Pourquoi le coup de fouet cervical se transforme en douleur chronique
Le coup de fouet cervical est l'une des blessures aiguës les plus courantes qui entraînent des douleurs chroniques. Étant donné que de nombreux cas ne sont pas signalés, nous ne savons pas exactement à quelle fréquence le coup de fouet cervical se produit. Certaines sources estiment que jusqu'à 3 millions de personnes souffrent de coup de fouet cervical aux États-Unis chaque année.
Studies show that at least half of the people who experience whiplash go on to develop chronic neck pain and related symptoms, collectively referred to as “whiplash associated disorders.” Researchers recognize that one reason why so many people suffer long-term effects is because doctors have “thus far been unable to fully characterize the condition.”
Dans ce post, je vais discuter:
- Les structures anatomiques qui peuvent être blessées en coup de fouet cervical
- Les diverses causes et symptômes du coup de fouet cervical
- Recherche sur la cause des troubles associés au coup du lapin
- Comment guérir des troubles associés au coup du lapin avec Somatiques Cliniques des exercices
Qu'est-ce que le coup du lapin ?
Le coup de fouet cervical se produit généralement dans les accidents de voiture lorsque la tête et le cou sont d'abord projetés vers l'arrière en hyperextension, puis vers l'avant en hyperflexion à partir de l'impact. Cependant, comme vous l'apprendrez dans la section suivante, il existe d'autres activités qui provoquent également un coup de fouet cervical. Le coup de fouet cervical peut également se produire lorsque la tête est soudainement projetée d'un côté à l'autre, comme lorsqu'une voiture est désossée en T.
Le degré de mouvement soudain et extrême peut blesser de nombreuses structures du cou et des parties environnantes du corps :
Muscles in the neck and shoulders can be strained or thrown into spasm
Ligaments that connect the cervical vertebrae and skull can be sprained
Cervical facet joints (the joints in between vertebrae) and the atlanto-axial and atlanto-occipital joints (the junction between the neck and skull) can be damaged
Cervical intervertebral discs can bulge or herniate
Cervical vertebrae can be dislocated or fractured
Joints adjacent to the neck (temporomandibular joint and joints in the thoracic spine, ribs, and shoulders) can be damaged
Nervous system structures including nerve roots, the spinal cord, and brain can be damaged
Vascular system structures including the vertebral artery and internal carotid artery can be stretched and torn
Vestibular system structures of the inner ear can be damaged
Causes du coup de fouet cervical
Le coup de fouet cervical peut se produire dans une variété d'activités qui impliquent un mouvement ou un impact soudain à la tête :
- Accidents de la route
- Abus physique ou agression ; être frappé ou secoué
- Sports comme le football, la boxe, le karaté, le hockey, le hockey sur gazon, le volleyball, le basketball et le soccer
- Accident de vélo
- Monter à cheval
- Saut à l'élastique
- Manèges de parc d'attractions
- Chutes dans lesquelles la tête se balance violemment en arrière
Symptômes du coup de fouet cervical
Les symptômes du coup de fouet cervical se développent généralement dans les 24 heures suivant la blessure et peuvent inclure :
- Douleur et raideur au cou
- Amplitude de mouvement limitée dans le cou
- Maux de tête, commençant le plus souvent à la base du crâne
- Tendresse ou douleur dans les épaules, le haut du dos ou les bras
- Fourmillements ou engourdissements dans les bras
- Vertiges
- Commotion cérébrale
- Acouphènes (bourdonnement dans les oreilles)
- Problèmes visuels
- Perturbations de sommeil
- Fatigue
- Perte de mémoire et de concentration
- Irritabilité
- La dépression
Pourquoi le coup de fouet cervical se transforme en douleur chronique
Some research estimates that 50% of whiplash sufferers go on to develop long-term symptoms. A 20-year prospective study found the number to be higher; of 193 people who had experienced whiplash, 66.9% developed chronic related symptoms. These symptoms included stiff shoulders, neck pain, headache, numbness or pain in the upper limbs, and tinnitus. Unfortunately, as I mentioned earlier, doctors have struggled to determine a consistent cause of these long-term symptoms.
Orthopedic surgeons from London conducted a four-year study of 1025 whiplash sufferers in an effort to understand the cause of long-term whiplash symptoms. They found that the “only totally consistent findings are reduced range of motion and dysfunction of the trapezius muscle.” The researchers suggest that whiplash rehabilitation should target neck stiffness and trapezius dysfunction in particular.
Another study used surface electromyography (EMG) to measure cervical muscle dysfunction in whiplash sufferers. The study found that people with whiplash associated disorders had higher levels of muscle tension than healthy control subjects in their upper trapezius muscle during physical exercise, and a significantly decreased ability to relax the upper trapezius after exercise.
About a second after the head is forcefully thrown or hit, neck muscles reflexively contract in an attempt to stabilize the head. After the injury, the muscles of the neck, and often the shoulders and back as well, remain contracted to splint the injury. Not surprisingly, nearly 9 out of 10 whiplash sufferers have some degree of muscle spasm following the injury.
From my perspective as a somatic educator it seems obvious that like these two studies found, chronic muscle contraction is a likely cause or contributor to many whiplash associated disorders. Chronically contracted muscles feel stiff and painful, and restrict movement of the neck. They limit blood flow, slowing the healing process of injured discs and connective tissues. Tight muscles also compress the spine, potentially causing nerve impingement, inflammation, and disc and joint degeneration.
Reflexive muscle contraction often continues long after a structural injury has healed, because muscle contraction becomes learned by our nervous system. The more often we repeat a muscle contraction, the more deeply learned it becomes; this is what we refer to as muscle memory. So the longer it takes for structural whiplash injuries to heal, the more likely it is that the surrounding muscles will continue to splint the painful area and remain chronically, subconsciously contracted for years.
Another factor that increases the likelihood of developing chronic muscle tension is the emotional trauma of being in a car accident or experiencing any event that causes injury. Strong negative emotions not only trigger muscle tension but also cause that muscle tension to become deeply learned quickly. Instead of requiring many repetitions like practicing your tennis swing, your nervous system immediately learns to keep certain muscles tight, and links that subconscious muscle tension with your emotional state. Researchers have found that an important predictor of whiplash associated disorders 12-14 years later is being in a negative emotional state in the days following the injury. And a study of 6,000 whiplash sufferers found that those who had a positive attitude about their recovery actually recovered more than three times faster than those who didn’t, and those who had low expectations of complete recovery were four times more likely to experience long-term symptoms.
Traiter les troubles associés au coup du lapin avec Somatiques Cliniques des exercices
Clinical Somatics exercises are an ideal method of recovery for many whiplash associated disorders because pandiculation is the most effective way to release subconsciously held muscle tension. In addition, the exercises are extremely slow and gentle, and can be modified or substituted if the position or movement is painful.
Les personnes souffrant de douleur chronique et de mobilité réduite résultant d'un coup de fouet cervical devraient travailler en relâchant tous les muscles du cou, des épaules, du haut et du bas du dos, de la poitrine et de l'abdomen. Même si la douleur n'est pas présente ou si la tension n'est pas ressentie, la musculature de tout le haut du corps s'est adaptée à la blessure, et le schéma général de tension et de posture doit être traité afin de faire des progrès durables. La libération des tensions musculaires chroniques préviendra également la future dégénérescence de la colonne vertébrale et soulagera souvent le conflit nerveux en réduisant la pression sur la colonne vertébrale et les nerfs rachidiens.
Following is a list of exercises from the Level One and Level Two Courses that are particularly helpful for whiplash associated disorders. If any of the exercises increase your pain, skip them for now. I’ve made a few notes about modifications.
Cours de Niveau Un
Arch & Flatten: If this or any exercise in which you lie on your back is uncomfortable for your neck, put a folded towel or thin pillow under your head and neck. Only use as much padding is needed to make your neck comfortable; don’t overdo it. Reduce the padding as you are able to.
Back Lift: If turning your head to the side is not comfortable, you can do this with your neck straight and head facing the floor, with your forehead on the floor so that the back of your neck stays long.
Upper trapezius release: This is at the end of the Bonus Video: “Ultimate Pandiculation.” This exercise can be done standing or sitting upright.
Arch & Curl: Same modification as Arch & Flatten if necessary.
Side Curl: Be sure to support the weight of your head with your hand. If the movement is still not comfortable, then do just the lower body part of this movement—it will still help to release your obliques.
One-sided Arch & Curl: Same modification as Arch & Flatten if necessary.
Diagonal Arch & Curl: Same modification as Arch & Flatten if necessary.
Washcloth: Start by focusing on just the upper body part of this exercise.
Shoulder releases: These are in the Bonus Video: “Carpal Tunnel Exercises.”
Flowering Arch & Curl: Same modification as Arch & Flatten if necessary. Start by focusing on just the upper body part of this exercise.
Cours de Niveau Deux
Head Lifts: Same modification as Arch & Flatten if necessary.
Lower Back Release: Same modification as Arch & Flatten if necessary.
Exercice Proprioceptif 1
Scapula Scoops Part 1: Same modification as Arch & Flatten if necessary.
Scapula Scoops Part 2: Same modification as Arch & Flatten if necessary.
Diagonal Curl: Same modification as Arch & Flatten if necessary.
Directions de l'épaule
Shoulder, Elbow & Wrist Releases: Same modification as Arch & Flatten if necessary.
Twist assis
Debout Libération des Ischio-jambiers
Assise Libération des Ischio-jambiers
Lifting de la tête et des genoux
Exercices du visage et de la mâchoire
Lecture recommandée:
The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE
Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna
