Why head and neck injuries should not be ignored
Following a road traffic collision, sporting impact, fall, or sudden acceleration-deceleration injury, many people expect to feel neck pain or stiffness. However, symptoms can sometimes extend beyond the neck and include headaches, dizziness, concentration difficulties, visual symptoms, fatigue, and balance issues.
Two commonly associated conditions after these types of events are whiplash-associated disorder (WAD) and concussion. Although they are different diagnoses, they can sometimes overlap and produce similar symptoms. Understanding the difference, knowing what symptoms to expect, and seeking appropriate assessment can help improve recovery and avoid prolonged symptoms.
What is whiplash?
Whiplash-associated disorder describes a collection of symptoms that occur following a rapid movement of the neck, commonly involving a sudden forwards and backwards motion.
Common symptoms include:
- Neck pain and stiffness
- Headaches
- Reduced neck movement
- Shoulder or upper back pain
- Dizziness
- Fatigue
- Difficulty concentrating
Whiplash symptoms can vary significantly between individuals (Sterling, 2014).
What is a concussion?
Concussion is a mild traumatic brain injury caused by biomechanical forces affecting the brain.
Symptoms can include:
- Headache
- Dizziness
- Brain fog
- Difficulty concentrating
- Memory problems
- Visual disturbances
- Balance difficulties
- Sensitivity to light or noise
- Fatigue
Loss of consciousness is not required for a concussion diagnosis and many people remain awake throughout the event (McCrory, Meeuwisse, Dvorak, Aubry, Bailes, Broglio and Cantu, 2017).
How physiotherapists assess whiplash and concussion
Assessment starts with a detailed discussion around:
- Mechanism of injury
- Symptom behaviour
- Head injury history
- Dizziness or visual symptoms
- Balance issues
- Functional limitations
Physical assessment may include:
- Neck movement and strength assessment
- Vestibular screening
- Balance testing
- Eye movement assessment
- Functional testing
Treatment options
Treatment is highly individual and may include:
- Education and reassurance
- Gradual return to activity
- Neck mobility and strengthening exercises
- Vestibular rehabilitation
- Balance retraining
- Graded exercise programmes
- Symptom-guided return-to-sport progression
Research increasingly supports early, appropriate movement rather than prolonged rest (Leddy, Haider, Ellis, Willer and Schneider, 2018).
Red flags and when further assessment is needed
Seek immediate medical attention if symptoms include:
- Loss of consciousness lasting more than a brief period
- Progressive neurological symptoms
- Significant weakness or numbness
- Severe worsening headaches
- Repeated vomiting
- Seizures
- Significant confusion or behavioural changes
Takeaway: recovery requires the right progression
Recovery from whiplash and concussion is rarely about complete rest or simply “waiting it out.” A structured and progressive approach can help restore confidence and function safely.
If you or someone you know is struggling with anything like this and would be interested to find out more then please get in touch and book in. We will help wherever we can.
Written by Stuart Williams | Physiotherapist | Vestibular Physiotherapist | Running Analysis
References
Leddy, J.J., Haider, M.N., Ellis, M.J., Willer, B.S. and Schneider, K.J. (2018) ‘Exercise is medicine for concussion’, British Journal of Sports Medicine, 52(5), pp. 262–263.
McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J. and Broglio, S. (2017) ‘Consensus statement on concussion in sport’, British Journal of Sports Medicine, 51(11), pp. 838–847.
Sterling, M. (2014) ‘Physiotherapy management of whiplash-associated disorders’, Journal of Physiotherapy, 60(1), pp. 5–12.