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.