Bill Gallagher 2014-07-26 00:33:22
The Importance of Cervical Sprain All too often when I speak with an attorney about cervical sprains the response is “like a sprained ankle?” In part that assumption is correct, but for the most part it leads far from the truth about the extent and permanency of an injury. To be clear, a sprain is an injury to a ligament – the dense connective tissue that holds bones together. To that extent the ligaments in your ankle are very similar to the ligaments in your neck. In both cases the purpose of ligaments it to hold bones together and limit how much motion is allowed across any joint. Beyond that the differences are as much as night and day. The Differences: In the ankle, ligaments hold the tibia and fibula to the tarsal bones allowing for stability and flexibility of motion. When an ankle is sprained ligaments are stretched beyond their limits. The involved joint becomes less stable and loses some of its flexibility. The ligaments of the neck offer the same with two major differences. First, the ALL and PLL (anterior and posterior longitudinal ligaments) are broad bands of fiber that not only hold the bodies of the vertebrae together but also form a barrier that helps keep the discs in place. When these ligaments are sprained there is greater translation, motion front and back between two vertebra as well as increased angular motion, the hinging movement between them. More than that is the weakness that allows for the weight pushing down on the spine to cause the disc to bulge where the support of the sprained ligament is lost. This pressure on the discs without the supporting ligaments will decrease the height of the disc space and in doing so decrease the space available for nerve roots to pass through. Ultimately, this is a leading cause of paresthesia and radiating pain. The Healing Process: Healing occurs along the lines of stress. If you break an arm or leg and immobilize it with a cast the fibers of repair are laid down along the length of the bone. When the process is complete the area where the fracture occurred will actually be stronger than the bone on either side of it. Ligaments are different. The lines of stress for ligaments are far more random. Unlike bones, ligaments are designed to allow for motion. As such the fibers of repair are laid down more randomly. This creates a healing site that is inherently weaker than the tissue around it. This also creates an area that is more susceptible to future injury. Long-Term Effects: Athletes who have suffered a severe ankle sprain and spent a week or two on crutches can tell you, that down the road it is more than just a sprained ankle. That weakened joint will affect motion not just at the ankle. Over time compensating for the injury will create additional stress to the knees and hips. This is why aging athletes may not walk so well. Someone who has suffered from a whiplash injury will likely stretch those two main ligaments along with several others in their neck. This can lead to a bulging disc and impingement of a nerve root. Like the athlete who is more susceptible having once sprained an ankle, someone who has had a whiplash will be far more likely to be injured in the next accident. This is because the strong ligaments that supported through the first trauma no longer have the integrity to protect in the next accident. Conclusion: So what is the bottom line for your client’s case? For that all we need to do is look at how the AMA Guides 6th Edition rates these injuries. For an ankle sprain with measurable instability and the need for orthotics the rating will be at 6 percent. Similar findings on a cervical sprain with measurable instability and nerve root involvement will earn a whole person permanent impairment of up to 28 percent (To give even more perspective a first heart attack will be rated as high as 23 percent.) Both sprains are measurable and both have long-term adverse effects but clearly a cervical sprain is not like a sprained ankle. Dr. Bill Gallagher, DC has been in practice using Directional Non- Force Technique for over 25 years. His research for the technique has led to improvements of adjustments in all areas of the body. He can be reached by email at firstname.lastname@example.org or (480) 664-6644. For more information visit, www.drbillgallagher.com
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