March is the highest snowfall month of the year in Calgary. We now have the worst conditions for slips, falls and motor vehicle collisions due to the snow on top of underlying ice. As Therapists, we are always striving for ways to prevent injuries. The one injury you want to avoid in the winter in Calgary is motor vehicle collision (MVC). With the icy and snowy road conditions in the winter, your vehicle will not respond as well as it does in the summer with dry, clean roads. Be a cautious driver throughout the year, but especially when the snow is flying in the winter months. Motor vehicle collisions do happen, so be prepared by leaving earlier for work so you can drive slower if needed, and leave enough braking distance to allow your vehicle to stop before you rear end the vehicle in front of you. I know when I first starting driving a truck a wise man told me that yes you have better traction with a four wheel drive vehicle, but you will not slow down any faster than other smaller vehicles do. I have been in four MVCs over the years and it is not an experience I want to repeat. The good news is that if you have been in an accident, the majority of clients we see make a full recovery of their function once they have completed our comprehensive whiplash rehabilitation program.
If you have been in a recent MVC make sure to:
a) collect vehicle information from the other person involved, specific their name, phone #, VIN # on the dash of vehicle, and license plate #. If you have a phone take pictures of these, so you do not lose this information. I would also take a picture of the vehicle damage as well. Then it is easy to email the pictures to your insurance adjuster.
b) report the collision at your local police station
c) call your insurance company to let them know you have been in an MVC.
d) You should start your recovery with your Nose Creek Physiotherapist within 10 days of the MVC.
You are likely experiencing pain, discomfort, stiffness and a headaches depending on the severity of your collision. You want to apply a soft ice pack to your neck the day of the collision when you get home, and for the next 3 to 4 days. The ice will make your neck feel stiff and will temporarily numb it a little, but that is good as you do not want to be doing a lot of movement with your neck in the first week. Once the pain starts to resolve in the second week, you can start to apply heat to help relax those tight, stiff muscles in your neck and provide pain relief. In your first assessment and treatment session with us you will be given some gentle range of motion (ROM) exercises to do within your pain free limitations. It is very important to work within your pain free intensity and ROM during your recovery over the next 3 months. As you attend consecutive treatments in your treatment plan, your Nose Creek Physiotherapist will prescribe pathology specific exercises to assist in your recovery. We want to restore both your static and dynamic strength and endurance into your spinal muscles. We will be testing your endurance during your recovery to make sure we get you back to the normal endurance in these key muscle groups. Participation is the key to your success. We cannot do your exercises for you.
Rehabilitation exercises are the key to getting your normal function and endurance back in your neck and upper back.
We will often start clients on simple chin tucks to begin strengthening their deep neck flexor muscles.Once the chin tucks are pain free and comfortable, then we will progress to the chin tuck and head lift (CTHL) exercise. We usually start these about 4 weeks post injury. This is a loading exercise, so it will test your muscles and joints for sure, again do not work through your pain, only work up to your pain experience. Once the CTHL is comfortable, we will start on dynamic resisted neck motions with elastic resistance on our neck strap system. We recommend to only work through 45 degrees rotation each way until this is comfortable, then slowly increase the ROM. Eventually, you will be doing full ROM within 4 to 6 weeks. Resisted neck forward bend is also progressed slowly and we stay within our pain free ROM. All of these exercises can be found under neck injury on our website. It is also very important to work on the endurance of your Shoulder blade muscles with Scaption exercises. These are the main exercises that we like to prescribe at Nose Creek Physiotherapy for our MVC clients. These Scaption exercises can be found under Lumbar Disc on our website, under Level 2.
Stretches are important after you exercise to re-establish normal muscle length. The two main muscle groups that we like stretching in the neck are upper trapezius and levator scapulae. For the trunk we like to prescribe stretches for the Pectoralis (chest) and Latissimus (back/shoulder) muscles to assist in restoring normal upright posture. If you recall from a previous blog called This is really a pain in the neck!, Paul talked about the amount of pressure that you place on your neck in different postures. Your head weighs an average of 12 lbs in an upright posture. For every inch your head goes forward, you add an additional 12 lbs to your neck, so if you slump forward 4 inches your weight on your neck is now 48 lbs. If you do not want to wear your neck out before its normal time, straighten up! Your Nose Creek Physiotherapist will teach you how to lengthen these muscles that are tight and strengthen the muscles that are weak to support you in more of an upright posture for optimal function.
Timelines for recovery vary depending on the severity of the injury and the age of the client. We try to get most of our clients through their recovery within 3 months, some will take a little longer, but the majority are finished within 5 months. If there has been a fracture or a major nerve root injury and resulting weakness in muscles attached to that nerve this will likely require a longer recovery. We strive to get all clients back to normal, pain free function for returning to work and play. We want our clients to return to play so they can stay active and healthy for the rest of their lives.
If you have been in a collision, give us a call today at our Thorncliffe clinic at 403.275.7728 or our Beddington clinic at 403.295.8590. You can also visit our website http://www.nosecreekphysiotherapy.com and we can help with your recovery.
Submitted by: Blair Schachterle
On behalf of your Nose Creek Physiotherapy team.