Jackson Hole


Now that the snow is starting to fall, soon the roads will become a bit more dangerous. There’s nothing like the helpless feeling of sliding towards the car in front of you as your anti-lock brakes shutter and try to gain a grip on the ice beneath you. Whiplash is the most common injury following a car accident and can occur even at very low speeds. Here are some interesting statistics about whiplash that may surprise you.

Whiplash Statistics

  • Most injuries occur when traveling less than 12 mph
  • A read-end collision generally causes more damage to the cervical spine than side or frontal collisions do
  • Whiplash injuries are more severe in women and children because their necks are smaller
  • Whiplash injuries occur 5 times more often in women than men
  • Symptoms of whiplash can often appear weeks or months after an accident
  • In 75% of patients, symptoms of whiplash can last 6 months or longer
  • Victims of whiplash lose approximately 8 weeks of work
  • Whiplash injuries occur more often in people 30 to 50 years of age
  • A whiplash injury can increase your chances of chronic shoulder and neck pain
  • People suffering from chronic pain due to whiplash injuries often have abnormal psychological profiles
  • More than 60% of people who have whiplash injuries require long-term medical follow-up
  • More than 50% of those who have whiplash injuries will still have chronic pain 20 years after the injury
  • Pre-existing health conditions such as arthritis will lead to greater severity of injury and greater pain

Signs of a Whiplash Injury

After an accident, you are likely to feel some pain and limited ranges of motion. Even if the pain is minimal, it could worsen hours after the crash. Some signs of whiplash can include:

  • Pain when moving your head side to side
  • Tenderness
  • Headaches at the base of the skull
  • Fatigue
  • Dizziness
  • Difficulty sleeping
  • Memory problems
  • Tingling or numbness in the arms

Signs and symptoms of whiplash usually develop within 24 hours of the accident, which is why it is crucial to seek medical treatment immediately. If you’ve had an accident please let a professional make sure you are ok. You don’t want to be one of the 50% who has chronic pain 20 years after the injury.

Breathing and Low Back Pain

So often I have patients come in with neck pain, headaches, or lower back pain who exhibit something I call “paradoxical breathing”. Paradoxical breathing is characterized by inward motion of the abdomen with expansion of the chest and rib cage. This type of breathing utilizes “accessory muscles of respiration”, including intercostal muscles (those in between the ribs) and muscle of the neck, while excluding the diaphragm. There is a significant correlation between low back pain and dysfunctional breathing patterns.

The reasoning for this is that the diaphragm plays an important role in trunk stability and postural control. When someone exhibits paradoxical breathing, the diaphragm doesn’t descend (contract) like it should and instead rib expansion and lifting is used for inspiration. By constantly using accessory muscles for inspiration, those muscles start to have increased resting tone which can be perceived as neck pain and tension. In contrast, the diaphragm becomes weak and inactive.

There is a significant “co-contraction” between the diaphragm, the transversus abdominus, the lumbar multifidi, and the muscles of the pelvic floor which stabilizes the spine during movement (1). It has also been found that this co-contraction significantly reduces stresses on the spine by as much as 50% (50% in the upper lumbar spine and 30% in the lower lumbar spine) and reduces the loads experienced by the muscles of the low back by as much as 50% (2). When one of these muscles is injured or weak the co-contraction fails to reduce stress to the lumbar spine and musculature and can lead to injury and pain.

The good news is that the diaphragm can be trained and by practice and training the function can be restored and trunk stability increased. Breathing mechanics should always be assessed when treating patients with lower back pain and included with a specific core stability treatment plan when appropriate.

1. Nele Beeckmans et al., “The presence of respiratory disorders in individuals with low back pain: A systematic review”, Manual Therapy, 2016, Vol 26, page 77–86.

2. The Effects of Deep Abdominal Muscle Strengthening Exercises on Respiratory Function and Lumbar Stability. Eunyoung Kim, PhD, PT1 and Hanyong Lee, PhD2