Physical Therapy for Whiplash: How Physical Therapy Can Help, Exercises, and More

The neck pain after an accident can be persistent and debilitating. Your shoulders are sore, your neck hurts, and relief can seem out of reach.  

Physical therapy for whiplash can help heal and strengthen your neck and shoulders. 

Here we will talk about what physical therapy for whiplash looks like and how it can help get you on the road to recovery.

• What Is Whiplash?
• What Causes Whiplash?
• Symptoms of Whiplash
• Physical Therapy for Whiplash: How Can it Help?
• Acute Injury: Whiplash Physical Therapy
• Chronic Injury: Whiplash Physical Therapy
• Physical Therapy After Surgery For Whiplash Symptoms
• What Does Physical Therapy After Whiplash Look Like?
• What Are Whiplash Physical Therapy Protocols?
• 3 Common PT Exercises for Whiplash
• How Long Is Physical Therapy for Whiplash?
• Can Whiplash Therapy Prevent Re-Injury?
• The Licensed Physical Therapists at PRO~PT Are Here for Your Physical Therapy Needs After Whiplash

Whiplash-associated disorders (WAD) describe injuries that result from your head and neck jolting violently forward and backward. 

Synonymous with being rear-ended, or other non-catastrophic vehicle accidents, the term whiplash actually describes how the injury happened, not how it presents in the body. 

Whiplash varies in severity, and most WAD are soft-tissue-based injuries. 

Depending on the severity of your whiplash, it can take months to fully recover your previous range of motion in your neck and back.

The most common cause of WAD is car accidents. 

When you are first struck, your head experiences hyperextension. This is when your cervical vertebrae are flexed beyond their normal range of motion, causing the spine to form an S shape. 

When your head stops moving, it falls forward in hyperflexion. This is a muscle moving beyond its normal limit. 

During this movement, within the fluid-filled protective cover, the brain is moved forcefully toward the front and back of the skull.  

Some symptoms of whiplash include:

• Neck pain and stiffness
• Headache
• Dizziness
• Blurred vision
• Fatigue
• Backaches or pain; and 
• Numbness or tingling in the shoulders or arms

WAD also comes with several psychological symptoms, including:

• Somatization
• Depression; and 
• Obsessive-compulsive behaviors

In acute whiplash, symptoms usually last between two and three months. Those that have neck pain before the accident are more likely to have acute neck pain after the accident.

Acute whiplash can also be caused by:

• Bike accidents
• Contact sports
• Blows to the head
• Amusement park rides; and
• Physical abuse

Physical therapy for acute whiplash includes both active and passive treatments. Keep reading below to learn about the different kinds of treatments that aid in recovery.

Chronic pain is defined in a couple of different ways. 

Some describe chronic pain as something that lasts for a certain amount of time. For example, pain that lasts 12 weeks or longer can be considered chronic. 

Chronic pain can also be described as pain that is no longer related to inflammation. It’s now caused by an injury that has not healed correctly.

Most patients with whiplash recover within three months, but for some, it takes longer. These patients are considered to have chronic whiplash. 

If your body is not responding well to conventional treatments such as painkillers and physical therapy, researchers have found that radiofrequency neurotomy is an effective treatment option for chronic whiplash.

Whiplash rarely requires surgery, but it can be appropriate if you have persistent and chronic pain in your neck or shoulders. The type of surgery depends on what part of your cervical spine has been injured.

Some conditions associated with WAD that may require surgery include:

• Ruptured disc
• Herniated disc; or
• Spinal stenosis

After surgery, your doctor will probably recommend that you restrict your movement. You’ll receive instructions about how to sit, rise, and stand. 

Returning to baseline movement is an achievable goal. Recovery isn’t instant, but it’s possible with care and by following the instructions of your doctor and your physical therapist.

To treat WAD, a physical therapist may use active treatments or passive treatments.

Passive treatments include things such as:

1. Deep tissue massage 

This can help release tension in the soft tissues of your neck and shoulders and may help your body heal faster. And it may feel good to release that tension, which is a bonus. 

2. Cold and hot therapies 

Using heat increases the blood flow and oxygen to the injured area. This blood flow removes waste byproducts created by muscle spasms. Cold therapy slows the circulation in the area, which helps reduce:

• Inflammation
• Pain; and 
• Muscle spasms 

3. Ultrasound 

Ultrasound sends sound waves into the affected area, which creates light heat. This promotes healing and enhances circulation. This increased blood circulation helps reduce:

• Muscle spasms
• Cramping
• Stiffness; and 
• Pain

Keep reading to learn about more active exercises your physical therapist may include in your individualized treatment plan. 

Before treatment, your doctor and physical therapist might want to know some history about you and the injury. For example, they may want to talk about:

• Prior history of neck problems, including previous whiplash injuries 
• History of long-term problems, like an injury or an illness
• Current psychosocial problems, such as family, job-related, or financial stress
• Your current symptoms and where and when they occur
• How you received the injury, such as a vehicle accident or playing sports

Begin to think about and record these things before your first physical therapy appointment. This can help tailor your treatment.

The first thing your doctor will do is a physical exam. They may:

• Conduct orthopedic tests which help measure pain in the affected areas. 
• Complete a neurological screen that tests you for sensation, responsiveness, and power.
• Do imaging, such as an X-ray, CT scan, or an MRI.

Your physical therapist will use this information to design your treatment plan based on your specific needs.

When you have whiplash, exercises need to be taught and supervised, at least at first, by a physical therapist. 

Below are 3 possible active treatments used to treat WAD. 

It’s important not to attempt any PT exercises without consulting with a physical therapist and developing an individualized treatment plan.

Your physical therapist will make sure you are using the correct form for the needs of your body.

The serratus anterior muscle stretches from the shoulder blade and wraps upward and forward to the rib cage. It is a stabilizing muscle of the shoulder.

For those who have whiplash, the timing of this muscle is often compromised. This means that reaching and moving your arm is more difficult. Also, those who have whiplash injuries are more likely to have a shoulder injury.

The serratus wall slide is a light strengthening exercise. This is a good re-training exercise for the serratus anterior muscle.

Here’s how to do a serratus wall slide:

1. Facing a wall, place a resistance band around your back, over your shoulder blades, and under your armpits. 
2. Hold the resistance band in each fist with your forearms resting on the wall and your elbows at a 90-degree angle. Make sure your head and neck are neutral, and your hips are over your heels.
3. Slide your arms up the wall in the shape of a V.
4. Be sure to add a slight outward rotation in your arms, which wraps your shoulder blades around your body. 
5. Bring your arms back down, so your elbows are level with your shoulders.

Be sure to not go beyond your body’s limits. This exercise should be done without pain, so if you reach your limit, pull back.

The chin tuck helps retrain important muscles that are deep in the neck. After a car accident, the longus colli and longus capitis muscles in the neck often have decreased activity.

Here’s how to do a chin tuck:

1. You’ll need a tightly rolled towel that is thick enough to fill the space between your neck and the floor. 
2. Lay down on your back and place the towel underneath the curve of your neck. Your knees can be bent or straight, depending on whatever’s most comfortable for you.
3. Place your hand over your neck with an open palm. The bottom edge of your hand will rest on your collarbone, and your fingertips will rest on the scalene muscles in your neck. Your goal is to limit the activity of these muscles. 
4. Lengthen the base of your skull away from your shoulder blades. Your chin should slightly rotate down towards your chest until you feel your scalene muscles activate. 
5. Back off from the movement slightly to relax the scalene muscles. Maintain the length in the back of your neck. Breathe into the back of the rib cage, exhaling fully. Your scalene muscles will remain relaxed and inactivated. 
6. Rest after three breaths, then repeat the exercise.

This is an exercise to reduce muscle tightness where the shoulder and the neck meet. The levator scapulae muscles are often tight after whiplash.

Here’s how to do a levator release with a ball:

1. Find a tennis ball-sized ball.
2. Lie on your back.
3. Put your hand on the bony point of the shoulder and walk your hand back along that bony line until you reach the muscle. That’s where you’ll place the ball. You’ll want to place the ball on a sore spot.
4. Raise your arm towards the ceiling and nod your chin towards your chest slightly.
5. Drop your arm back to stretch over the ball.
6. When you feel a limitation in the shoulder motion, turn your elbow in and hold for about 5 seconds.

Physical therapy for whiplash varies by patient. It’s individualized due to: 

• The severity of the injury
• Patient goals; and 
• Previous injuries

Previous injuries may affect your healing process. For example, you might have scar tissue from a previous injury which affects how you heal.

When working with a physical therapist, the goals for treatment involve treating the immediate injury and preventing future injuries. 

Throughout PT, your physical therapist will help you gain strength and increased flexibility. 

Exercises designed to treat WAD help you heal. They also help train your body to support itself, helping to prevent injuries in the future. 

Let the licensed physical therapists at PRO~PT show you how easy it can be to begin the healing process. 

When you come in for your first visit, we’ll:

• Perform a complete evaluation of your range of motion 

• Review any imaging you may have; and 
• Create an individualized treatment plan

Our team is dedicated to providing innovative and comprehensive care to our patients, to help them return to their highest quality of life.

If you’re suffering from whiplash, contact PRO~PT today to make an appointment.