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That Little Fender Bender Is More Than You Think
By
Victoria L. Magown,
CMTPT, LMT and George S. Pellegrino, LMT, CMTPT
"I was only going five miles per hour, how could I be in so much
pain?" How often have you heard someone say this or something similar
following a fender bender? At MyoRehab, we frequently hear this from
quite a few of our patients who have been in a car accident they
thought was of little or no consequence.
Pauline was referred to MyoRehab by her chiropractor. Her car
was rear ended and pushed into the car in front of her. Both impacts
were at five to ten mph. Studies show that low speed impacts can
cause substantial injury to the neck. During impact the head is whipped
causing significant damage to the muscles and other soft tissue components.
Pauline was suffering with moderate to severe neck pain and headaches
as well as upper back and shoulder pain. Since a seatbelt only restrains
the driver's left shoulder, the right shoulder is allowed to whip
forward with the head. This causes the torso to twist facing left
while the head remains facing forward. The impact of the lap portion
of the seatbelt produces myofascial trigger points in the abdomen
and chest triggering pain and stiffness.
A myofascial trigger point is a hypersensitive spot in a muscle
that when stimulated, usually produces pain referred in a predictable
pattern away from the trigger point. These points also trigger contractions
in muscles called taut bands. Taut bands cause limited range of motion
at the joints.
Following a review of Pauline’s medical history, range of motion
testing was performed. Several muscles were found to be involved.
Among the primary muscles was the sternocleidomastoid (SCM) in the
front of the neck, the trapezius which attaches at the base of the
skull and the pectoralis major, a large muscle of the chest.
The SCM (Illustration A), often referred to as the whiplash muscle,
can produce more than just pain. It can cause dizziness, loss of
balance, drooping eyelid, ringing in the ear and visual disturbances.
The trapezius (Illustration B) is one of the most notorious producers
of headaches. When the head and right shoulder are whipped forward,
trigger points are develop in the trapezius causing headaches, upper
back and shoulder pain.
After a MVA, some people have experienced chest pain like a heart
attack and indeed the pectoralis major (Illustration C) can produce
such a pain. It can also trigger pain at the front of the shoulder
and down the arm and into the hand. Since this muscle is under
the breast, woman frequently experience breast tenderness on the
involved side.
The sharp compression by the lap portion of the seatbelt to the
abdomen can cause pain across the back (Illustration D) and other
phenomenon not usually associated with a MVA. These can include
constipation and diarrhea and disruption of the menstrual period
in women. Some people experience acid reflux, attributing this
to eating spicy food, when in fact, this can be another symptom of
a seatbelt injury to the abdominal muscles.
When we treated Pauline's SCM, trapezius, pectoralis major, and
other involved upper body and neck muscles, her pain significantly
decreased. Also, Pauline's menstrual cycle returned to normal
after treatment of the abdominal muscles. Her home exercise program
was tailored to keep the release obtained during treatment and retrain
the muscles to stay at their full resting length and pain free.
Together, Myofascial Trigger Point Therapy combined with chiropractic
care and Pauline's diligence to her home exercise program, created
an integrated therapeutic approach that produced excellent results.
Pauline found out that her “little fender bender” was more than
she thought it was. Are you are suffering with headaches, neck, shoulder
or upper back pain, abdominal distress, dizziness, loss of balance
or chest pain? Has it been one month, six months or even years after
your "little fender bender"?
Give us a call at MyoRehab.
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