Impingement symptoms after low velocity car accidents: Is there a whiplash of the shoulder joint?
After low-velocity rear-end accidents, a plethora of symptoms can arise. In addition to neck pain, there are particularly complaints radiating into the shoulder, which can either radiate from the trapezius or be localized in the shoulder joint, which in turn can radiate back into the neck.
In 9% of cases, signs of impingement can be present. We examined patients with impingement signs from an expert clinic. In their case, clinical criteria for impingement had to be fulfilled.
It was found that patients are generally older and female. Manual laborers recovered from complaints faster. MRI and ultrasound showed pre-existing degenerative changes up to tears in the rotator cuff. Signs of a seatbelt injury could not be found.
The examiner and expert can assume that the type of accident is not suitable for causing bodily harm. Studies have shown that patients develop an altered scapulothoracic rhythm.
We argue that acceleration/deceleration alters proprioception and thus muscular guidance. This, in turn, leads to functional impingement, which makes pre-existing changes clinically apparent. This would also explain why complaints can develop on both sides or only on the non-seatbelted shoulder.
The therapy consists of targeted physiotherapy aimed at stabilizing the shoulder girdle muscles rather than focusing on the neck muscles.
Literature
