rotation or upslip/downslip.

I know that whiplash is not TMJ, but....the same areas are affected, right?
 


StressSolutions said:
you have to work with the pterhowdoyouspellgoids.

Oh, man, I don't think we covered these mm. in anatomy class. :lol:

Actually, Mick, that makes a lot of sense that you would want to work the LB, hip, and ab mm. Good thinkin'! :smt023
 


StressSolutions said:
You know that with TMJ, you have to work with the 3 P's..psoas, piriformis and pterhowdoyouspellgoids. Likely too the pelvis is unbalanced with either a rotation or upslip/downslip.

I know that whiplash is not TMJ, but....the same areas are affected, right?

That does make sense. I haven't paid a lot of attention to his piriformis. Psoas are both definitely hypertonic, and pterygoids have had TP's that are worked out....but I should check to see if they've returned. Thanks!
 


Good tips! The TMJ often takes a thrashing in a whiplash accident, as does the c-spine. If you are able to address the anterior cervical tissues, you often find asymetries in both the soft tissue as well as the vertebrae. Pre-existing vs. new is hard to determine, but work here tends to benefit nicely. Chiropractic can benefit if the displaced c-spine does not come back with the soft tissue work and is hindering motion. I can't agree that the course to recovery is always a long one, though some are. Long duration, low load manual cervical traction to me is the key (MFR guy here) to restoring balance to the neck and region. Pterygoid releases intra-orally and, especially, thoracic inlet releases can really open things up.
 


Question for you regarding the manner in which your client received the whiplash injury: was the auto accident a sideline crash, head-, or t-bone? Each of those, or even worse, a spinning crash, have different variable that can and do add even more insult to the injury. Have had instances in my practice where "unwinding" had to be done to get anywhere in the relief and repair part of the treatments. Have also used Orthobionomy and a "cheaty" craniosacral-like hold [put your hands on the tissues with your hands sandwiching them and just hold still] that seems to help loosen things up enormously when all else fails. The worst case of whiplash I ever worked on I saw within 3 hours of the auto accident the lady was in ---- her car was hit in the R rear quarter panel at 35 mph as she backed out of an angled parking space. She said she could feel her head, neck and entire body being spiraled around under the shoulder restraint system [check the anterior thorax for problems there too!!!] The doctor's office called and sent her straight from there to see me............. the spiraling effect was a monster, but, thankfully it only took 3 1/2 weeks to get it to go away for good.

Best of luck to you and the client!
 


It was a very straightforward head-on collision, and my client was in the front passenger seat, so the seatbelt was at his left SCM (he was sitting very low) and right lower ribs. He was in the hospital 2 days because there was such swelling over his carotid artery that they had to keep checking to be sure it wasn't leaking.

That does make the pelvic imbalance seem very likely.

Thank you for all your help!
 


Sounds like you are doing everything right. Your client will have to do home care strengthening (if you aren't already having them do it). Core, especially.

From what I've heard and read, and was taught, 75% of MVA's may live with pain for the rest of their lives even with treatment. Now a lot of this I suspect is because clients tend to stop doing their exercises and home care, and get discouraged.

Be patient. You are doing good work. If you are both committed, and your client is willing to work at home, it will happen.
 


Rose of Sharon said:
OffIce said:
Don't compromise your treatment by sending him to a chiro...it is a soft tissue injury and that is what you are best at not the chiropractor.

I can't imagine how chiropractic care could compromise my work with the soft tissue. The chiro would not be trying to deal with the soft tissue, but checking for misalignments and realigning, if need be. Aren't the two therapies complementary?

YES. You really can't have one without the other. This does go both ways :)

Muscle is innervated by nerves. Nerves get irritated when pressure is put on them. This happens when vertebrae are knocked out of place. This can cause the muscles to spasm. A chiropractor is necessary to "fix" this. In turn, bones (e.g. vertebrae) sit where muscles put them. Muscles will pull on bones at the attachment sites and pull them out of place. Even after the doctor (of chiropractic) fixes the nerve irritation at the vertebral level, muscles may remain in spasm. A massage therapist is necessary. Both are needed, for best results. If you are only doing one of the two, you're missing the big picture :)

Hugs,
~Jyoti
(current licensed massage therapist AND future doctor of chiropractic)
 


Not with whiplash injury, the problem is inflammation and weakness. Resistance training and soft tissue work is the best not chiro adjustment.
 


Sorry to disagree with you Office, but as a recent victim of a MVA (6 mos ago) and a LMT, I can say that my chiropractor has become my second best friend. I had severe stair stepping of C-3, 4, and 5 and no amount of massage was going to correct that. I agree with others in believing that chiro and massage go hand in hand. As a therapist, I also find it helpful in my practice to have x-rays to refer to. My palpation skills are pretty good, but it's nice to have something to confirm what I'm feeling. Thank you StressSolutions for the comment about releasing the Psoas and Piriformis for TMJ, I never thought about it, but it makes sense. Great to be able to see the big picture.
 


OffIce said:
Not with whiplash injury, the problem is inflammation and weakness. Resistance training and soft tissue work is the best not chiro adjustment.

I disagree. Good chiropractic care can help with many of the flexion/extension injuries sustained in MVA's, etc. Keeping the joints mobilized (when called for) increases healing rates and helps with function.
 


I think Cranial Sacral alone or in conjunction with your regular session could be beneficial and healing for your client.
 


A question regarding whiplash and a link to swollen lymph node area around the occipitals was posed to me recently. Anyone know or heard of a link between the two? This person may actually come and post a question in the client area but until then I'd like to gather some info.

I think anything is possible...although I can't seem to find any correlation in the materials that are available to me, on lymph nodes/lymphatic system/whiplash pathology, etc.

Here is a quote:
In 2001 I was invloved in a rather nasty car wreck that caused lots of muscle damage in my neck. It tore ligaments at c1-c2 on the left and c5-c6 on the right. Ever since the wreck, I have had problems with the lymph nodes at the base of my skull (right side) swelling and being rather painful. It cycles, but I haven't been keeping track of it (stupid me) to know what triggers it.

Since I have only been having problems with this since the wreck, I am wondering if the whiplash I suffered could have damaged the lymph drainage system in my neck. I know I still have a lot of inflammation in my neck muscles which could account for the swollen lymph nodes, but I haven't noticed a correlation between bad episodes with my neck and the swelling. Especially since all the episodes of swollen lymph nodes is on the right at the base of the skull - the opposite side from where I have most of the pain and muscle spasms.

The doctors don't think much of it. I get the shrug off about it and they don't really answer any of my question. So, I am trying to understand what is going on and trying to figure out something to stop this constant reoccurence.

Anybody know anything about any possible correlation between the two, or good sources on the lymph system that will be more enlightening than what I have read so far? Unless I have some information to take to the doctor, I have a feeling nothing will ever be done about it.


As always, any thoughts are appreciated! :)

P.S. This person is getting regular Chiropractic care and has had massage therapy in the past . Also reports that Acupuncture treatments did nothing.
 
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    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  31. Red Rose Spa:
    ๐ŸŒธ We have 5 hot brown girls today ๐ŸŒธ MONICA, PAOLA, MALIYA, MONIKA, AMANDA, ASHA, JAZMINE, PREETI, ANGELINA, KIRAN ๐ŸŒธ 2588 Birchmount ๐ŸŒธ 2 Invergordon ๐ŸŒธ 647-702-8800 ๐ŸŒธ Please visit for a great erotic massage
  32. wilson holistic centre:
    ๐Ÿ’•๐Ÿ’•Beautiful Korean girl working at 382 Wilson Ave ๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-840-0071โค๏ธโค๏ธ
  33. wonderspa:
    ๐ŸŒบWonder spa,(9421Jane st unit127)call416-5000-800โ˜Ž๏ธbest massage in vaughan,Wednesday RMT available,๐Ÿ’„sexy face young girl Joey natural c cup,very good looking nice body slide,really popular ๐ŸŽlong hair Q Lucy good strong to relax oil massage, Relieve pain and remove stress,more experience,๐ŸŒนvery nice new girl CiCi, amazing the end,give you warm time,must try๐ŸŒน๐Ÿฅค
  34. AliceSpa:
    WEDNESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—” 416-298-0898, 4915 Steeles Ave. E, Scarborough 3 very nice girls here today. Open 10am to 9pm: CLOUDIA (11am-8pm): is Vietnamese, young, petite 5'2" & 96 Lbs, B Cup, best rim deep bbbj cim. $40 Room Fee + $80 (incl bbbj & fs). +$20 for rim/cim. Excellent open minded services. DORIS (12pm-9pm): from Taiwan, is young & petite with loing thick black hair, 105 Lbs
  35. Annie Spa:
    ๐Ÿ’‹๐Ÿ˜˜Sexy Petite Korean๐Ÿ‡ฐ๐Ÿ‡ทGirl Eva working with Sweet Beautiful Japanese New Cummer to Canada Feifei ๐Ÿ‡ฏ๐Ÿ‡ต and Sensual Pleasing Busty Coco๐Ÿ‡จ๐Ÿ‡ณtoday๐Ÿ’‹๐Ÿ˜˜Call or text ๐Ÿ“ฒ647-891-9688 or 416-291-8879๐Ÿ“ฒ
  36. EMSpa_schedule:
    Hey! Where have you been? Today (Wednesday), our amazing attendants are Carla โ€, Cici ๐Ÿ˜, Opal ๐Ÿคฉ, Sandy ๐Ÿค— and Yoyo ๐Ÿ˜. Call us at โ˜Ž๏ธ (905) 479-6668 โ˜Ž๏ธ to book your favourite and head on over to 7665 Kennedy Road, Unit 4, Markham!
  37. ForeverWarden:
    Wednesday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Bella, Cindy & Sasa. Bella is around 5โ€™3โ€ with a thin to medium build, C Cups, and a pleasing personality. She can offer dfk, bbbj and cfs as well as a good massage experience. Cindy is a slim beauty, 5โ€™4โ€, natural C Cups. Her massage is nice, her services will drive you wild & her finish is a dream
  38. HolidaySpa:
    Wednesday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: FIONA, KIKI & CINDY. FIONA is a slim hottie with long dark hair, great melons and ass, and nice services. Kiki is very attractive, young, about 5โ€™4โ€ and 110 Lbs., slim with a banging body. Kiki is very popular for her great attitude and services. CINDY is slim & incredibly sexy
  39. SugarLoveSpa:
    Wednesday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: SARAH, SUSAN, TIFFANY & VIVI. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž SARA is a beautiful Thai lady with C Cups, 160 Cms and 50 Kgs, with a full set of services to delight you. SUSAN is a small, slim & sexy Latina girl, 5'4" & 116 Lbs, with nice boobs and ass, very versatile services.
  40. ใ™ใฟใพใ›ใ‚“:
    Top notch line up with superstars like sunny , gabby , elena , kiki , Ella and cindy. At top notch wellness
  41. bnwellness_wilson:
    We have 4 young girls are working today, young Taiwanese Victoria slime 26โ€™s and young flirty Mia 25โ€™s with curly body , pretty Ella and cute GFE Lina are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  42. luckywellness:
    Lucky Wellness Center 4379721888 295 Eglinton Ave E,Unit 7,Mississauga We had two girls today, Niko and Kiki. They were both young, pretty and cute. The massage and back massage were great.
  43. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน2 girls ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ Table Shower Sea Salt Bath Body Scrub๐Ÿ˜˜ Japanese girl Nina โค๏ธ Natural Big Boobs 38 DD ๐Ÿ˜˜Pink Mini Nipples Hot body slide, super enjoyable๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธYou are welcome to make an appoint
  44. DareDevil:
    ARIA WELLNESS โ™ฅ๏ธโ™ฅ๏ธADDRESS: 360 HWY 7, UNIT #6, RICHMOND HILL,647-222-5683 โ™ฅ๏ธโ™ฅ๏ธ(PHONES CALL ONLY, NO TEXT'N AVAILABLE) โ™ฅ๏ธTODAY'S Schedule!โ™ฅ๏ธ Loaded lineup with Beautiful Girls : Young RMT Student Helen, Sexy Busty Apple, Magical Mia and Work out๐Ÿ‹๐Ÿšด๐Ÿ’ช Babe Amy! SPECIAL PROMO 30 MINS 2 GIRLS $70 ๐ŸŒน๐ŸŒน**TODAY'S PICKS OF THE DAY ARE ๐Ÿฌ๐Ÿญ HELEN AND APPLE๐Ÿฌ๐Ÿญ**
  45. DareDevil:
    Blackpink Wellness โ™ฅ๏ธโ™ฅ๏ธ190 Marycroft Ave. Unit #2, Vaughan, ๐Ÿญ๐ŸฌON L4L 5Y1 (647) 395-3188. BEAUTIFUL AND SEXY GIRLS TODAY: Fun Girl Angela, New Indian Girl Radika and Beautiful Tiffany on duty๐ŸŒน.
  46. Lulu_Villa_Spa:
    Sami is a gorgeous model type Vietnamese Girl Mia new Vietnamese sweetheart girl with amazing personality Tiffany She is new as MPA From Philippines Slim Body Great Massage Fun personality Bella She is Mexican Gorgeous face Natalie she is CBC/filipina mixed
  47. Sunrise Relaxation(416)916-7276:
    Tomorrow@Sunrise Relaxation Downtown: Tiffany, Vivian and Kitty will be on shift. Call (416)500-0921 for detail schedule and insight info
  48. EMSpa_schedule:
    Tomorrow's sneak peek: On Wednesday May 28, 2025, our attendants will be Carla ๐Ÿ’‹, Cici ๐Ÿคฉ, Opal ๐Ÿคฉ, Sandy ๐Ÿ˜ and Yoyo ๐Ÿฅฐ. Call us at โ˜Ž๏ธ(905) 479-6668โ˜Ž๏ธ to book!
  49. wilson holistic centre:
    new girl works at ๐Ÿ’‹535 Evans Ave today ๐Ÿ’•๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-531-6969โ˜Ž๏ธโ˜Ž๏ธ
  50. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน Table shower .body scrub ๐Ÿ˜˜Three girls every day ๐Ÿ”ฅ๐Ÿ”ฅ๐Ÿ”ฅ 5124 Dundas West Street, Etobicoke โ˜Ž๏ธ 416-817-3366 ๐Ÿ‘ Newโ—๏ธNew girl Angela ,so young Petite and pretty๐Ÿ˜‹ open service ๐Ÿ˜œ๐Ÿ˜œ Sweet girl Luna deep massage ๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜ Hot and sexy body very provocative service ๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธ You are welcome to make an appointment at any time or walk in directly through the back door. We have ample parking spaces available
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