Many times, in a car crash we injure our neck and back due to whiplash type motions, however, there are many other injuries that can occur that might go undiagnosed until much later. By spotting these potential problems early, it will give you a better chance to be evaluated and treated immediately. The earlier intervention takes places, the more likely the injuries will resolve without long term effects. Some of these injuries are:
- Shoulder injuries: Typical position would be with your hands on the steering wheel during impact. Whether you are hit from behind, front or side, the shoulders can take a large force. With a rear impact the body may go forward while the shoulders remain locked out. This can cause a sudden anterior/posterior translation of the shoulders which could result in tearing of the muscles and ligaments that stabilize the shoulder, rotator cuff muscles, pectoral or bicep muscles. Also, ligamentous structures can be damaged. Pain in the front or back of shoulders, or pain in the pectorals, (chest muscles) that make it difficult to move the shoulders. This pain may be mild to moderate, but constant and unrelenting.
- Elbow injuries: If the hands are on the steering wheel and the elbows are extended, then compression or hyperextension injuries can occur. Tight gripping of the steering can cause sprain/strain at the lateral epicondyles, which can cause inflammation and pain that can limit movement at the elbow. In some causes fracture can occur at the elbow. A fracture may be obvious immediately, but sprain/strain to the elbows may be minimal at first only to worsen over time and with use.
- Wrist injuries: Following this trend, with the wrists on the steering wheel and a forceful grip can cause sudden wrist extension and flexion. Sometimes the injury occurs at the weakest link. If the wrist grip is loose when the collision happens, it may cause the wrist to hyper flex/extend. Also, if it is a head on collision, or a rear end collision that causes your car to collide with a vehicle in front of you, airbags may deploy. A deployed airbag can cause trauma to the hands and wrists.
- Hip injuries, (right side more common): When the right leg and foot are extended and, on the gas, or most likely the brake, a sudden impact from behind causes a sudden force applied that goes into the lower back causing some forwarded movement of the whole body, except the outstretched right leg is in a fixed position. Trauma can happen anywhere along the leg, (ankle, knee, or hip), but the hip socket, (acetabulum) can be a common problem. Pain can be present in the front of the hip, just lateral to the groin. Over time, movement can become restricted along with pain. Another way the hip can become injured, either right or left, is if the knee hits the dashboard with the thigh in a flexed position. This can push the thigh back into the hip socket and some cases can cause a fracture.
- Facet injuries: This is the capsule that holds the joints of two adjacent neck vertebrae together. Yes, we know that the neck can be injured with a whiplash-type injury, but many times we think of just some of the muscles being strained, or even a disc being injured. Many times, there are injuries to the neck that may seem mild, but do not resolve with time. In many cases it is one side of the neck that is affected. One reason for the facet injury to be injured on one side is if the head is turned to one side, (looking out the window or turned to talk to someone else in the car). When hit from behind there is a flexion/extension mechanism as well as a rotational component to cervical spine. A study in SPINE, Feb 2006 found that three dimensional injuries caused more damage than two dimensional injuries. This over stretching can cause ligament tears with increased strain to the facet capsules of the opposite side of where the head is facing. Having your head turned during a rear end collision, even at lower speeds, may cause serious injuries to the cervical spine.
After a collision, it is a good idea to be evaluated by someone who is trained in the diagnosis and treatment of auto injuries. By being able to identify these five potential injuries and relaying this to the health care professional if you did indeed experience one of these injuries, can be helpful in the early diagnosis and treatment to be ensure proper referral for early intervention.
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