Whiplash

We commonly associate whiplash injuries with car accidents or collisions, but whiplash can occur any time your head moves suddenly, such as a fall where the head is jolted backwards, or as an sporting injury in a contact sport like rugby.

Unlike more serious injuries, like a fracture, the pain of whiplash may not develop for a day or two after the initial injury. But the pain that develops from it can be debilitating, because it often causes severe stiffness, spasms, neck pain and headaches.

Whiplash falls into two categories:

  1. “Simple whiplash” – this is due to sprains and strains in the soft tissue of the neck which happened at the moment of impact
  2. “Stingers/Burners” – where the nerves in the neck and shoulder are also damaged leading to tingling, numbness, pins and needles and/or pain in the arm

For the vast majority of people, the pain from whiplash is manageable and the whiplash will resolve by itself. In these circumstances the best thing to do is get some rest, use gentle heat on the area and take paracetemol.

It’s very important in the immediate aftermath of a whiplash injury to keep the neck moving as much as possible. Under no circumstances should it be immobilised in a brace or collar.

If you remember nothing else from this blog post, remember this. DO NOT USE A NECK BRACE ON WHIPLASH!

Got that? Ok.

DON’T USE A NECK BRACE FOR WHIPLASH INJURIES!

Chronic Whiplash

For some people, however, whiplash can become a chronic condition, where the pain persists even after the initial injury has healed. This can make day to day living difficult, and can even lead to depression due to the chronic pain. In situations like these having some treatment, such as chiropractic treatment, can be very helpful. (You can click here to see the results of a patient I treated after she had pain for 7 years after her whiplash, and has now found significant relief.)

The truth is that we don’t really know what the factors are that predict whether someone will have chronic pain or recover quickly from whiplash, but it seems to be some combination of the following:

  • How emotionally traumatic the original event was
  • How painful the initial onset of whiplash was

But it doesn’t seem to be correlated with:

  • How bad the initial accident was, eg. if the car was rear-ended or rolled into a ditch
  • Whether or not you claimed for your treatment on insurance
  • Whether you had “simple whiplash” or a “stinger/burner”
  • How quickly you got treatment for it

Because of this I usually recommend that you continue with your normal day to day life as much as possible for at least 3 weeks. If your pain or stiffness have not improved at that point, or the headaches become unbearable, or it is affecting your sleep, then make an appointment to see me and we will get right on top of it.

Top Tips for Knee Pain

All the techniques described below are demonstrated on my Facebook live video about this topic, which you can find here

Knee pain is relatively common in the UK and the good news is that it’s often very easy to treat! Here are my top tips for knee pain.

1 – Hands on!

The most common form of knee pain is muscular, that is, pain caused by tightness, tension or weakness in the muscles of the knee. In 90% of cases it’s the vastus medialis oblique (VMO) muscle which is the culprit, so here’s what you can do to help.

The VMO muscle is responsible for 90% of muscular knee pain

Massage the muscle. You can find it by placing the palm of your opposite hand on the kneecap of the affected knee – the point at which the tip of your thumb lands is the most common area for a knot in that muscle. Grab some lotion and give it a vigorous rub until the knot is reduced and the pain has subsided.

Exercise it. Stand in a high squat leaning against the wall with a soft ball between your knees. Squeeze the ball between your knees and, at the same time, push your bottom into the wall. You should feel your inner thighs tense up. Hold this for 10 seconds and relax. Repeat. If you find this version of the exercise too easy you can sit into a deeper squat or bring your feet closer to the wall.

2 – Move, Move, Move!

The next most common cause of knee pain is osteoarthritis (OA). As we discussed in an earlier post, OA is not in and of itself a painful condition, but sometimes the presence of OA can irritate other structures or make the joint stiff. In this case, the best thing is to move that joint! Motion is lotion!

Underwater exercises can be very effective for knee pain

Walking is great, dancing is great, cycling is great! So if you enjoy any of those, do lots of them! But you’ll probably find swimming is the most effective way to move the knee and reduce pain and stiffness. Not only does being in the water remove some of the weight-strain on the knee, by making you weightless, but the act of moving the knee through the water provides some resistance and helps to strengthen the knee muscles, build up cartilage and improves blood flow. Better still, why not try marching through the water, or cycling your legs as if you were riding an underwater bike?

I would also highly recommend taking a supplement for your joints if you know you have OA – the BioCare Glucosamine MSM Complex and their MegaEPA are an excellent combination. Or, if you don’t like tablets and you prefer a liquid supplement to put in smoothies, BioCare also make a JointGuard solution which has high levels of Glucosamine and Omega 3 oils (and it actually doesn’t taste too bad because it’s got ginger and citrus in!). If you are an existing patient of mine, I have a discount code that you can use on their website too.

3 – Lay down your heavy load

Having a Body Mass Index (BMI) over 25 classifies you as overweight, while a BMI over 30 is classed as obese. And being overweight or obese has a significant impact on your knees by increasing the stress on them. Losing weight will significantly improve your knee pain as well as having lots of other health benefits. You can work out your BMI here.

Being overweight is a major contributor to all types of knee pain

In spite of what many very fashionable fad-diets will tell you, there is only one way to lose weight: to be in a calorie deficit. This means as long as you are eating fewer calories than you are using, you will lose weight.

Here’s an online tool to work out how many calories you can eat (otherwise known as your Basal Metabolic Rate – BMR).

If you eat exactly the same number of calories as your BMR you will stay the same weight. If you eat more calories than your BMR you will gain weight. If you eat fewer calories than your BMR you will lose weight. It’s that simple!

When knee pain is more than knee pain

You should see your GP if any of the following happen in your knees:

  • You can’t put any weight on your knee
  • If your knee locks or gives way frequently (painless clicking is normal)
  • If your knee is red, hot and swollen and you also feel unwell/hot and cold/shivery
  • If your knee has changed shape
Most knee pain can be treated with non-invasive techniques and does not require a GP or hospital visit

The Big Secret…

Welcome to 2019! Happy New Year! I hope this year is a wonderful one for you and your family.

At this time of year, it’s only natural to look back and reflect on the year that has been, as well as make plans going forward. We may even make a resolution or two.

I’ve historically never been one for resolutions, but last year I made a few and found it really helpful. It was actually amazing to see how small changes, made regularly and turned into habits, make a huge difference by the time New Year rolls around again. It even became my unofficial motto for the year: “It’s better to be consistently good than occasionally brilliant”

A large study done 2 years ago by The Kings Fund – a large, independent charity working to improve healthcare in England – found that over 80% of diseases and conditions here in the UK are either partially or entirely mediated by 3 lifestyle factors. Put another way – crack these 3 lifestyle habits, and 8 out of 10 premature diseases could simply pass you by.

And here are those 3 factors:

  1. Exercise – Adults should aim to take part in at least 150 minutes of moderate intensity physical activity each week, in bouts of 10 minutes or more. Included in this, all adults should undertake muscle strengthening activity twice a week and minimise the amount of time spend sedentary for extended periods.
  2. Diet – Adults should aim to eat a diet with the right amount of calories (this is individual to you, but generally around 2000Cal/day), with 40% of their food intake being fresh fruit and vegetables (not including potatoes), and choosing foods high in protein, fibre and EFAs (essential fatty acids) over foods high in processed sugar and salt.
  3. Exposure – Stopping smoking and reducing your alcohol intake to less than 14 units per week (this is now the same for men and women – new research showed the old limit of 21 units for men was too high)

These may sound like things we have all heard before. We’re familiar with the health campaigns of “eat your 5 a day”, “stoptober”, “dry January”, “move more”.

But just take a moment to review that statistic that I shared earlier. Get these 3 things right, and you’ve lowered your risk factors for 80% of known health conditions.

In fact, even just implementing the exercise guidelines reduces all causes of mortality by 30%.

Just think about that.

So what New Year’s Resolutions will you be making? What new healthy habits are you taking forward into 2019? Remember that a small change, done consistently, can snowball into big changes.

And don’t be put off by the amount of time it will take to achieve your health goals. The time will pass anyway – the only question you need to ask yourself is “by next New Year’s Eve, do I want to be as healthy as I am now, or healthier?”

Leave a comment and let me know your New Year’s Resolutions! Wishing you a happy and healthy 2019!