When to Begin Physical Therapy for Whiplash



For many, it makes common sense to not move a recently injured neck. In this case, the common sense may be wrong. It’s better to let a physical therapist evaluate an injury and determine the right time to introduce motion. The answer is often, “right away.”

In one research study, Mark Rosenfeld, RPT and colleagues randomized 100 people with whiplash into three treatment groups.

Group 1: Old-fashioned care with medical advice, restricted activity, and help with self-guided stretching.

Group 2: Physical therapy within 96 hours of the injury.

Group 3: The same treatment as Group 1, but with physical therapy added two weeks after the injury.

Even after two years, only Group 2 (the group that received physical therapy right away), had a neck range of motion that was close to normal. Group 2 was also the fastest group to return to work, lessening the economic hardship on people.

When the body is healing an injury, functional motion, even passive motion, can help healing tissues lie down in functional patterns. However, the advice and treatment guidance of a physical therapist is the best bet for determining when to introduce movement and what types of movement to use.

 

Sources

Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders. Spine, 2000, 25 (14): 1782-87.

Rosenfeld M, Seferiadis A, Carlsson UJ, et al. Active intervention in patients with whiplash associated disorders improves long term prognosis. A randomised controlled clinical trial. Spine 2003, 28, 2491-2498.

Rosenfeld M, Seferiadis, Gunnarsson. Active involvement and intervention in patients exposed to whiplash trauma in automobile pressures reduces costs. A randomised controlled clinical trial and health economic evaluation. Spine 2006, 31, 1799-1804.

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