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Now that I am out of a neck brace, it is very difficult to turn my head -- what can I do?

Q: About six weeks ago, I had a car crash that put me in a neck brace for a month. Now that I'm out it's very difficult to turn my head. I certainly can't turn quickly and that's a major problem driving. What can I do about this?

A: Anyone who has had an accident resulting in a whiplash injury knows the neck pain, stiffness, and loss of motion that can develop afterwards. Many people recover in a few days to a few weeks. But just as many develop chronic symptoms referred to as whiplash-associated disorder (WAD). Exercise may be a useful tool in getting past these symptoms and even preventing the transition from an acute problem to a chronic one.

A physiotherapist may be able to help you. Therapists understand the impairments in movement and problems with neuromuscular control that can occur with neck injuries. Helping you regain motion, motor control, coordination, and muscle endurance are important goals.

A rehab approach may help prevent the development of a chronic whiplash-associated disorder. A second goal of rehab would be to reduce the number of repeat episodes of neck pain following your whiplash injury.

It can be a challenge to change the way muscles contract and relax when pain is the main feature preventing normal patterns of muscle activation. Coming out of a brace after four weeks has similar challenges. As you have discovered, movement patterns that are particularly affected by whiplash injury include the ability to move the head and neck quickly (speed) and smoothly.

Both the superficial (surface) and deeper muscles are often affected. If the problem is severe enough or goes on long enough, changes in muscle behavior and movement patterns begin to affect the nearby joints as well. Any rehab program that is successful must address all of these different components of the problem.

Reference: Gwendolen A. Jull, PT, PhD. Considerations in the Physical Rehabilitation of Patients with Whiplash-Associated Disorders. In Spine. December 1, 2011. Vol. 36. No. 25S. Pp. S286-S291.

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