7 Common Aggravating Factors for Car Accident Whiplash

7 Common Aggravating Factors for Car Accident Whiplash

A look at 7 out of dozens of aggravating factors that can worsen a whiplash type injury after a motor vehicle collision. Some are counter-intuitive and may surprise you. In addition, precautions and countermeasures to prevent worse injury are also included where possible. References have been cited to aid in further study.

Who Can Benefit from Reading This Article?

1. Victims of car crashes that want to learn more about their injuries or have questions left unanswered by their medical providers.
2. Personal injury attorneys looking for more understanding of the medical facts behind whiplash injuries to better understand their cases.
3. Consumers who would like to learn how to minimize their risk for injury in auto accidents.

Car Accident Whiplash Injuries Overview

Injuries caused by motor vehicle collisions are unique. Prior to the victim becoming aware of the impact, the neck is subjected to the forces of compression, tension, shearing and rotation in a rapid sequence that is almost instantaneous. The cervical spine is forced into an “S”-shaped configuration causing damage to the facet joints, discs and nerve roots. This often occurs without the neck ever entering into full flexion or extension. No other incident has been found to produce such injury and damage with seemingly minimal force.(1)

Independent researchers, using live human test subjects, have found that the “S” configuration and joint injury occurs at approximately 70 milliseconds after impact and can be reproduced in collisions with a change in velocity of only 2.5 mph. (2)

Chapline et al found the vast majority of neck injuries from motor vehicle collisions occur when there is little to no vehicle property damage present. (3)

The above scenario is for the classic rear-impact collision with the occupant perfectly positioned in a controlled environment. However, in reality, there are many variables or aggravating factors involved in a motor vehicle collision that subject the victim to increased risk of injury.

7 Aggravating Factors for Car Crash Injury and How You Can Minimize Them

Several factors have been identified in the medical and scientific literature to worsen the injuries sustained and therefore worsen the long-term prognosis of MVC victims. The following list are only some factors and not an exhaustive list. It’s important to remember that each collision and each victim is entirely unique. The forces imparted into a collision and the injuries sustained is dependent on a multitude of variables. So, being aware of key factors in play at the time of the collision can help explain why some people are hurt and others are not in seemingly similar crashes.

1. Surprised, Unaware of Collision

According to Teasell, injury is greater “when the impact is unexpected and the victim is unable to brace.” (4) Sitting relaxed in a vehicle your spine is in a vulnerable state. A sudden acceleration will cause a jerk motion that the spine cannot guard against. Therefore, it is not the overall magnitude of the crash, but rather the quickness of the jolt the body experiences that causes damage.

How to guard against this: Be vigilant. Watch your mirrors and surroundings. If it looks like you are about to be hit, press on the brake pedal hard and push your self back into your seat with your arms locked pressing the steering wheel. In this position you become one with the vehicle and are less likely to flail around in the cabin.

2. Head Turned, Angled Impact

Havsy states “Injuries are greater when non-symmetrical loads are applied to the spine.” (5) Having your head in a position away from looking straight ahead causes much greater risk. Simply, looking straight ahead in a rear-impact collision, both sides of your neck is protected. Muscles and ligaments on each side are protecting you. However, once your head is turned, you give away some stability of your supporting muscles and ligaments and the asymmetrical loading is more likely to cause injury to one side versus the other.

Guarding against this means as much as possible keep looking straight ahead. For example, talk to your occupants without looking at them. Look straight ahead particularly at red lights or stopped in traffic when most rear collisions occur. If you need to turn and look, do so briefly and return to neutral position.

Similarly, if you are struck at an angle by another vehicle the forces will be asymmetrical and cause more injury to one side of your body versus the other.

3. Female Occupant

Females and males have differing outcomes in motor vehicle collisions. By virtue of smaller neck diameter, less neck muscle mass, thinner facet joint cartilage and smaller facet joint gaps, the female anatomy is more likely to suffer facet joint injuries compared to male counterparts. (6) Also, vasculature and nerve distribution in the neck, shoulder and upper back areas among females differs as well causing women to suffer more symptoms like nausea, arm and hand numbness, dizziness and more.

While you cannot change your anatomy, you can read on to learn the other risk factors and minimize them.

4. Pre-existing Degeneration

Auto insurance adjusters and attorneys oft cite pre-existing arthritis as a negative against the victim claiming injury. Specifically, remarks such as “… they already had arthritis and so had prior neck pain and the pain is due to arthritis not the collision” are routine. What they fail to understand is in reality scientific studies show it is the reverse. Toe be sure, a great deal of people are walking around with osteoarthritis and degenerative disc disease in their necks and are totally unaware of it. In fact, they may have no more greater incidence of neck pain than someone without degeneration. But once an arthritic neck is subjected to abnormal forces it will fail more easily than a non-degenerative neck.

Calliet reports that “the pre-existence of degeneration may have been quiescent in that no symptoms were noted, but now minor trauma may “decompensate” the safety margin and symptoms occur.” Many other notable authors have found similar findings citing increased injury, prolonged treatment and worse prognosis. (7)(8)(9)

5. Head Restraint Position

Studies have concluded that head restraint offset (the distance between the back of the head and the head restraint) of 4 inches or more predisposes the occupant to whiplash injuries. Similarly, head restraint top set (the distance the head is above the top of the head restraint) predisposes the spine to more trauma.(10)

Fortunately, head restraint design has gone from simply an aesthetic device to a functional part of the seat. Unfortunately, most head restraints lack the adjustability required to make it a device that prevents whiplash. Saab and Volvo’s approach to seat and head restraint design could minimize most whiplash injuries, but other manufacturers resist the technology due to profit margins. Therefore, most head restraints do more harm than good.

For the head restraint to work properly, you must be seated in a slightly reclined position with the head restraint tilted towards your head and within a couple of inches if not touching. Additionally, the height must be adjusted so the top of the restraint is above the top of your head. This is because when you are struck from behind your entire spine telescopes upwards and the top of your head elevates inches. So, if the restraint is too low, your head overshoots it and acts as a fulcrum on your neck creating worse injury.

6. Little to No Vehicle Damage

Numerous studies have shown that crashes that have little vehicle damage are the collisions most likely to cause long term injuries and impairment. One of the more shocking studies was by Hijioka and Narusawa in Japan. (11) They studied medical records of victims of vehicle crashes with no damage, mild damage, moderate damage and total vehicle destruction. Surprisingly, they found the group with the highest incidence of injury and prolonged symptoms and treatment were the victims of crashes with no visible vehicle damage.

Obviously, this flies in the face of the automobile insurance industry who’s main defense has always been “no crash, no cash.” Again, it is counter intuitive, but other studies have also shown this. However, the physics behind it is straight forward. For example, in a heavy vehicle crash scenario, the two vehicle’s bumpers crumple bleeding off kinetic energy so the left over energy that reaches the occupant is dampened. However, in a crash with no vehicle crumpling, much less energy is dissipated leaving more potential energy to be experienced by the occupant.

7. Head Trauma

Head injuries are commonly not diagnosed after accidents even if patients report frank head trauma during hospital visits. Injuries to the head have been linked to chronic headache, dizziness, hearing loss, visual symptoms, impaired smell and taste sensations, and cognitive dysfunction and sleep disturbances. Varying combinations of these symptoms have been named “Post-Concussion Syndrome” or “PCS”. (12)(13)

Head trauma can occur without direct contact with the head. Specifically, the sudden jolt of the head can cause deformation of the brain and brain stem in the skull and upper spine much like “shaken baby syndrome.”

Other common sources of head trauma include the head slapping the head restraint in rear-impact collisions, the side window or frame in side impacts and an airbag or steering wheel in front impact collisions. Clearly, having a properly adjusted head restraint can prevent or minimize the most common cause of head trauma.

These are 7 common factors that aggravate car accident whiplash injuries. It is of vital importance to take whatever precautions you can to minimize your risk for injury.

If You Have Been Injured in a Vehicle Accident and Need Help, Contact Dr. Marks Immediately.

There is no up front cost for treatment in most cases

Learn More About Dr. Marks Here

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References:

1. Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.”

2. Spine 24(8): 763-770. Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.

3. Chapline JF, Ferguson SA, Lillis RP, Lund AK, Williams AF. Neck pain and head restraint position relative to the driver’s head in rear-end collisions. Accident Analysis and Prevention 32:287-297, 2000.

4. Teasell in Spine: State of the Art Reviews: Cervical Flexion-Extension/Whiplash Injuries, Hanley & Belfus, September 1993, p. 360.

5. Havsy, in the Amer. Journal of Pain Management, Whiplash Injuries of the Cervical Spine and their Clinical Sequelae, January 1994, p. 30.

6. Foreman, D. and Croft, A., Whiplash: The Cervical Acceleration/Deceleration Syndrome, 1989, Williams & Wilkins

7. Webb, Whiplash: Mechanisms and Patterns of Tissue Injury, Journal of the Australian Chiropractor’s Association, June 1985

8. Mairmaris, Whiplash injuries of the neck: a retrospective study, Injury: the British Journal of Accident Surgery, 1988

9. Foreman, D. and Croft, A., Whiplash: The Cervical Acceleration/Deceleration Syndrome, 1989, Williams & Wilkins

10. John R Brault, MS, Jeffrey B Wheeler, MS, Gunter P Siegmund, BASc, Elaine J Brault, MS, PT Clinical Response of Human Subjects to Rear-End Automobile Collisions. Arch Phys Med Rehabil Vol 79, January 1998

11. Hijioka A, Narusawa K; Risk Factors for long-term treatment of whiplash injury in Japan: analysis of 400 cases. Arch Orthop Surg 121:490-493, 2001

12. Moss NEG, Wade DT. Admission after head injury: how many occur and how many are recorded? Injury 1996;27(3):159-161.

13. Parker RS, Rosenblum A. IQ loss and emotional dysfunctions after mild head injury incurred in a motor vehicle accident. Journal of Clinical Psychology 1996;52(1):32-43.