Viscoelasticity- A Special Property of Human Tissues

Viscoelasticity- A Special Property of Human Tissues

Human soft tissue, whether it be muscle, skin, ligament, tendon, nerve, intervertebral disc, or bone all contain a special property known as viscoelasticity. This is a property that allows these tissues to deform depending on the type and direction of force applied. It allows for these structures to start in one place/shape, change as a result of forces applied, and then to “bounce back” to their original size and shape. It is really a remarkable characteristic.

You can liken viscoelasticity to a rubber band. You can stretch them and they bounce right back. However, if the force used to deform them is too strong or occurs to quickly, the tissues are irreparably torn and broken.

If you sit in your chair reading this, you can bend your chin to your chest, and then you can extend it backwards. Provided that you don’t have any underlying problems with your neck, by the time you are done you will have your neck and its tissues in the same shape and condition as it was before you stretched it. Now imagine you are sitting at a stop light and you get rear-ended suddenly. In a matter of milliseconds your neck undergoes the same motion pattern. However, since the impulse occurrs so quickly the viscoelasticity of the neck soft tissue does not allow the tissue to return to its pre-accident shape. This results in torn soft tissues, and a trip to your local Baltimore Chiropractor for whiplash treatment.

While the motion of the neck is within anatomical limits (that is, we can bring our neck to our chest and bring it all the way back) the speed at which this motion occurs in an auto accident is so great as to not allow the viscoelastic structures of the neck to “bounce back” resulting in injury.

As a Baltimore Chiropractor that routinely treats patients with neck pain following a Baltimore auto accident, I routinely treat patients who have torn viscoelastic structures in their neck. If you, or anyone you know, as suffered from a Baltimore Auto Accident and can use the help of a Baltimore Chiropractor, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help!

Dr. Gulitz

*This information was taken from “Whiplash and Mild Traumatic Brain Injuries” by Dr. Arthur Croft, page 134.

No Correlation Between Property Damage and Bodily Injury

As a Baltimore Chiropractor that routinely treats clients injured in Baltimore auto accidents (Baltimore car accidents) I routinely see patients whose accidents run the gamut from a simple bumper tap collision to a total loss. Most insurance companies (largely responsible for paying out claims for accidents) would have you believe that there is a direct correlation between property damage to a vehicle and the likelihood of injury to an occupant.

The thought process goes like this: If two cars are involved in a crash with a small crash velocity, particularly a crash where there is no damage to either vehicle, no occupants can be injured. Any claim made for bodily injury must therefore be fraudulent.

I’ll admit. Before I became a Chiropractor I sort of believed this to be true myself. But how did I know it to be the case? I had never done any research, I had just “believed it” inherently.

When I started treating patients as a Chiropractor in Las Vegas I came across a lot of “low property damage” or “low PD” crashes where occupants were claiming injuries to their necks and backs. X-rays, physical examination and orthopedic examination confirmed injury. Professional interest lead me to the literature and research of Dr. Arthur Croft of the Spine Research Institute of San Diego and his post graduate series on Whiplash and Mild Traumatic Brain Injury.

Dr. Croft is one of the leading researchers on whiplash biomechanics/kinematics. As an epidemiologist he has studied all published research on the topic and determined that there is no correlation between crash velocity and injury risk. He states “Using paired comparison methods, the authors were able to demonstrate that when correlating crash delta V and comparing subjects within the same vehicle on the basis of injury risk, it appeared that human factors were more deterministic…than crash metrics.” (p. 98 “Whiplash and Mild Traumatic Brain Injuries”).

This makes some sense. I have seen plenty of older patients who suffer severe injuries that are involved in the same crash as young children/younger adults that walk away unscathed.

At the end of the day, as a Baltimore chiropractor that is involved in whiplash treatment in Baltimore, I do not necessarily concern myself with property damage. I treat injured clients- not injured cars. Often insurance companies will look to deny claims that involve low property damage to vehicles, claiming that they must be fraudulent. Fortunately, my patients know that I have research on my side to fight the insurance companies that look to deny their claims.

If you, or anyone you know, is in need of a Baltimore Chiropractor to treat you for injuries sustained in a Baltimore auto accident, please call Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Baltimore Whiplash and S-Shaped Cervical Curves

The normal anatomy of the neck (cervical spine) is a C-shaped curve. In rear-end auto accidents that result in whiplash prevailing thought was that getting struck from behind would result in a hyperextension/hyperflexion injury of the neck. That is, first the neck would extend all the way backwards and then it would rebound and hyperflex all the way until the chin touches the chest.

Research has shown that in the milliseconds during a rear-end auto accident the cervical spine actually forms an S-Shaped curve. This is important because it explains why patients with neck pain following an auto accident typically present with pain at the base and the apex of their necks.

During the 150 milliseconds of the rear-end impact the lower part of the neck hyperextends and simultaneously the upper part of the neck hyperflexes, creating an S-Shaped curve. This places extra stress and strain on sensitive tendons, ligaments, discs, and other connective tissue that normal exist in a C-shaped curve formation. The result is inflammation that leads to pain.

Baltimore Chiropractors, such as myself, routinely treat patients with whiplash in Baltimore resulting from auto accidents in Baltimore. If you, or anyone you know needs treatment for a Baltimore auto accident please do not hesitate to contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help!

Adverse Drug Reactions

As a Baltimore Chiropractor that often treats patients involved in Baltimore auto accidents and Baltimore slip and fall injuries, I spend a fair amount of time co-treating my patients with local medical doctors, neurologists, orthopedists, etc. Typically I will assist with the rehabilitation for the patients and the other providers will medicate them. If a patient has muscle spasms, they will be given a muscle relaxer. If they have inflammation, they will be given an anti inflammatory. If they are having difficulty sleeping following their Baltimore auto accident, they are prescribed sleeping pills.

On the surface, these are sound approaches to symptomatic management of painful conditions. However, not is all as it seems. There is a disturbing trend seen between the use of prescription drugs and adverse drug reactions (ADRs). According to a landmark study in the Journal of the American Medical Association (JAMA) in 1994, it was estimated that 106,000 people died as a consequence of ADRs.  By some measurements that would rank ADRs as anywhere from the 4th-6th leading cause of death in America! There is a possibility that these numbers are actually under-reported since there are on average 7,000 motor vehicle collision (auto accidents) that lead to death that are caused by ADRs that are not officially attributed to deaths by adverse drug reaction.

By all means if you are involved in a Baltimore auto accident or Baltimore slip and fall injury and you need medicine, go see a medical doctor. They will use their medical expertise to prescribe you appropriate medication for your condition. All I am suggesting is that you think before you blindly take medications without considering the risk involved. It is ok to experience some discomfort- it lets you know your limitations and gives our bodies time to heal while you undergo therapy. Unlike cars which can be replaced if they break down, we are only given one body. Do the best you can to take care of it.

Dr. Gulitz

The preceding statistics were provided by Dr. Arthur Croft in his book “Whiplash and Mild Traumatic Brain Injuries: A Guide for Patients and Practitioners” on page 45.

Whiplash and Chiari Malformations (Brain Injury)

A study in the July 2010 Issue of “Brain Injury” reveals that up to 20 percent of whiplash victims undergo a form of brain injury referred to as a Chiari malformation. The study examined neck MRIs in 1200 whiplash patients and determined that those with neck trauma following a whiplash injury had an increased likelihood of chiari malformation.

So what is a chiari malformation? It is an injury that occurs when part of the brainstem (the cerebellar tonsils) herniate through the hole at the base of the skull (the foramen magnum) thereby exposing the brain stem to potential trauma. Patients with chiari malformations can experience headaches, neck pain, upper extremity numbness/tingling, and balance problems. Many times these chiari malformations require surgical intervention to prevent further injury.

While it is true that whiplash is fairly common and chiari malformations are exceedingly rare, it is a good idea to present for evaluation if you suspect you might have this condition. If you or a friend has recently suffered whiplash from a Baltimore auto accident and are in need of Baltimore auto accident treatment, contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help.