Cesar Fernandez de las Penas
Journal of Bodywork and Movement Therapies (2005) 9, 109–119
Abstract Introduction: There are many therapeutic approaches aimed at treating the clinical syndrome resulting from whiplash injury. However, there seems to be little agreement between therapists as to the ideal treatment for these patients. Spinal manipulation/mobilization and soft tissue mobilization techniques are manual therapies commonly used in the management of neck disorders. The aims of the present paper are to detail a manual approach developed by our research group, to help in future studies of the management of the sequels to whiplash injury, and to suggest explanations for the mechanisms of this protocol. These manual approaches are considered by the authors to be more effective than conventional physical therapy in the management of whiplash patients
Vertebral manipulations: The biomechanical analysis of whiplash injury showed that upper cervical manipulation, cervicothoracic junction manipulation, thoracic spine manipulation, and pelvic girdle manipulation are the major areas requiring such treatment, for beneficial outcomes to be assured. Although the exact biological mechanisms underlying the effects of spinal manipulation are not clearly understood, there are previous papers justifying most methods used in the current experimental protocol.
Soft tissues manipulation techniques: The soft tissues techniques used in this protocol were neuromuscular technique in paraspinal muscles, muscle energy techniques in the cervical spine, myofascial release in the occipital region, and myofascial trigger point manual therapies as required.
Clinical dissertation: The definition of spinal joint dysfunction (hypomobility) implies that muscle shortening is involved. This suggests that manual treatment of persons suffering from whiplash injury requires the treatment of muscular and fascial shortening, as well as the treatment of spinal joint dysfunction, when appropriate.