In Part 1 of this article we discussed Whiplash Associative Disorder and the implications that go along with the condition. Here we’ll discuss some ways you can address the complications and potential rehab strategies.
EXAMPLES OF EXERCISES USING VISUAL FEEDBACK
Below are some examples of potential exercises — you can also do these without visual feedback. The visual feedback just allows an external focus and makes motor control and strategy visible to both patient and practitioner. I find it sometimes helpful to use because it directs attention away from neck movement per se, and more towards the goal of making the laser move, which is accompanied by neck movement.
“Indirect rotation” techniques allow the tissues to undergo stresses into new ranges in a different context (perhaps less threatening), and can allow the patient to realize they can move. Show them after the exercise, “see you just rotated your neck fully with very little pain.” This might be encouraging.
The “motor control” components are attempted to re-establish fine motor skill with constant scrutiny to accuracy from the visual feedback. This can be applied in various positions (neutral standing, seated, in rotation standing or seated, standing on one leg, combine with a verbal or other body task etc.). Further, simple balance exercise may be warranted to allow the patient to practice postural control mechanisms globally.
SET REALISTIC EXPECTATIONS
Explain that abolishment of pain after WAD is typically slow, for reasons mentioned above. Explain that it is very common to have a roller coaster like pain, where one day it will flare up for no reason. Explain flare-ups as protective behavior, and the body acclimating to the demands of life again. If there is rapid progress, great! If it is slow, that is normal. We can’t force a tissue state to change and we need to respect that, but we can attempt to affect all things influencing it.