Not all whiplash injuries result in a concussion injury, but all concussion injuries will have a component of a whiplash injury.
Your cervical spine, commonly known as your “neck,” is composed of key muscles, joints, and ligaments that all work together to play a pivotal role in providing your body with the stability and spatial awareness necessary for movement.
These important parts of your neck are filled with specialized nerve receptors that monitor how your muscles contract, stretch, and feel tension.
All this information is sent to your brain, helping it understand where you are and what you’re experiencing in your body.
After a concussion or whiplash injury, these intricate neck structures are typically disrupted, resulting in inhibited muscle function and increased tension.
This disruption can confuse signals sent to the brain, leading to various related concussion/ whiplash symptoms.
Common Symptoms (1)
Below we’ll provide strategies for effectively strengthening neck muscles following a concussion or whiplash injury.
Both whiplash and concussion injuries share a close connection in terms of occurrence and subsequent symptoms.
Commonly seen during car accidents, a whiplash injury occurs when the head and neck undergo a rapid acceleration followed by a rapid deceleration, causing muscular strains and ligament sprains. This can subsequently lead to reduced range of motion, increased neck stiffness, neck pain, and muscular weakness immediately following an injury.
Concussion injuries are similar to whiplash because the mechanism of injury is identical.
A concussion results from a rapid acceleration followed by a rapid deceleration of the head. This rapid brain movement within the skull results in the stretching of brain cells, initiating a “neurometabolic cascade.”
In this cascade, the initial stretching triggers an excitatory phase characterized by millions of nerve impulses, followed by a spreading depression resulting from an energy deficit (2).
The primary distinction between these two serious injuries lies in the force required for their occurrence. Whiplash injuries require around 4.5 g-forces. A concussion injury typically arises at forces ranging between 70-120 g-forces (3,4,5).
Therefore, not all whiplash injuries result in a concussion injury, but all concussion injuries will have a component of a whiplash injury.
The cervical spine is supported by over 20 muscles, spanning from the base of your skull to your last cervical vertebrae and extending to other areas such as your upper back, shoulders, and skull. These muscles constantly coordinate with each other to provide movement, stability, and proprioception.
When seeking to strengthen neck muscles post-concussion or whiplash injury, it’s crucial to recognize the importance of emphasizing stability and proper muscle activation through a functional and global approach.
While it may seem intuitive that increasing overall neck strength is the solution to rehabilitating your neck after whiplash or a head injury, pure strength alone isn’t necessarily linked to improved outcomes or symptom relief. Focusing on building strength and muscle size doesn’t necessarily translate to better recovery.
However, there are benefits to increasing stability and improving proper muscle activation. Enhancing our capacity to stabilize and activate neck muscles correctly not only contributes to functional neck strength but also aids in reducing chronic tension and pain. Motor control and coordination play crucial roles in this process.
Your neck muscles are constantly engaged in a delicate balance, with the posterior muscles (including the upper trapezius and levator scapula) on one side and the anterior muscles (such as the deep neck flexors) on the other, striving to maintain coordination and posture.
Muscular inhibitions and imbalances may occur after a head or neck injury (6,7). By activating and strengthening our deep neck flexors, we can significantly enhance neck strength while ensuring proper stabilization. This has the added advantage of alleviating physical symptoms, muscular tension, and pain, thereby promoting overall better function aligned with our bodies’ natural design for movement.
One available and effective method for training deep neck flexor strength and ensuring proper activation is through a rehabilitation technique known as Dynamic Neuromuscular Stabilization (DNS). DNS positions are effective because they place our bodies in the perfect position to train the small stabilizing muscles without using compensation through larger, more commonly used muscles.
The following exercise will help train the deep stabilizing muscles often weakened after a whiplash neck injury.
Additionally, this exercise is safe and accessible for most individuals, even those following acute whiplash or concussion neck injuries, as it doesn’t require weights or machines; rather, it relies on isometric contractions.
Below we will bring you through the steps needed to perform the exercise correctly. You can follow along step by step; let’s get started.
Dr. Denner has extensive training and clinical experience in Dynamic Neuromuscular Stabilization. A rehabilitation technique that was founded and taught through the Prague School of Rehabilitation. Dr. Denner uses his clinical expertise in functional rehabilitation through a DNS approach to effectively treat and rehabilitate post-concussion syndrome, whiplash injuries, and other musculoskeletal conditions at his private practice, Denner Chiropractic & Performance, located in Charlotte, NC.
Begin by finding a safe space on the ground where you can lie on your stomach comfortably.
Once you’re lying on your stomach, assume the correct position by placing your arms above your head, with your forehead gently resting on the ground. Ensure that the crease of your elbows is slightly above your ears, and align your wrists with your shoulder joints.
In this position, focus on having your base of support “contact with the ground” on the inside of your elbows and your lower stomach.
Now, perform a slight chin tuck to maintain a neutral spine, allowing you to activate your deep neck flexor muscles. Lastly, you will raise your chest to the ceiling as you maintain the above positioning and support points.
Initially, this exercise may seem challenging, so it’s crucial to allow your body to gradually adapt to prevent soreness and excessive fatigue. Beginning with 3 sets of 20-second holds, with rest periods involving placing the head on the floor, can be an excellent starting point for effectively training neck strength post-concussion or whiplash injury.
As you become more proficient and stronger in this position, you can gradually increase the duration of time with your head up in the full position.
Another effective exercise for building deep neck flexor endurance and strength is commonly known as the ‘chin tuck lift.’
As the name suggests, this exercise involves performing a chin tuck to achieve a neutral spine through activation of the deep neck flexors. Then, the head is lifted off the ground to increase the demand and force on the muscles for enhanced strength and control.
Begin by lying on your back with your legs and feet propped up on a chair or couch so they are relaxed and supported.
Next, perform a slight chin tuck to ensure your neck is neutral, activating your deep neck flexor muscles. Visualize the posterior side of your neck becoming flat.
Maintain this neck position as you attempt to lift your head approximately 6 inches off the ground.
You can start to hold this lifted position for 10-second increments and gradually increase time as you build strength and control. An excellent starting point would be 3-4 sets of 10-second holds, twice daily.
Pure muscular neck strength isn’t always the key to neck pain recovery. Given the design of our necks, the muscles primarily function for stability, range of motion, and proprioception. Whiplash and mild traumatic brain injury rehab should focus on balanced muscle activation and endurance rather than simply training muscles for higher force output.
Heavy weights or extensive rehabilitation programs aren’t necessarily required to build strength; rather, a focused amount of appropriate activation and training in the correct pattern can greatly contribute to building functional stability and control, ultimately restoring the neck to its intended function and movement.
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