Crash Course: Physical Therapy after a Motor Vehicle Accident
Statistically speaking, every person traveling in a motorized vehicle will be in an accident at one point in their lifetime. On average, there are more than 6 million car accidents on the roads annually (1). According to the 2015 census, there are approximately 2.4 million people in the Portland region (2). That is a lot of impending injury! Post-accident care for non-fatal crash injuries can range from a same day ER visit to a primary care physician visit a week later with medications, Xrays or MRIs frequently prescribed. This initial medical care to rule out red flags is important especially considering advanced age, high speed collision, paresthesias or numbness/tingling, and if mobility is extensively limited. Though, this is often the end point of treatment for most individuals and they are left to guide their own care. Typically, massage and chiropractic treatment is the duo of care accessed, yet more and more people are realizing that there is something missing in their recovery and that is the restoration and rehabilitation of functional strength that was lost after the accident. Without functional strength retraining under the guidance and expertise of a physical therapist, healing can be severely delayed and result in, among other issues, loss of job attendance and revenue. In 2010, motor vehicle crashes in the United States equated to almost $1 trillion in productivity loss (3). Yet, a lot of physicians do not prescribe physical therapy, especially for the “minor injuries” with little to no pain at all.
You might be surprised to have just read that I suggested physical therapy for “no pain at all” after a motor vehicle accident. Pain is a peculiar thing. Initial pain from an injury can be present or not depending on inflammatory processes ignited, pain processing per individual, and sometimes severity of injury. I am eluding to the idea that the absence of pain does not equate to non-injury. There is research that demonstrates decline in muscle activity post MVA resulting in diminished muscle bulk over time and this almost always leads to significant dysfunction and pain down the road with additional loss of productivity at work, participation in recreational activities, and altered daily lifestyle. In the neck, for example, post MVA MRI assessments of injury to the cervical spine in relatively “injury-free” individuals revealed swelling in the major deep cervical flexor muscle (4). Swelling within a muscle renders it dysfunctional and muscles so close to the spine have basically ZERO leverage to be able to just “come back on their own” with daily movement and typical exercise approach. The longus colli muscle is responsible for supporting the neck the way the abdominal core supports the trunk. It provides crucial stability for the cervical spine to disallow shearing forces with the day to day insults, let alone more aggressive endeavors in recreation like running, soccer, crossfit, and yoga, to name a few.
Without proper rehabilitation of these deep neck flexors and core musculature, they will remain inhibited and atrophy as a result. Say goodbye to these deep, small, essential muscles and prepare to welcome the beast that is pain. Or…. seek the care that you need. An orthopedic physical therapist is trained to screen for red flags that would prevent one from being able to participate in a rehab program at that current time and help get you the right care. They will examine the pathoanatomical causes of symptoms and are uniquely trained to tease out the impairments and dysfunctions from the crypt! The sooner one seeks treatment, the less underlying dysfunctions that set in and cultivate. This equates to less down time from life, less $USD spent on playing catch up in care, and happier, pain-free people in the long run. If you have or know someone who has had a motor vehicle accident, we at Therapydia would be happy to help with an assessment and treatment as needed. Give us a call or email us to get started.
- Deepak Takhtani, Eduardo Scortegagna, Oguz Cataltepe and Sathish Dundamadappa. MRI Findings of Injury to the Longus Colli Muscle in Patients With Neck Trauma. Neuroradiology/Head and Neck Imaging, August 2016, Volume 207, Number 2.