Motor Vehicle Collisions and Misconceptions
Motor vehicle collision injuries can be life changing. Early in my life, my mother was rear-ended and sustained multiple injuries including a mild traumatic brain injury or mTBI. My life was forever changed and to some degree why I choose to be a Doctor of Chiropractic and specialize in Sports Medicine. Understanding the impact these injuries can have on the victim and the victim’s loved ones, I wanted to be well-equipped to handle this special patient population. My wife and I started treating victims of motor vehicle collision early in practice. We realized that there was a lack of understanding about these injuries, how to examine the patients (special tests that should be ordered), how to manage these cases and where to refer these patients for these injuries when needed. My wife and I became certified in whiplash injury biomechanics and traumatology, to better understand these injuries and the mechanisms of injury. We became certified in the most advanced soft tissue treatments and effective rehabilitation, to understand how to treat and then rehabilitate these injuries. Additionally, I became board certified as a Chiropractic Sports Physician and a Diplomate of the American Chiropractic Board of Sports Physicians, because many of the injuries that occur as a result of motor vehicle collisions are very similar to the injuries that occur in sport. We hope that you find this material to be helpful. Of course, this material is not intended to diagnose or treat any patient’s conditions or illness. If you have any additional questions, please feel free to contact our office.
Common misconceptions about motor vehicle collisions
There was little to no damage to the cars involved in the accident, thus, it is unlikely anyone suffered injuries.
This is often the stance that an insurance company claims reviewer uses so they are not responsible for paying medical bills. Unfortunately, this is not reality. I became certified in whiplash and traumatology shortly after finishing graduate school. I did this to better understand the forces involved in a motor vehicle collision and to better understand how to properly examine, treat and rehabilitate their victims. Having cared for many motor vehicle collision patients over the years, I can attest damage can be done to a human even when the car appears unscathed. This is made possible because most cars today are meant to be able to absorb and redistribute forces in low speed collisions. For instance, in a rear end collision, the target vehicle’s (car that was struck) bumper will bend when the bullet vehicle collides with it. However, that bumper was made to be able to “pop” back after the impact. This is often evident if the bumper cover is removed, and the inside of the bumper (the impact foam) is observed. Once the bumper cover is removed, you’ll have a better understanding of what happened. Additionally, humans are not built like cars. As a board-certified Chiropractic Sports Physician, I have a good understanding of what happens when humans collide with humans. That force is much less than a motor vehicle collision. Even at low end collisions the force transfer involved can be much greater than any football or rugby tackle.
Low speed collision with little to no damage to the vehicle does not equate to no damage to the driver and or passengers.
As stated in the previous paragraph, human damage is possible even at low end collisions. Studies have found that a person can sustain an injury in collision that occurred at 3-4 mph (Freeman MD, Centeno C, Croft AC, Nicodemus CN: Significant spinal injury resulting from low-level accelerations: a comparison with whiplash. International Congress on Whiplash-Associated Disorders, Berne, Switzerland, March 9-10, 1, 2001). Neither the speeds of the collision nor the monetary damage of the vehicles are good indicators of the potential injury. So than the question becomes, “Is there a good predictor for potential injuries induced by a motor vehicle collision?” Yes, there is. Risk factors. Risk factors consider specific human variables that have been shown to correlate with injury. I will go into more detail about risk factors later.
I felt fine after the motor vehicle collision thus, I wasn’t injured.
It is important to have a comprehensive exam (performed by a physician trained in musculoskeletal medicine who understands the nuance of MVC patients) following a motor vehicle collision. Soft tissue injuries can be somewhat funny in that they don’t all present the same between different patients. Additionally, because soft tissue injuries are often undetected by visual inspection it may be tricky to tell what or where the problem is truly coming from. Sometimes victims of MVCs have immediate pain and discomfort and seek medical care immediately. Other times victims of MVCs don’t feel pain immediately following the trauma. These injuries sometimes take a while before the victim recognizes them. Still other victims of MVCs have presented to our clinic thinking that their headaches, jaw pain, neck pain, low back pain etc. was the result of something else entirely. Often not making the connection between their trauma and the resulting injury/pain.
The sooner an injury can be detected the sooner the injury can be addressed. This helps to decrease the total time of your injury. This is a better option than “waiting and seeing what happens” both in the short-term and long-term. In the short term, it means less total time in pain and statistically less total money spent on healthcare needs. If left untreated, soft tissue injuries may not get better, or worse, they continue to deteriorate becoming worse injuries and possibly creating other injuries through compensation.
I went to the Emergency Department (ED) and I was released with muscle relaxers and some pain meds, so I should be fine right?
The ED personnel is an essential component of the healthcare team. They have special training and protocols in place to help us when there is an emergent medical problem. Unfortunately, the acute (and the chronic) soft tissue injuries often encountered as a result of an MVC are not emergent. Additionally, the injuries sustained in an MVC often times need conservative treatment and the proper rehabilitation exercises. These are not services offered in an ED.
My family doctor (general practitioner, GP), examined me and said I needed muscle relaxers and pain meds with rest.
Like the ED personnel, a GP is a vital component to our healthcare team. However, most GPs on average do not posses adequate training in the examinations and treatment of the type musculoskeletal conditions seen as a result of a MVC. This is why it is important to see a doctor trained in musculoskeletal medicine whom has additional training in the details of MVCs (biomechanical forces, crash physics, etc.).