Unfortunately over a quarter of Americans have been in a car accident or motor vehicle collision (MVA) in the last five years and statistically most Americans will be involved in at least one car accident in their lifetime. Collision avoidance systems are quickly improving and eventually we might all be riding in (I can't say 'driving' because we won't be!) Google's driverless car, which should drastically reduce car accidents, but we are not quite there yet. Watch this video to see what the future holds:

Car accidents can cause many injuries, but one of the most common injuries are those referred to as 'whiplash injuries'. People who suffer these injuries often complain of neck or back pain, stiffness, headaches, and can be diagnosed with a cervical disc herniation, nerve impingement, and/or facet joint injuries. Whiplash injuries are caused by rapid hyperextension and then hyperflexion of the cervical spine during the typical rear-end collision. 

While making sure your headrest in the proper position or getting a car with an active head restraint can help reduce injury rates, have you ever thought about how important your posture can be to preventing injury from a car accident? 

The position your cervical spine is in when you are rear-ended can mean the difference between a severe injury and a mild injury. When sitting relaxed, if you have a normal cervical lordosis this can prevent or minimize injury to your neck. 

Forward head posture greatly increases the risk and severity of injury during car accidents. 

Bone and joint position, which is dictated by muscle strength and tension, is essential for injury prevention whether we are talking about an ACL tear, rotator cuff injury, meniscus damage, or cervical injury from a car accident. Cervical lordosis puts the bones, ligaments, tendons, muscles, nerves, fascia, blood vessels, and spinal cord in their most protected position and will minimize stress during a car accident. 

Forward head posture typically produces lower cervical flexion and upper cervical hyperextension which means the upper cervical spine is vulnerable to facet joint injuries and the lower cervical spine to disc injuries from whiplash. 

If someone has lower cervical flexion typically sitting on top of thoracic kyphosis, during a rear-end collision the thoracic spine and lower cervical spine are unable to absorb the rapid extension which can cause a spondylolisthesis or herniated disc in the cervical spine. 

Lowering your risk of whiplash injuries starts with correcting any postural imbalances you have especially thoracic and cervical spine position. Most people have excessive thoracic flexion or kyphosis and the accompanying lower cervical flexion and possibly upper cervical hyperextension. The kyphosis is the first thing that needs to be addressed because without getting more thoracic extension the cervical spine will not be able to move into and stay in a better position. It is important to remember that the body works as a unit and the kyphosis might very well be caused by a pelvis imbalance. Both an excessively posteriorly tilted pelvis and an excessively anteriorly tilted pelvis can cause compensation in the thoracic spine that causes kyphosis. 

If you have been involved in a car accident and suffered a whiplash injury or would like to prevent neck or spine injury, I would highly recommend getting your posture evaluated by an Egoscue certified Postural Alignment Specialist and Advanced Exercise Therapist with experience treating these types of injuries. 

I would be happy to offer a FREE posture evaluation and consultation to anyone interested in learning more about why their injury isn't healing and learning how Postural Alignment Therapy can help them get back to living a pain free and active life. 

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Spondylolisthesis is a forward slipping of one vertebra, typically L5, on the vertebra below. A spondylolisthesis, or "spondy" for short, can be classified as a grade 1, 2, 3, or 4 depending on how far the vertebra has slipped out of position. If you have been diagnosed with a spondy the question you want to find the answer to is: "what caused the spondy?" 

First you must remember that the body works as a unit, which means don't just focus on the spondy, but rather what is happening above and below the spondy and throughout the rest of the body that might be contributing to or causing the vertebra to slide out of position. 

Areas I always look at are:

• Pelvis - Is the pelvis anteriorly or posteriorly tilted? Does the pelvis has good movement or is it limited in its range of motion?
• Spinal column - Is there a normal curve throughout the spinal column or any areas of excessive flexion or extension? Does the spinal column have good range of motion into flexion and extension or are there sections that either don't move much or move excessively?
• Load joints - Are the eight load bearing joints (ankles, knees, hips, shoulders) of the body vertically aligned and if not, what joints are out of alignment and how? Do all load joints have normal range of motion or, if limited, which ones and how?

Looking at these other parts of the body will give us clues as to why the body has caused a spondylolisthesis and help direct us to what we need to correct posturally and biomechanically to relieve the symptoms and prevent further damage to the spine. 

Surgery is often brought up as a treatment option, mostly when symptoms are severe, but surgery is only going to treat the symptom of the slipping vertebra not the cause of the slipping vertebra. Surgeons will usually tell you that many people who they operate on for a spondy will be back in the office for another spondy surgery a couple years later because they have developed another spondy. Why? Because that person never addressed the postural and biomechanical reasons why the spondy occurred in the first place, they only had surgery to address the symptom. 

Watch this video to learn more about spondylolisthesis:

I have worked with many clients with spondylolisthesis of varying grades and differing levels of pain and most have done very well with Egoscue therapy and the simple posture exercises we use to correct postural alignment. Most clients have relieved their pain and been able to return to a fully active and pain free life. 

If you would like to learn more, discuss this further, or for a free posture evaluation and consultation, contact Matt at matt@oregonexercisetherapy.com or 971-279-2189

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Matt's segment starts at 12:20 into the show.

Interesting article from the Stanford School of Medicine, talks about how having more MRI machines may actually be a bad thing for many people. This is because more MRI machines means more MRI scans which means people with new-onset back pain or knee pain get MRI’s sooner which leads to more back and knee surgeries which have not shown great results.

So if you suffer from lower back or knee pain, whether you’ve had a MRI or not, what should you do?

Maybe running to your doctor to get an MRI is not the most important thing.

What does getting an MRI tell you?

It will tell you about the symptom. The symptom might be showing up as arthritis or a disc herniation or a facet joint problem or meniscus tear or maybe nothing shows up and you are told it’s just muscles spasms or stress.

We all know what symptoms are: they are the outward expression of something internally going on. One of the most common symptoms we have all experienced is a runny nose. We can take something to stop the runny nose but why is our nose running? It could mean we have a bacterial infection or it could be a viral infection. Or it could be we were running outside in the cold morning air and nothing more. Treatments for the bacterial infection are different than for the viral infection and very different for the run outside. Using the incorrect treatment can result in no change to the symptom or worse yet it could cause a new symptom that might be worse than the original (and even contribute to the antibiotic resistance strains of bacteria that has been building over the last couple decades).

Another great example is a headache. A brain tumor can cause a headache, but it’s not very common obviously. But what if we treated all headaches like they were caused by a tumor. We’d be slicing and dicing millions of peoples brains every year and they’d still have their headache (and less brain cells – hopefully not important ones!) because it was not caused by a tumor but by drinking too much wine, not drinking enough water, forgetting to eat for 10 hours, or slouching at work all day.

It is easy to see how this would be crazy, but that’s what surgery is turning into in this country.

You go to your doctor and tell them your back hurts and your doctor says:

          “You have back pain? Let’s do an MRI.”

When the results come back, they say:

          “Oh, look, a little herniation. We can fix that with surgery.”

The person thinks the herniation is the problem, but comes out of surgery and 2 weeks later the pain returns. What’s going on?

Same goes for knees, hips, feet, shoulders, wrists, etc. We have become quicker and quicker to use our high-tech (and high cost) surgery to try to fix the symptom, without looking for the cause or source of the problem.

The key to discovering the source of the problem? Ask more questions.

• Why did the disc herniate?
• If the arthritis is because of my age, why does only my right hip hurt?
• If running caused my meniscus in my knees to wear away, why don’t all runners have the same problem?
• If I have surgery, what will guarantee that the problem doesn’t come back again?
• Why did the rotator cuff tear?
• If it is genetic, why does only one of my siblings have the same problem and the other two don’t?

Then follow your intuition. Your gut feeling. And what makes common sense. 

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