The Hospital released me after an accident…. I am ok right?

Released from hospital after an accident injury

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SafeCare Docs – Central Florida
Accident Injury Medical Care – Accident Doctor
www.safecaredocs.com
Serving Central Florida
(407) 438-2432

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Alright, so another question that we get almost any doctor who’s in private practice always gets this is i’ve been into the hospital and they released me so i guess i am O.K. I just know this, our hospitals and ER physician probably some of the best physician on the planet but you have to realize what their job is? Their job is to make sure that when you going to that hospital, that you going to live……. ?

So what they are checking on you is:
Have you broken any bones?
Do you need anything set?
Do you have any internal injuries that you gonna bleed out that night?
Do they need to send you for emergency surgery?

What do they need to do to tree out you, which is basically an emergency situations medically. So, they may do X-rays, they may do MRI’s, CT scans and they will look for life threading injuries and then got we have them. A Lot of time what i would say probably close to 70% of patients that we see who had been to the hospital. Do not have life threading injuries. As a matter of fact sometimes after people go to the hospital and they have that false sense of O.K that i am gonna be O.K or a false sense of that there are no problems there that they just continue to go with their life or they continue to have negotiations with insurance carriers or an insurance agent and then they wanna selling the case with the hidden injuries actually still being within them. So, like i said the hospital there to detect life threading situations and got forget to something have life threading the hospital there to heal, handle and deal with all that. But you really need to be check by somebody who is a specialist in car accidents or be checked by someone who is a specialist in a soft tissue injuries in particular because have a specific criteria that we look for. You’ve heard some of other podcast here what we have talked about earlier for symmetry and measure emotions. We’re looking for pain in certain areas there are specific test that we do to basically find hidden injuries or areas where this function that you would normally pick up. This body is an amazing piece of machinery. If you have a deficiency in one area the body is gonna hide it, the body is gonna make it so you can still function normally so you can sit, stand, run, move , walk, work. The body is still gonna make it so that you can function but we wanna look for things that more than just your ability to function. We don’t want you just to survive, we want you to thrive so look for area in the body that have deficiency and all the SAFE CARE DOCS are trained to find the areas of problems. Once we detect that you do have a deficiency the we put you on a specific course of treatment to take that deficiency and improve that area and then re-test it again to make sure that you backed to function where you were before the accident. You would also need to know this, is that your insurance carriers only responsible for the injuries from the car accident. They are not responsible for something happened 20 years ago. So its very critical that you get to an expert in auto injuries who knows how to define, document, treat and then also measure your progress and those areas of the injuries from the car accident. The insurance carrier can’t deny the claim and it could also hurt you if you do …………. You have to go to the trial or you do have to get an attorney, you do gonna be working with the specialist who can specifically and objectively find the injured area, show it and then share what the progress is or show if there is lack of progress.

How Do I deal with the stress of an Injury

Stress after a car accident injury

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Call Us Today: (407) 438-2432

SafeCare Docs – Central Florida
Accident Injury Medical Care – Accident Doctor
www.safecaredocs.com
Serving Central Florida
(407) 438-2432

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One of the most common questions i get asked is that I am so stressed that after my accident, What do I do about that or is that normal? And of course if you have been in an accident yes getting stressed is normal feeling, stress is natural mechanism of the brain that protect you, it get you out of a harms way, it moves you in action, so yes if you’ve been in a car accident and you feel stressed out then its normal, that’s part of the process of healing that you going through accident, and there is different types of stress. There is physical stress which are things physically happens to you like from the car accident. There is chemical stress which in the car accident is a hormonal response, there is a stress hormone which is called CORTISOL which rises very quickly after a car accident and then there is emotional stress, that’s the fear or anxiety that comes along with being in a car accident. Now, all three of them need to be kind of handle and these all three need to be come down to normal if you want a functional after the accident. a lot of accident people that we see can hold on to that fear for months and even in year after the car accident and of that the case you want to dealt early , so the early detection again that is better. A lot of things come out there after a car accident , so many people come to you after the car accident for attorneys or financial problems sometimes you can’t go back to work, sometimes your car is going to be a lot more expensive than you thought affects the insurance doesn’t covers, so all this adds to that stress. The quickest way we found out to deal with the stress working with someone who is an expert in car accidents. Now that doesn’t need to be attorney , lot of time your doctor since we work so close with patients who have been in a car accidents, we get to know about the case, we get to know all about the scenario that bled up to that. And just that whole process of sharing that with somebody seems kind of disappear a lot than a emotional stress that comes with this. The financial side of things is whether the insurance is gonna cover your care , is gonna cover your car or you will lose wages because of work , it’s also helpful to walk through all that with someone who’s done may be hundred or thousands of times , so it kind a let you see this from a bird’s eye perspective about what the end of this would look like instead of being so caught up stress of the situation and not really knowing what’s really gonna happen next. It’s probably one of the most powerful things we do at SAFE CARE DOCS is give people the ability to see what in next three months, six months and next year look like, so that a lot less on certainty of lives and that seems to calm most people down and then once you get calm down than they can lay out a plan that get you fixed physically , emotionally and chemically and that’s really ultimately the goal than anyone at SAFE CARE DOCS is going to be doing with you.

What happens if I don’t GET CHECKED after a car accident?

Get Checked after a Car accident

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Call Us Today: (407) 438-2432

SafeCare Docs – Central Florida
Accident Injury Medical Care – Accident Doctor
www.safecaredocs.com
Serving Central Florida
(407) 438-2432

LISTEN TO THE AUDIO

Another common question that we get is what exactly can happens to me if i don’t GET CHECKED. What exactly can happens to me if i was in a car accident and things just simply heal on their own and in a lot of cases that actually is what happens is that the body is pretty amazing piece of equipment that will heal itself. The challenges is going to heal itself to keep you functional and after something like a car accident what actually happens to your severed spine is the lower part goes backward and the top part goes forward and that in itself restricts motion in the neck even that you might feel nervous and feel pain it will usually show up is some level of restriction. So what we recommend the people who have been in a car accident, A very quick and easy test for yourself to do is to look in the mirror and turn your head all the way to the left and then all the way to the right and see if you have symmetry, symmetry means that it is the same on the both sides and watch you look and see if there is any area which is not moving same from one side to another and that usually indicates that there is some level of problem with the joint and the next thing you do is to put your head forward and then put it backward and again look for a symmetry see if there is any pain or just nice flow and movement, If anything of those arranges and motions cause discomfort or you don’t see symmetry in that area then that usually indicates that the joint somewhere the spine have a problem.

And then with Safecare Docs what we look for is part of our protocol is to check for injuries or hidden injuries to look for that area where the joints are not moving correctly and just do some simple diagnostic tests to measure the space between joints and that is usually what we diagnose that the pain or sprain, you may have heard the word “whiplash injury”, What technically, what that is? Is an area the joint has been stretch passed a normal limit and then its snaps back in but it’s still has a little trauma to that area that needs to be corrected.

Interesting Car Accident Facts

In 1891, engineer James Lambert was driving one of his inventions, an early gasoline-powered buggy, when he ran into a little trouble. The buggy, also carrying passenger James Swoveland, hit a tree root sticking out of the ground. Lambert lost control and the vehicle swerved and crashed into a hitching post.

This is America’s first recorded car accident.  

Since than car accidents make up the leading cause of death and injury do to personal injury and car accidents.  

While we know a lot about car accidents and the impact they can have on our life, some of the statistics are shocking. In addition to that, the growth and development of the auto industry over the years is surprising as today it would be hard for us to imagine cars any other way. Check out these facts that you probably didn’t know about car accidents.

1) Until 1973, some car transmissions took whale oil.

2) Each day an estimated 135,000,000 cars are on the roads in the U.S.

3) The first speeding ticket was issued in 1904—the speedster was traveling at an astounding 12 miles per hour.

4) 40 percent of all fatal accidents involve alcohol.

5) It is estimated that a motorist will curse 32,000 times in their life while operating a car or truck.

6) The first car used a lever not a steering wheel to direct the car.

7) The windshield wiper was invented by Mary Anderson before Henry Ford’s Model A was even manufactured. Her window cleaning device became standard on all automobiles in America in 1916.

8) The majority of car accidents occur within 3 miles of the driver’s home.

9) Each year approximately 15 pedestrian students are killed by school buses—most often these accidents occur after school is out.

10) Vehicle rollovers are the most deadly type of car accidents.

11) According to various research men actually cause twice as many accidents as women.

12) Teens are at a much higher risk of being injured or killed in car accidents. Each year 300,000 are injured and 5,000 are killed on average.

13) When you talk on a cell phone while driving you are increasing your chance of being in an accident by 400 percent.

14) The average text message takes 4.6 seconds to write and send. While driving that would take your eyes off the road long enough to drive the length of a football field blind if you are travelling at 55 miles per hour.

15) In the time it took you to read this list there have been four car accidents. Statistics show that car accidents that involve injury occur every 14 seconds and every 12 minutes a car accident will be fatal.

In addition the Association For Safe International Road Travel released these statistics. 

Annual Global Road Crash Statistics

  • Nearly 1.3 million people die in road crashes each year, on average 3,287 deaths a day.
  • An additional 20-50 million are injured or disabled.
  • More than half of all road traffic deaths occur among young adults ages 15-44.
  • Road traffic crashes rank as the 9th leading cause of death and account for 2.2% of all deaths globally.
  • Road crashes are the leading cause of death among young people ages 15-29, and the second leading cause of death worldwide among young people ages 5-14.
  • Each year nearly 400,000 people under 25 die on the world’s roads, on average over 1,000 a day.
  • Over 90% of all road fatalities occur in low and middle-income countries, which have less than half of the world’s vehicles.
  • Road crashes cost USD $518 billion globally, costing individual countries from 1-2% of their annual GDP.
  • Road crashes cost low and middle-income countries USD $65 billion annually, exceeding the total amount received in developmental assistance.
  • Unless action is taken, road traffic injuries are predicted to become the fifth leading cause of death by 2030.

Annual United States Road Crash Statistics

  • Over 37,000 people die in road crashes each year.
  • An additional 2.35 million are injured or disabled.
  • Over 1,600 children under 15 years of age die each year.
  • Nearly 8,000 people are killed in crashes involving drivers ages 16-20.
  • Road crashes cost the U.S. $230.6 billion per year, or an average of $820 per person.
  • Road crashes are the single greatest annual cause of death of healthy U.S. citizens traveling abroad.

The best way to be safe is to avoid an accident in the first place.  Defensive driving is now taught in almost every state.

The First Principle of Defensive Driving

Traits that all defensive drivers have in common are that they never take for granted that nothing will go wrong, and they never assume that other drivers will do the right thing. It’s this mindset that ensures they never put themselves in unnecessary danger and that they’re prepared to react in any emergency.

As such, the first principle of defensive driving is to avoid risky behavior. On the road, it can be tempting to bend the rules sometimes because the risk seems low. For instance, maybe you’re feeling frustrated because the car ahead of you is traveling 10 mph under the limit, and there’s only one lane going in your direction. On your left, there’s a double solid yellow line, prohibiting passing, but the road ahead seems clear. So why not pass? As long as nothing goes wrong, everything will be fine, right?

The problem is, any plan that relies on nothing going wrong is a bad plan. Maybe a car is approaching along a hidden T-intersection on the side of the road. Maybe there’s a driver speeding towards you on the other side of the highway. Or maybe your illegal maneuver will confuse the driver ahead of you, causing him to speed up just as you’re trying to reenter the lane ahead of him.

The point is, you don’t know what will happen, and the only way to ensure your safety is to expect the worst and act accordingly. This means always driving in a safe, legal, and responsible way, even if you have no reason to expect trouble.

Defensive Driving Helps You Avoid Danger

The second principle of defensive driving is to expect others to ignore the first. That is, you must be ready for something to happen that could put you in danger. In other words, you must:

  • Stay alert. Pay constant attention to what other road users are doing and watch carefully for potential hazards.
  • Scan the road ahead and keep your eyes moving so that you spot potential hazards sooner.
  • Maintain a safe following distance and identify areas of the road you can use if you have to make evasive maneuvers.
  • Watch out for changes in driving conditions so you won’t be surprised by the actions of other drivers.
  • Don’t make assumptions about what other drivers will do and be ready to respond when they do something you don’t expect.
  • Take action immediately when you notice a potential threat on the road.

The Driver’s Golden Rule

The golden rule of driving is always treat other drivers the way you want to be treated. As a defensive driver, your goal is to put yourself in a place where you can response calmly, patiently, and courteously when the unexpected inevitably occurs.

Everyone makes mistakes sometimes. But on the road, a single bad decision or lapse in judgment can easily result in disaster. By driving defensively, you don’t just protect yourself. You also give other drivers room to make mistakes safely—just as you hope others will do when the same thing happens to you.

If you are in an accident stay calm. Make sure to remove yourself from any immediate danger.  Call the police and get checked by a doctor who specializes in auto injuries. SafeCare Docs can help you find a qualified physician near you.  

History of car accidents
History of car accidents

What does the research show about 8 mph car accidents and injury?

Can pain and dysfunction develop from a low speed car accident? “Low-speed” impact refers to 1-2 miles per hour and goes up to 20-25 mph. “Moderate speeds” are 25-40 mph and “high speeds” are 40 mph and over.

Jackson16 and States13 estimate that 85 percent of all neck injuries seen clinically result from automobile crashes, and of those due to such collisions, 85 percent result from rear-end impacts. Morris reported that rear-end impacts of as little as five mph can give rise to significant symptoms.17 The dynamic and vehicle factors that contribute to rear-end collision injury are: 

  • vehicles involved
  • speed differential
  • vehicle weight
  • location of impact
  • direction of impact
  • head restraint location
  • seat failure
  • seat back angle
  • seat back height

Wiesel states that approximately 10 percent of the occupants of the stricken vehicle in rear-end automobile collisions will develop whiplash syndrome.10 Approximately 10-15 percent of patients suffering from cervical soft tissue injuries following motor vehicle accidents fail to achieve a functional recovery.

Emori and Horiguchi state: “Whiplash, in some cases, persists for years but usually no obvious symptoms show up with radiological or other quantitative diagnostic techniques.”9 Our present technology does not permit precise identification of deranged soft tissues.

Research quoted by White and Panjabe11 states that an eight mph rear-end collision may result in a two g force acceleration of the impacted vehicle and a five g force acceleration acting on the occupant’s head within 250 msec of impact. (One g equals an acceleration of approximately 32 ft./sec.) Car crashes happen in literally one/two eye blinks. The point is that the head and neck experience more g forces than the car in low-speed impacts.

Kenna and Murtaghsay state: “It is wrong to assume that maximum neck injury occurs in a high-speed collision; it is the slow or moderate collision that causes maximum hyperextension of the cervical spine. High-speed collisions often break the back of the seat, thus minimizing the force of hyperextension.”21

A major dilemma exists for the auto manufacturer, insurance companies, and the consumer of autos. Each would like the vehicle to provide the maximum protection for the occupant with the minimum material damage to the vehicles during a collision. Stiffer cars with spring-like rear bumpers that increase the rebound have less damage costs, however the occupant experiences an increased neck snap and the potential for greater injury. When a car gets struck from the rear by another auto, the very first thing that happens is the struck car is accelerated. The occupant of the struck care experiences higher speeds as it attempts to “catch up” with the car. Navin and Romilly state: “This relative movement of the head to the shoulder during the rebound is the likely cause of neck injuries as this is the point at which dynamic loading of the neck will be maximum.”8 They conclude: “Of major concern to researchers is the lack of structural damage present below impact speeds of 15 kmh. This indicates that the bumper system is the predominant system of energy absorption between the impact and the occupant. It was also observed that deflection of the seatback tends to pitch the occupant forward, with the shoulder displacement leading the head. This relative head to shoulder motion is the likely source of whiplash injury.”

Research has shown that high impact forces are transmitted directly to the occupant in low-speed impacts and that the vehicle does not begin to crush until impact speed exceeds 15 or 20 mph.1,13 Severy1 demonstrated a 10 mph impact produced total collapse of only 2 1/2 inches in the rear structures of the impacted vehicles. Therefore, minor property damage does not necessarily equate to minor injury. The most important question is not, “What is the damage to the vehicle?” but, “What was the acceleration to the vehicle that you were in?” Injury will occur because of the acceleration differences between the different inertial parts of the occupant’s body, especially from the person’s head, versus trunk inertial acceleration differences.

Navin and Romilly have demonstrated that, “Rear vehicle impacts between 5-12 mph indicate that some vehicles can withstand a reasonably high speed impact without significant structural damage. The resulting occupant motions are marked by a lag interval, followed by a potentially dangerous acceleration up to speeds greater than that of the vehicle.”8

Severy1 demonstrated conclusively that seemingly harmless low-speed rear-end collisions were capable of producing damaging forces to the head and neck. Severy and associates recorded head accelerations as great as 11.4 g. Most research evidence suggests that the major injuries are due to the hyperextension phase of the cervicothoracic spine.

Factors that Influence the Extent of Injury

Headrests are the best protection in rear-end collisions. However if the headrest is set too low, the head is able to roll over the top of the headrest, producing even more hyperextension.2

Emori’s experiments were to simulate relaxed necks of unexpected passengers in struck vehicles. Without a headrest, the neck extension can become almost 60 degrees, which is a potential danger limit of whiplash at collision speeds as low as two mph.9

The exact position of the head at the moment of impact is important to know. If the head is turned, the injury will be greater on the side it is turned to. When head rotation is present, the pattern of tissue injury is potentially more severe.19

A surprise collision will usually cause more injury because the ligaments will be injured more than the muscles. When a person knows they are going to be struck, they will tense up the muscles and therefore injure the muscles first. MacNab states: “In impacts up to 15 mph the right front seat passenger stands in greater danger of injury than does the driver, because the driver can brace himself to some extent by holding onto the steering wheel.”14

Common predisposing factors include degenerative joint disease and spinal stenosis. The potential for injury is increased because the neck is less resilient.

The seatback stiffness requires investigation. The harder/stiffer the seatback the less forward acceleration and therefore the less injury. The less stiff the seatback the more forward acceleration and therefore the risk of increased injury.

Jackson states: “The belt has very little if any deterring effect on the cervical spine as the head and neck continue forward motion. Even the addition of a shoulder harness will not relieve but will only increase the forces which must be absorbed by the head and neck, although such a harness may prevent contact injuries.”12 Seat belts save lives by preventing occupants from going through the windshield, but they contribute to the neck injury.

The Office of the Chief Scientist (London), Department of Health and Social Security, had this comment regarding seat belts in 1985: “We predicted an increase in the case of two injuries: sprains of the neck and fractures of the sternum. Both were confirmed. The other apparent increase in a major injury which was not predicted was abdominal injuries of organs other than the kidney and bladder.”

Clemens and Burrow20 report that any shoulder restraint mechanism in front-end collision increases the degree of cervical flexion, with potential for injury.

The car fender or bumper is designed to avoid or reduce damage in a low-speed collision. It is not a safety device to prevent or reduce injuries to people in the car. The government requires bumpers on passenger cars to prevent damage to the car body and parts, such as headlights, tail lights, grille, hood and trunk latches, at barrier impact speeds of up to 2 1/2 mph. This is equivalent to a five mph crash into a parked vehicle.

Injuries Sustained

Myofascial structures can be stretched; asymmetric increase in muscle tension can develop, causing altered joint movement; the facets can become affected, and posture altered.

MacNab did whiplash type research with monkeys and was able to describe these injuries:3slight muscle tears of the sternocleidomastoid ruptures; ruptures of the longus colli; retropharyngeal hematoma; esophageal hemorrhage; cervical sympathetic plexus lesion; tearing of the anterior longitudinal ligament.

Dunn and Blazer7 concluded: “The most injurious head deflection in an acceleration injury is hyperextension. Even though sustained in low-velocity, rear-end collisions, this acceleration injury can produce forces significant enough to produce musculoligamentous tears with resultant hemorrhage and even disk disruption and avulsion fractures of the vertebral bodies. In addition, the integrity of the apophyseal joints may be violated.” They also conclude that in head-on collisions (flexion injuries): “In low- velocity flexion accidents, because the chin strikes the chest when the full range of physiologic flexion has been reached, minimal damage occurs.”

Prognosis

If present, degenerative changes should be noted as they may affect the prognosis. A claim of aggravation of a known pre-existing injury may occur after a low-speed impact.

Hohl4 and Hohl and Hopp5 found that complaints of interscapular pain, upper extremity pain, and numbness carried a poor prognosis, as did findings of a sharp cervical curve reversal, or restricted motion at one level on flexion/extension radiographs. Greenfield and Ilfeld15 also noted that shoulder pain and arm and hand pain indicated slower progress toward recovery, and that if upper back pain and interscapular pain present, a longer and more intensive treatment program was needed.

Norris6 found that the presence of objective neurological signs, significant neck stiffness and muscle spasm, and/or pre-existing degenerative changes adversely affected the outcome.

Hohl did a seven year follow-up after injury of patients without previous x-ray evidence of disc disease and found that 39 percent had developed degenerative disc disease at one or more disc levels since injury.4

Discussion

We enjoy the thrill of driving bumper cars travelling at approximately 1-2 mph without a head restraint and without adequate seat belts at amusement parks. We like the feel of speedy roller coasters that whip our head and neck, and push our body to provide a sense of increased g forces. And if we should experience soreness or discomfort after these rides we have the ability to continue to go on and have fun the rest of the day. We relax and tell ourselves that it will go away. And so it could be with many of our patients involved in low-speed, low-impact collisions. The doctor must reinforce to the patient that it will go away. If the pain doesn’t go away we must be able to discuss the mechanisms of injury and substantiate the presence of injury/illness.

Insurance companies and the general population have a skeptical attitude about these types of cases. Television commercials are polluting the jury’s viewpoint and the public is frustrated with the cost of insurance premiums. Ask people what they think of rear-end collisions, jury awards, and attorneys. They will respond with a different value than 10-15 years ago.

We need to make sure that patients are being sincere in their complaints. Credibility on the patient’s side is very important. The issues of the low-dollar damage amount and low speed will come up. The doctor has a credibility image to maintain as well. Adjustors will look at the doctor’s records and the treatment plan; insurance companies want to see a treatment plan. The important issues are the type of treatment, the cost of treatment and the length of time. The diagnosis is not indicative of the extent of the injury. Reports to the adjustor should supply the diagnosis and prognosis. At this point it does not appear that the insurance industry cares that chiropractic can substitute for more expensive care.

The key to documentation is showing that the patient is receiving benefit from the treatment (getting pain relief and improving functional capacity). Documentation must justify the treatment for the injury. It must show that treatment was actually rendered, and substantiate the injury by detailing the subjective and objective findings on the examination; justify treatment by showing decreases in pain and suffering; increasing recovery time; decreasing the likelihood of complications; increasing the function of the person during the recovery.

References 

  1. Severy DM, Mathewson JH, Bechtol CO. Controlled automobile rear- end collisions, an investigation of related engineering and medical phenomena. Can Serv Med J, 1995;11:727.
  2. Ewing C, Thomas DJ. Human head and neck response to impact acceleration. Navel Aerospace Medical Research Laboratory Monograph, #21, Aug. 1971.
  3. MacNab I. Acceleration injuries of the cervical spine. J Bone Joint Surg, 1964;46A:1797-1799.
  4. Hohl M. Soft tissue injuries of the neck in automobile accidents. J Bone Joint Surg, 1974;56A:1675-1682.
  5. Hohl M. Hoop E. Soft tissue injuries of the neck: II. Factors influencing prognosis, abstracted. Orthop Trans, 1978;2:29.
  6. Norris S. The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg, 1983;65:9.
  7. Dunn EJ, Blazer S. Soft tissue injuries of the lower cervical spine. Instructional course lectures, Am Academy of Ortho Surgeons, 1987;36:499-512.
  8. Navin FP, Romilly DP. An investigation into vehicle and occupancy response subjected to low-speed rear impacts. Proceedings of the Multidisciplinary Road Safety Conference VI, June 5-7, 1989, Fredericton, New Brunswick.
  9. Emori RI, Horiguchi J. Whiplash in low-speed vehicle collisions. Vehicle Crash-Worthiness and Occupant Protection in Frontal Collisions. Society of Automotive Engineers, Feb. 1990.
  10. Wiesel SW, Fetter HL, Rothman RH. Neck Pain. Charlottesville, VA. The Michie Co., 1986, pp 10-26.
  11. White AA, Panjabi MM. Clinical Biomechanics of the Spine, New York, JB Lippencott, 1978, pp 153-158.
  12. Jackson R. The Cervical Syndrome. Springfield, IL. Charles Thomas Co., 1977.
  13. States JD, Korn MW, Masengill JB. The enigma of whiplash injuries. Proceedings of the 13th Annual Conference of the Amer. Assoc. for Auto. Med., 1969.
  14. Rothman RH, Simeone, FA. The Spine, 2nd edition. W.B. Saunders Co., p. 648.
  15. Greenfield J, Ilfeld FW. Acute cervical strain: evaluation and short-term prognostic factors, Clin Orthop 122:196, 1977.
  16. Jackson R. Crashes Cause Most Neck Pain. Amer. Med. News, Dec. 5, 1966.
  17. Morris F. Do head restraints protect the neck from whiplash injuries? Archives of Emergency Medicine, 1989, 6:17-21.
  18. Rutherford W, Greenfield T, Hayes HR, Nelson JK. The medical effects of seat belt legislation in the UK. Dept. of Health and Social Security, Office of the Chief Scientist, Research Report #13, 1985.
  19. MacNab I. The “Whiplash Syndrome.” Orthop Clin North Am 1971;2:389-403.
  20. Clemens HJ, Burrow K. Experimental investigations on injury mechanisms of the cervical spine at frontal and rear-end vehicle impacts (from the German). Acta Ortho Unfall-Chir, 1972;75:116-45.
  21. Kenna C, Murtagh J. Whiplash, Australian Family Physician, June, 1987; 16:6.