Monthly Archives: December 2011

The quickest way to prevent whiplash

Whiplash can have detrimental consequences on your quality of life, not to mention your pocket book. As one of the most common auto injuries, whiplash costs Americans more than $29 billion annually.1 But there’s an easy way to minimize your risk of whiplash that few people take advantage of: proper head-rest positioning.

Studies show that properly adjusting your car’s head rest, technically called a head restraint, can reduce your risk of whiplash by at least 24%.2 Despite this easy preventative measure, few people know about proper head-restraint positions.  In a new study of drivers at an Irish university, researchers found that 73% of drivers did not know correct horizontal head-restraint positions although the majority of people could identify correct vertical head-restraint positions.3 Even if people could identify correct positions, that did not mean that they actually had proper positioning. Drivers under 30 years old and males were more likely to have poorer head-rest positioning. Despite that females often had better head-restraint positions, in general, whiplash affects more women than men. Researchers point out this demonstrates that while head restraints play a significant role in whether someone has whiplash, there are a number of other contributing factors as well.

Researchers believed that a combination of improved driver education and manufacturer innovation could greatly improve head-restraint positioning and the safety of drivers.

How do I adjust my head rest?

While recommendations vary based on type of automobile and your height, generally experts recommend two key guidelines:

  1. The top of your head restraint should be as high as your eye level. Ask a friend to assist you in determine your head-restraint height.
  2. Your head should be as close to the head restraint as possible, preferably touching but no more than 2-3 inches away.  

 

References

  1. “Whiplash statistics.” Whiplash Prevention Campaign. Accessed December 20, 2011.http://www.whiplashprevention.org/Employers/WhiplashMatters/Pages/Statistics.aspx.
  2. Farmer, C.M., Wells, J.K., & Werner, J.V. Relationship of head restraint positioning to driver neck injury in rear-end crashes. Accident Analysis and Prevention.1999; 31:722.
  3. McCreesh, K., S. Arthurs, S. Horgan, L. Keane and L. Meagher. “Vehicle head restraint positioning knowledge and behaviours in a sample of Irish drivers.” International Journal of Injury Control and Safety Promotion. 2011, September; doi:10.1080/17457300.2011.628754.
  4. “Prevent Injury, Adjust your Headrest.” CAA South Central Ontario.  Accessed December 28, 2011. http://www.caasco.com/insurance/auto-vehicle-insurance/adjust-your-headrest.jsp.
  5. “How to Adjust Your Head Restraint.” The Royal Society for the Prevention of Accidents. July 2005. Accessed December 28,2011. http://www.rospa.com/roadsafety/info/adjust_head_restraints.pdf.

Computerized testing improves high school response to athlete concussion

The past decade has seen a drastic increase in the number of young people visiting the emergency room with sports or recreational-related brain injuries.1 This, combined with growing public attention to sports-related brain injuries, has lead many high schools to improve their responses to athlete concussions.

More schools are now using computerized testing to evaluate athletes’ concussions. In just one school year in 2010, the number of schools using computerized testing jumped by 15%, so that now 40% of schools with at least one athletic trainer report using computerized testing, according to a recent study from the journal Pediatrics.2-3 Schools that used computers were also more likely to have physicians decide when an athlete should return to play.

Sometimes, it’s difficult to tell when an athlete has fully recovered from a concussion, and with pressure to return to the game, athletes may be playing sooner than they should. This could lead dangerous outcomes later on. In other posts, we’ve talked about how a lifetime of small head traumas can develop into more serious brain damage and even a degenerative disease known as chronic traumatic encephalopathy (CTE). CTE has claimed the lives of at least 20 professional athletes in recent years. Lifetime athletes of football, hockey, boxing, and soccer are high-risk because of the collision nature of the sports.4-6

Researchers said that computerized testing helped physicians better evaluate whether or not athletes were ready to return to the game. Often this meant that more athletes waited longer than 10 days to play. Other studies have shown that teens between the ages of 11-15 years can take up to 14 days to regain their normal cognitive functioning after a concussion.7A slight increase in recovery time then may prevent teens from further injury.

If you are an athlete in a collision sport, if you do get a concussion, it’s crucial to consult with a physician about when’s it’s appropriate to return to the game in order to avoid further brain damage.

References

  1. “Nonfatal Traumatic Brain Injuries Related to Sports and Recreation Activities Among Persons Aged ≤19 Years — United States, 2001—2009”. Morbidity and Mortality Weekly Report (MMWR). Center for Disease Control and Prevention. 7 October 2011.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6039a1.htm?s_cid=mm6039a1_w. Accessed October 19, 2011.
  2. Meehan WP III, et al. “Computerized neurocognitive testing for the management of sport-related concussions” Pediatric. January, 2012; 129: 1-7.
  3. Phend, Crystal. “More Schools Using Computers to Test for Concussions.” Medpage Today. November  30, 2011. Accessed December 20, 2011. http://www.medpagetoday.com/Neurology/HeadTrauma/29936
  4. Master, J.T., A.G. Kessels, B.D. Jordan, M.D. Lezak, and J. Troost. “Chronic traumatic brain injury in professional soccer players.” Neurology.1999: 791-6.
  5. “Boston University Doctor Answers Questions from Readers.” December 6, 2011. Accessed December 6, 2011. http://slapshot.blogs.nytimes.com/2011/12/06/boston-university-doctor-answers-questions-from-readers/.
  6. Walsh, Nancy. “Pro-Bowl Player’s Suicide Renews Head Trauma Debate.” February 25, 2011. Medpage Today.Accessed December 6, 2011. http://www.medpagetoday.com/Orthopedics/SportsMedicine/25064.
  7. Maugans TA, et al “Pediatric sports-related concussion produces cerebral blood flow alterations” Pediatrics 2012; 129: 1-10.

Why do more women have whiplash than men? Not because of small necks

In previous posts, we’ve written about how men and women experience auto accidents differently; particularly, women are more prone to whiplash symptoms than men. For a long time, scientists thought that this was a result of women’s reduced neck muscle volume. The idea was that reduced neck muscles means women have less protective bracing around their cervical spine when it is whipped out of its normal range of motion. While this hypothesis makes sense, it may not be true according to new research published in the Journal of Magnetic Imaging.

Most studies of whiplash look at patients within the first few weeks or months after the auto accident.  Many of these studies have noted that whiplash patients have reduced neck muscles compared to people without whiplash. Researchers in this study pointed out that this decreased muscles volume may be a result of muscle atrophy from a patients not moving their neck as much due to pain. To rule out this variable, researchers took the unique approach of examining patients within the first 48 hours after an auto accident.

Researchers looked at 38 patients with whiplash, and 38 healthy participants. They found that patients’ initial muscle volumes were about the same as participants without whiplash. They also confirmed that women had smaller neck muscles around their cervical spine, or the part of the spine comprising the neck. Despite having smaller cervical spine muscles, women did not tend to have more neck and head pain than men. Instead, having greater cervical spine muscles tended to mean less neck pain and more headaches amongst both sexes.

These surprising results lead researchers to conclude that reduced muscle volume in women does not increase their likelihood of having whiplash symptoms.  “Although essentially a negative result,” researchers wrote, ” this is…worthy of publishing as we are correcting a misunderstanding.” These findings contribute to scientists’ work to better understand the complexity of whiplash.

 

Ulbrich, Erika, et al. “Cervical Muscle Area Measurements in Acute Whiplash Patients and Controls.” Journal of Magnetic Resonance Imagine 33 (2011): 668-675.

Dead hockey player diagnosed with degenerative brain disease CTE

After professional hockey player Derek Boogaard died of a drug overdose in May, his family decided to have his brain evaluated for damage. New results from an autopsy revealed that Boogaard had chronic traumatic encephalopathy (CTE). CTE is a degenerative brain disease caused by having multiple head injuries and concussions. It has been found in athletes engaging in contact sports like American football, hockey, boxing, and wrestling.

The disease causes a number of cognitive and behavioral abnormalities, and eventually progresses to dementia.  Currently, the only way to diagnosis CTE is  through autopsy postmortem. But scientists say there are signs of CTE while a person is living including memory loss, mood swings, impulsive behavior, addiction, and depression.

Since the 1920s,  scientists noticed the some boxers suffered from cognitive decline after repeated head trauma. It wasn’t until the early 2000s though that scientists realized the gravity of that brain damage from autopsies of NFL football players, and named the condition CTE. Since then, around 20 professional athletes have been confirmed to have CTE. Scientists are currently looking for ways to prevent, diagnosis, and treat CTE while a person is still living. Just last month, Boston University announced that they will be testing 100 former NFL football players for signs of CTE while living.

Researchers recommended that people who suspect they have CTE be examined by a clinic specializing in degenerative brain diseases, like Alzheimer’s disease. Although there is still no single treatment for CTE, there are ways for people to manage and treat their symptoms.

 

“Boston University Doctor Answers Questions from Readers.” December 6, 2011. Accessed December 6, 2011. http://slapshot.blogs.nytimes.com/2011/12/06/boston-university-doctor-answers-questions-from-readers/.

Branch, John. “Derek Boogaard: A Brain ‘Going Bad’.” The New York Times. December 5, 2011. Accessed December 6, 2011.

“New brain study to test 100 NFL players.” CBS News. November 18, 2011. Accessed December 6, 2011. http://www.cbsnews.com/8301-400_162-57327505/new-brain-study-to-test-100-former-nfl-players/.

Walsh, Nancy. “Pro-Bowl Player’s Suicide Renews Head Trauma Debate.” February 25, 2011. Medpage Today.Accessed December 6, 2011. http://www.medpagetoday.com/Orthopedics/SportsMedicine/25064.

Soccer poses risk of brain injury

Soccer is often thought of as a safe alternative to football. But new research suggests that soccer may share some of the same risks of concussions and brain damage that football has. Although it’s still unclear how soccer measures up to football, it is clear that heading a soccer ball can take its toll on athletes’ brains. New research suggests that heading a soccer ball can mildly damage the brain in tiny increments that add up when someone is a longtime player.[1]

These findings were presented by the Albert Einstein College of Medicine at the Radiological Society of North America’s annual meeting in November 2011. Researchers examined 32 amateur soccer players around 31 years of age who had been playing soccer since they were children. They found that players who headed a ball 3-4 times day had low fractional anisotropy — a state associated with cognitive impairment.

Others studies have demonstrated that heading  caused deficits in attention, memory, planning, concentration, and judgment in professional soccer players.[2]

Researchers noted that the latest study, while preliminary, does indicate that even low-level injuries can have detrimental consequences. More research is needed to understand the full effects of heading on soccer players. In the meantime, the American Youth Soccer Organization has recommended that children under the age of 10 should not head the ball, and that coaches should take efforts to teach safe, proper heading techniques.[3]

References:


[1] “Soccer Brain Injury Raises Concerns Among Researchers.” Huffington Post. November 29,2011. Accessed December 1, 2011. http://www.huffingtonpost.com/2011/11/29/frequent-heading-tied-wit_n_1118610.html.

[2] Master, J.T., A.G. Kessels, B.D. Jordan, M.D. Lezak, and J. Troost. “Chronic traumatic brain injury in professional soccer players.” Neurology 51.3 (1999): 791-6.

Tysvaer AT, and E.A. Løchen. ” Soccer injuries to the brain. A neuropsychologic study of former soccer players.” American Journal of Sports Medicine 19.1 ( 1991): 56-60.

[3] Ouellete, John. “Is Heading Safe?”.

http://soccer.org/resources/safety/is_heading_safe.aspx.  Accessed December 1, 2011.

 

Fear of movement can worsen whiplash

Imagine what happens when you injure your neck. Your muscles contract, there’s a burst of pain, and a soreness that makes you want to avoid moving your neck too much or turning too far. You may worry about re-injuring yourself or you may think, “I could do more harm than good by moving my neck.” Unfortunately, this fear of movement often makes matters worse, especially for people with whiplash from a car accident.

A new study examined the effects of fear of movement on neck disability and range of motion in 98 patients with whiplash. While the patients’ injuries ranged in severity, all the patients had whiplash for under a month and all were injured in an auto collision. Researchers measured patients’ levels of fear using two different scales. They also examined neck range of motion and degree of neck disability. Patients were evaluated after one, three, and six months post-injury.

Often, patients who more afraid to move their neck had more severe neck disability and reduced range of motion. Increased fear also prolonged the symptoms of whiplash. In contrast, patients with reduced fear were more likely recover within 6 months.

Feeling more comfortable with moving an injured body part does more than just decrease anxiety. It also ensures that tissues don’t become more tense, restricted or damaged.   Chiropractors can help you learn to move your injured neck safely to avoid re-injury.Chiropratic works by restoring the natural movement of the ligaments and joints in your neck to allow your body heal more efficiently.

Pedler, Ashley and Michele Sterling. “Assessing Fear-Avoidance Beliefs in Patients With Whiplash-associated Disorders: A comparison of 2 measures.” Clinical Journal of Pain 27.6 (2011): 502-7.