Its common in the world of automobile wrecks and injuries to associate the damage to the vehicle with the likelihood that the occupants are injured. In my experience nothing could be further from the truth. I've had patients injured in cases where the cars were smashed as well as in cases where the damages to the vehicles was not even visible. Likewise, in many cases where the vehicle was smashed, the examination of the occupants revealed little or nothing which I could treat.
As doctors we are required to document injuries based upon examination findings, both subjective and objective. We are bound by ethics to only report things we find on these examinations. In other words we can't just take a patient's word for it that they are hurt. Of course, if they are complaining of pain, in most cases we find the cause and are able to treat it. They wouldn't be in the clinic if they weren't feeling something, right?
However, believe it or not, I have people come in from time to time with little to nothing to complain about, pain wise that is, but just want to get checked out. In most cases the examinations are negative but from time to time we find something that even the patient was unaware of. Since the onset of symptoms related to neck and back sprains can be delayed, it makes sense.
I guess the take home lesson here is that no matter how badly damaged your vehicle is, you could still be injured and need to get it checked out by a doctor. If you are not hurting, fine. You probably aren't injured. However, even a little pain or discomfort warrants a closer look, no matter what your vehicle looks like.
Saturday, November 2, 2013
Saturday, October 19, 2013
Drive Carefully
As a Doctor of Chiropractic at Accident and Injury Chiropractic, I see a lot of people who have been injured in a car wreck. Although most of those I treat were injured by someone else's neglegence, it would appear that many who get injured could have avoided the accident by being a little more watchful and basically, careful. Yes, many accidents are totally unavoidable but by being watchful and anticipating others just a bit, one can avoid many accidents.
In my younger days I drove a motorcycle quite a bit to and from work and school, on some very busy and somewhat dangerous roads. Driving a motorcycle is unique in that even a slight fender bender type of accident can be deadly. On a motorcycle one must practice the most defensive of driving strategies. At a red light, when it turns green, I would always hold off on going until I gave any other traffic one more look. All too often a car would speed through the intersection a full second or two after I had the green to go. Had I gone, even though I then had the right of way, I would certainly have been killed or severely injured. The point being, if we drove our cars as if we were on motorcycles, many accidents would be avoided all together.
I have heard many stories of people taking their right of way only to be hit by other vehicles which failed to yield that right of way. Had they simply waited a bit or yielded themselves a bit, the entire accident would have been avoided. I am reminded of the driver who slammed into a vehicle blocking a road to turn across traffic. The driver who did the slamming had the right of way, true, but seeing the vehicle pulling out or even looking as if they might, the driver could possibly have avoided the collision by simply slowing a bit to see what that other vehicle was going to do before assuming the right of way.
I'm not an attorney but I have heard it said that the law requires all drivers to maintain an adequate lookout for situations such as I have described here. And that brings me to speed limits. People just drive too fast. A speed limit is not the speed one should actually drive, it is the maximum allowable speed IF it is safe to do so. There are many places where the posted speed limit is just too fast for the street in question. Drivers should think about that as they approach intersections.
Then we come to rain and wet roads. I was driving with my daughter a couple of nights ago in some pretty steady rain. Visibility was not too bad but the rain was steady and at times heavy. I was amazed at how fast traffic was going on both the streets and freeways. Many were exceeding the speed limits and driving as if there was actually no change in traction or visibility as the rain continued to pour down. I spent most of the night avoiding others in my efforts to get to where we were going. Incedentally, we saw quite a few accidents.
So, to make a long story short, if we would just drive more watchfully much as a person on a motorcycle should and most do, the number of accidents would be reduced significantly. Assume the other guys are going to do what they shouldn't, assume they are talking on their cell phones or are being distracted in some form or fashion and many, many accidents can be avoided. Drive like an old codger? No. Just drive safe.
But if the unavoidable happens and an injury occurs, get to the doctor as soon as possible.
In my younger days I drove a motorcycle quite a bit to and from work and school, on some very busy and somewhat dangerous roads. Driving a motorcycle is unique in that even a slight fender bender type of accident can be deadly. On a motorcycle one must practice the most defensive of driving strategies. At a red light, when it turns green, I would always hold off on going until I gave any other traffic one more look. All too often a car would speed through the intersection a full second or two after I had the green to go. Had I gone, even though I then had the right of way, I would certainly have been killed or severely injured. The point being, if we drove our cars as if we were on motorcycles, many accidents would be avoided all together.
I have heard many stories of people taking their right of way only to be hit by other vehicles which failed to yield that right of way. Had they simply waited a bit or yielded themselves a bit, the entire accident would have been avoided. I am reminded of the driver who slammed into a vehicle blocking a road to turn across traffic. The driver who did the slamming had the right of way, true, but seeing the vehicle pulling out or even looking as if they might, the driver could possibly have avoided the collision by simply slowing a bit to see what that other vehicle was going to do before assuming the right of way.
I'm not an attorney but I have heard it said that the law requires all drivers to maintain an adequate lookout for situations such as I have described here. And that brings me to speed limits. People just drive too fast. A speed limit is not the speed one should actually drive, it is the maximum allowable speed IF it is safe to do so. There are many places where the posted speed limit is just too fast for the street in question. Drivers should think about that as they approach intersections.
Then we come to rain and wet roads. I was driving with my daughter a couple of nights ago in some pretty steady rain. Visibility was not too bad but the rain was steady and at times heavy. I was amazed at how fast traffic was going on both the streets and freeways. Many were exceeding the speed limits and driving as if there was actually no change in traction or visibility as the rain continued to pour down. I spent most of the night avoiding others in my efforts to get to where we were going. Incedentally, we saw quite a few accidents.
So, to make a long story short, if we would just drive more watchfully much as a person on a motorcycle should and most do, the number of accidents would be reduced significantly. Assume the other guys are going to do what they shouldn't, assume they are talking on their cell phones or are being distracted in some form or fashion and many, many accidents can be avoided. Drive like an old codger? No. Just drive safe.
But if the unavoidable happens and an injury occurs, get to the doctor as soon as possible.
Thursday, October 17, 2013
Knee Injuries in a Car Wreck?
It is not unusual for people to sustain injuries to their knees in car wrecks. Knees hit dashboards, front seats if a person is in the back seat, doors in side impacts, even stick shifts and steering wheels. When a patient braces for an impact or during an impact, the compressive forces of the bracing can damage the cartilages of the knees, known as the meniscus. In other words, there are many ways the knees can get injured.
Treatment, as always, involves an initial examination, possibly x-rays or MRI to determine the exact nature of the knee injury. If there are tears in a ligament or cartilage, we will usually begin some form of therapy and in most cases refer the patient to an orthopedist to see if there are other treatments needed in addition to the therapies we provide at the Accident and Injury clinic. In most cases all of the treatment needed for an injured knee can be taken care of here with your doctor of chiropractic; physical therapies, active rehab, therapeutic exercises, etc.
So yes, when you get into an accident and you are being evaluated for the first time, if your knee also hurts in addition to your other injuries, be sure to tell your doctor of chiropractic. I have, many times, had patients limp in, only to tell me about their neck hurting but never mention their knees. That is, until I ask them why they are limping.
As always, if you are in a car wreck and have pain, get to the doctor as soon as possible.
Treatment, as always, involves an initial examination, possibly x-rays or MRI to determine the exact nature of the knee injury. If there are tears in a ligament or cartilage, we will usually begin some form of therapy and in most cases refer the patient to an orthopedist to see if there are other treatments needed in addition to the therapies we provide at the Accident and Injury clinic. In most cases all of the treatment needed for an injured knee can be taken care of here with your doctor of chiropractic; physical therapies, active rehab, therapeutic exercises, etc.
So yes, when you get into an accident and you are being evaluated for the first time, if your knee also hurts in addition to your other injuries, be sure to tell your doctor of chiropractic. I have, many times, had patients limp in, only to tell me about their neck hurting but never mention their knees. That is, until I ask them why they are limping.
As always, if you are in a car wreck and have pain, get to the doctor as soon as possible.
My Doctor is a Chiropractor. Do I need to see a specialist?
The simplest answer to that is maybe, maybe not. Exactly what is a specialist anyway? Specialists are doctors who essentially treat a very narrow range of conditions. As far as most of our patient"s and their injuries are concerned, a specialist is usually an orthopedist or neurologist. Some are orthopedic surgeons or neurosurgeons. Their specialty is in the treatment of spines, or knees, or maybe just spines or just knees or just hands, etc, etc.
Of course your doctor of chiropractic is a kind of specialist meaning that we only treat disorders or injuries of the spine or the extremities like the joints of the arms or legs. We don't call ourselves specialists but that is essentially what we do.
So, do you need to see a "specialist"? Again maybe or maybe not. Your doctor of chiropractic will examine, diagnose and treat your neck, back, shoulder or knee injury with various physical treatments which are essentially drug free with the exception of patient's possibly taking over the counter medications such as ibuprofen, acetaminophen or even aspirin. We monitor our patients progress and change their treatment plans accordingly. If, however, a patient's injury is not improving as quickly as we think it should or if the injury is serious enough to warrant it, we will, in many cases, refer our patients to specialists to see if the specialist can offer other treatments in addition to that which we are doing.
Sometimes a specialist will prescribe a medication or suggest some sort of injection to assist the patient's recovery. On rare instances, the specialist might even recommend surgery. But the main point is, if you need to see a specialist, your doctor of chiropractic will refer you to one.
Occasionally we get patients who want to see one right away. That is usually not a problem. They simply need to speak with their doctor of chiropractic about it. There are many good reasons to refer a patient to a specialist for a consultation.
Of course your doctor of chiropractic is a kind of specialist meaning that we only treat disorders or injuries of the spine or the extremities like the joints of the arms or legs. We don't call ourselves specialists but that is essentially what we do.
So, do you need to see a "specialist"? Again maybe or maybe not. Your doctor of chiropractic will examine, diagnose and treat your neck, back, shoulder or knee injury with various physical treatments which are essentially drug free with the exception of patient's possibly taking over the counter medications such as ibuprofen, acetaminophen or even aspirin. We monitor our patients progress and change their treatment plans accordingly. If, however, a patient's injury is not improving as quickly as we think it should or if the injury is serious enough to warrant it, we will, in many cases, refer our patients to specialists to see if the specialist can offer other treatments in addition to that which we are doing.
Sometimes a specialist will prescribe a medication or suggest some sort of injection to assist the patient's recovery. On rare instances, the specialist might even recommend surgery. But the main point is, if you need to see a specialist, your doctor of chiropractic will refer you to one.
Occasionally we get patients who want to see one right away. That is usually not a problem. They simply need to speak with their doctor of chiropractic about it. There are many good reasons to refer a patient to a specialist for a consultation.
Wednesday, October 16, 2013
What's a soft tissue injury?
Every now and then a patient will mention that an insurance adjustor or agent had made the comment that their injury is only a "soft tissue" injury, as if that is not a real or serious injury. Apparently this is a way some people try to minimize injuries sustained in car wrecks. They want to paint a picture of a "victim" pretending to be injured; that any treatment is not needed and fraudulently provided by a clinic/doctor.
Again, as I have said many times about aspects of injuries sustained in car wrecks, nothing could be further from the truth. Of course injuries like concussions, lacerations, open or gaping wounds and broken bones are by far the most serious and even life threatening, but in low speed impacts and many high speed impacts, they are the exception rather than the rule. In fact, technically, many of those life threatening injuries are, themselves, soft tissue injuries.
What are soft tissues anyway? They are the tissues in the body which are not bone although cartilage, as in the knee, might not be considered soft tissue. They are the ligaments, which hold the bones together, muscles and tendons, which attach to bones and provide the forces needed to move and, of course, all the other "soft:" stuff like skin and other connective tissues. We are made of much more "soft" tissue than we are of "non-soft" tissue.
In car wrecks, the tissues most susseptible to injury are the ligaments, tendons and muscles as well as the cartilages of the joints like the knee or shoulder. The big problem with these tissues is that they tend to heal rather slowly if at all. In most cases damage to these tissues is replaced not with healthy tissues but with scar tissue which is not as flexible or strong as the original.
After an injury to these tissues the body surrounds them with an inflammatory process which promotes the formation of this scar tissue form of healing. Therapies provided in our clinic help to promote repair with more normal, functional tissues rather than stiff, inflexible scar tissue. These same therapies also help restore normal motion and function to joints associated with these tissues.
To the "non-believer" I simply point to the treatment of athletic injuries by sports teams with millions of dollars invested in the performance of their athletes. The injuries these athletes sustain are, for the most part, soft tissue injuries. The treatments they receive for their injuries are essentially the same treatments we provide for our patients injured in car wrecks. No one questions the need for treatment of the athletes injuries and thus I don't think anyone should question the need for the treatment of soft tissue injuries sustained in car wrecks; nor should they question or try to minimize these types of injuries either.
Again, as I have said many times about aspects of injuries sustained in car wrecks, nothing could be further from the truth. Of course injuries like concussions, lacerations, open or gaping wounds and broken bones are by far the most serious and even life threatening, but in low speed impacts and many high speed impacts, they are the exception rather than the rule. In fact, technically, many of those life threatening injuries are, themselves, soft tissue injuries.
What are soft tissues anyway? They are the tissues in the body which are not bone although cartilage, as in the knee, might not be considered soft tissue. They are the ligaments, which hold the bones together, muscles and tendons, which attach to bones and provide the forces needed to move and, of course, all the other "soft:" stuff like skin and other connective tissues. We are made of much more "soft" tissue than we are of "non-soft" tissue.
In car wrecks, the tissues most susseptible to injury are the ligaments, tendons and muscles as well as the cartilages of the joints like the knee or shoulder. The big problem with these tissues is that they tend to heal rather slowly if at all. In most cases damage to these tissues is replaced not with healthy tissues but with scar tissue which is not as flexible or strong as the original.
After an injury to these tissues the body surrounds them with an inflammatory process which promotes the formation of this scar tissue form of healing. Therapies provided in our clinic help to promote repair with more normal, functional tissues rather than stiff, inflexible scar tissue. These same therapies also help restore normal motion and function to joints associated with these tissues.
To the "non-believer" I simply point to the treatment of athletic injuries by sports teams with millions of dollars invested in the performance of their athletes. The injuries these athletes sustain are, for the most part, soft tissue injuries. The treatments they receive for their injuries are essentially the same treatments we provide for our patients injured in car wrecks. No one questions the need for treatment of the athletes injuries and thus I don't think anyone should question the need for the treatment of soft tissue injuries sustained in car wrecks; nor should they question or try to minimize these types of injuries either.
Tuesday, October 15, 2013
I am hurting after a car wreck but my car isn't damaged.
When a car wreck occurs, if the cars have sustained a lot of damage, it is all too obvious that the drivers or passengers might be hurt. But many times, the driver and passengers are hurting but the car looks fine. This is common in what most refer to as fender benders, but make no mistake, if there is pain, then there is probably an injury of some sort. The best thing to do if you are hurting, no matter how good or bad the car looks, is to get to the doctor for an evaluation.
It is a misconception that the occupants of a vehicle cannot be hurt if the vehicle itself is not damaged. A group in California headed by Dr Croft of the Spine Research Institute of San Diego, have run test collisions at low speeds with slow motion camera's focused on the drivers and passengers. Their findings are remarkable, showing the violent nature of the head and body motion in collisions which leave the vehicles with little or no damage.
Certainly, there are many low speed collisions where no one is injured and that is great. But in many cases such as this, the next day the occupants of the vehicles find that they have neck and/or back pain, headaches and stiffness. How can this be? Well, simply put, its basic physics. For example, when a vehicle is struck from behind, it moves immediately forward whereas the head remains still and from the side has the appearance of being thrown backwards into the head rest. The head rest then springs the head forward and the head is snapped when the body hits the seat belts, stopping the body's forward motion but not the head's.
This type of injury is called an acceleration/deceleration injury, aka - whiplash. Damage can occur to the ligaments and muscles of both the front and back of the neck. Basically, its a neck sprain/strain much as it might be if you sprained your ankle. Over the next few hours to days inflammation builds up around the damaged tissues with swelling, pain and stiffness. The bad thing about this swelling and pain is that its pressing against your neck, head and even your spinal cord, not just your tennis shoes.
Interestingly, if there is no damage to the vehicle, then the laws of physics tell us that the force, or more specifically the momentum of the vehicle, is transferred to the occupants. In fact, at these low speeds, if the vehicle body work or bumper were to cave in a bit, there would be a lessening of the impact on the occupants. But cars bumpers are designed not to cave in and actually spring back, transferring that momentum almost directly to the occupants.
So, make no mistake, injury can occur even if there is no damage to the vehicles. A person knows it by the pain they might be feeling. In fact, one should NEVER try to judge injury based upon the amount of damage to a vehicle. If no pain or stiffness is present and none develops, then there is probably no injury. But if its there, don't ignore it. Get to the doctor.
It is a misconception that the occupants of a vehicle cannot be hurt if the vehicle itself is not damaged. A group in California headed by Dr Croft of the Spine Research Institute of San Diego, have run test collisions at low speeds with slow motion camera's focused on the drivers and passengers. Their findings are remarkable, showing the violent nature of the head and body motion in collisions which leave the vehicles with little or no damage.
Certainly, there are many low speed collisions where no one is injured and that is great. But in many cases such as this, the next day the occupants of the vehicles find that they have neck and/or back pain, headaches and stiffness. How can this be? Well, simply put, its basic physics. For example, when a vehicle is struck from behind, it moves immediately forward whereas the head remains still and from the side has the appearance of being thrown backwards into the head rest. The head rest then springs the head forward and the head is snapped when the body hits the seat belts, stopping the body's forward motion but not the head's.
This type of injury is called an acceleration/deceleration injury, aka - whiplash. Damage can occur to the ligaments and muscles of both the front and back of the neck. Basically, its a neck sprain/strain much as it might be if you sprained your ankle. Over the next few hours to days inflammation builds up around the damaged tissues with swelling, pain and stiffness. The bad thing about this swelling and pain is that its pressing against your neck, head and even your spinal cord, not just your tennis shoes.
Interestingly, if there is no damage to the vehicle, then the laws of physics tell us that the force, or more specifically the momentum of the vehicle, is transferred to the occupants. In fact, at these low speeds, if the vehicle body work or bumper were to cave in a bit, there would be a lessening of the impact on the occupants. But cars bumpers are designed not to cave in and actually spring back, transferring that momentum almost directly to the occupants.
So, make no mistake, injury can occur even if there is no damage to the vehicles. A person knows it by the pain they might be feeling. In fact, one should NEVER try to judge injury based upon the amount of damage to a vehicle. If no pain or stiffness is present and none develops, then there is probably no injury. But if its there, don't ignore it. Get to the doctor.
Friday, October 11, 2013
What can I do as a patient to help my injury heal?
There are many things patients can do to help speed up their recovery from an injury sustained in a car wreck or other accident. Of course the most important thing is to get to the doctors at Accident and Injury Chiropractic for examination to determine if care is actually needed. If it is determined that a patient needs treatment, the doctor at Accident and Injury will formulate a treatment plan for you. The treatment plan will state what types of treatment a patient needs and how often it needs to be performed.
The next most important thing a patient can do to help recover more quickly is to follow the treatment plan as closely as possible. Patients should do their best to avoid missing appointments. If a patient isn't there for care, then they cannot benefit from it and their recovery period will be that much longer or greatly delayed if not actually impeded. Follow your doctors plan for you.
Patients are usually advised about things they can also do for themselves at home or work to help their injuries get better. Thinges like ice packs (cryotherapy) and over the counter medications can be used. Sometimes a patient will be advised on some stretches or home exercises that they will need to perform on their own at home. There are many things whicha doctor might have the patients do at home day to day as part of their over all treatment plan in addition to the treatment that is provided at the clinic.
The important thing is that the patient do as advised, follow the treatment plan and take that positive action towards recovery.
The next most important thing a patient can do to help recover more quickly is to follow the treatment plan as closely as possible. Patients should do their best to avoid missing appointments. If a patient isn't there for care, then they cannot benefit from it and their recovery period will be that much longer or greatly delayed if not actually impeded. Follow your doctors plan for you.
Patients are usually advised about things they can also do for themselves at home or work to help their injuries get better. Thinges like ice packs (cryotherapy) and over the counter medications can be used. Sometimes a patient will be advised on some stretches or home exercises that they will need to perform on their own at home. There are many things whicha doctor might have the patients do at home day to day as part of their over all treatment plan in addition to the treatment that is provided at the clinic.
The important thing is that the patient do as advised, follow the treatment plan and take that positive action towards recovery.
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