Gareth Sneath, PT, MCPA, MScCH Grad Dip Man Ther

 “Whiplash” (N) a rapid, uncontrolled movement of the neck backwards and forwards when hit from behind in a rear end car collision.

 As a physiotherapist I assess and treat many people who have sustained a whiplash type of injury. The consequences of this common injury can be painful, debilitating and require time and effort to recover from something that can often be prevented or minimized. While most patients recover there is a small percentage who go on to develop persistent pain and limitations which impact function and enjoyment of everyday life.

 Fortunately there is a simple and effective way to prevent this injury from happening and/or to reduce the damage to the tissues caused by a rear end car collision. Taking a moment to properly position your head restraint can pay off by avoiding the months of physiotherapy needed to help you recover.


 The answer to limiting and/or preventing “Whiplash” is to stop the neck from going too far into extension (backwards). This is the primary purpose of your head-rest however many people don’t have these safety structures properly set-up. Follow these simple tips to help to limit the likelihood of sustaining a whiplash.

  1. Ensure that the head rest is correctly positioned behind your head, no more than 2-3 inches away from the back of the skull. This may involve pulling the head rest forward or sitting up a bit straighter.
  2. The top of the restraint should be at least at the level of your ears and preferably at the top of your head. This position blocks the head and restricts the backward movement of the head to limit extreme, uncontrolled extension.
  3. Remember to consider passengers in the rear seats. If head restraints are available make sure these are properly adjusted.


Why does the neck injure more often when we are hit from behind?

 Even a relatively low speed collision can cause neck pain when you are in a car that is hit from behind. The problem is that in a rear end collision both you and the car accelerate forward quickly. Your heavy head “lags” behind your body and this rapidly forces the neck into extension (extension is the movement when you look up to the ceiling).

In everyday life extension normally does not injure our neck as we do it slowly and in a controlled manner. When the movement is too quick, the joints and soft tissues are forced into an extreme, compressed or stretched position. Your muscles, particularly those at the front of your neck, don’t have time to react to protect and limit this extreme movement. This strains the tissues causing pain and spasm.


In the event of an injury causing symptoms you may need medical advice and treatment from a health care professional. The first step is to exclude more serious injuries. Applying the cervical spine rules assists your health professional in determining if you need imaging such as an XRay.

If the diagnosis is a soft tissue strain the application of ice and rest is often the first course of therapy. Persistent  severe symptoms lasting longer than a week that cause reduced function should be evaluated by your physician or physiotherapist.

 Treatment is determined by your pain and by determining the structures that have been injured and how this impacts function. Initially therapy will focus on helping you to control the pain while you heal. As you improve the focus will shift to restoring strength, regaining flexibility and returning you to your full roster of daily activities.

 Funding for your treatment

 After an accident you should contact your insurer. In Ontario, once your claim is established your insurer will send you a series of forms that need to be completed to help you to have your therapy treatments funded. For more information on this process go to our website at

The Financial Services Commission of Ontario (FSCO) website also has helpful information on this process at

Gareth Sneath, PT, MCPA, MScCH, Grad. Dip Man. Ther., is a Toronto based licensed physiotherapist working at the Orthopaedic Therapy Clinic in downtown Toronto. He has over 30 years of providing treatment for clients with muscle and joint injuries in teaching hospitals and in private practice.

The recommendations and opinions expressed above are a guide and are not meant to substitute advice or treatment from your health care professional. A properly positioned head restraint will only reduce head and neck movement going backwards and will not prevent movements caused by forces from other directions.