The truth about low impact injuries

Low Speed Auto Accidents
Thousands of car accidents occur everyday. And every day thousands are injured. Researchers note that the majority of auto accident injury claims occur at relatively low speeds of about 12 mph or less.
Car Accident Disputes
This causes tremendous disputes between injured parties and the insurance companies that are responsible for compensating them for their car accident claim. To insurers, there really is no speed at which they want to admit an injury could occur. For economic reasons they try to dismiss whiplash or car accident injuries entirely, as if they don’t exist.

Thanks to recent irrefutable research studies proving the existence and exact mechanism of whiplash car injuries, insurers are hard pressed to try the “whiplash is a hoax” defense nearly as much as in the past.

A more recent tactic is to claim the speed of the collision is too low to cause injury. Enter the “low speed collision” or “slow speed collision” defense. The defense often relies on their insured’s reports of how fast they were going when they ran into the back of the other party-obviously biased data.

Other times photographs of the vehicle damage is used to show a low speed car accident. Often, the photographs are shown to an Accident Reconstructionist who by merely looking at photographic damage of a car crash then renders an opinion on how fast the vehicles were traveling. They will even go so far to make statements such as “the evidence suggests there was insufficient force to cause human bodily injury…” This would be laughable if it didn’t cause so many problems for injured car accident victims. By the way, in most states Auto Crash Reconstructionists are only allowed to testify or ender an expert opinion as to vehicle damage. They are not trained to determine bodily injury.

The Truth
Here are but a few facts concerning motor vehicle injuries and their relationship to speed with supporting scientific evidence.

Three different studies (Panjabi, Panjabi and Cholewicki and Kaneoka) proved the mechanism by which the neck is injured by a rear impact force simulating a car accident. [1], [2], [3] The studies involved simulating a rear impact collision on live human test subjects and recording the results with cineradiography (high speed motion x-rays). The researchers found that the neck was injured by deforming into an “S- shaped” configuration within fractions of a second of the impact before the occupant is aware of the impact and before reflexes can protect them. All three of these studies found that this physical event occurred at speeds as low as 2.5 mph. In other words, when they simulated car crashes sufficient to cause the head to move in relationship to the body at a rate of 2.5 mph, injuries were recorded.

The radiographically proven human threshold for injury in a rear impact auto accident therefore is 2.5 mph. Other authors have disputed these figures and some insurance company sponsored studies have found the threshold to be closer to 5 mph.

For the sake of argument, let’s stipulate that the 5 mph threshold is correct. It still means that a collision of only 5 mph can cause damage to the neck.

Freeman et. al. in Spine, Vol. 23, Number 9, 1998, p. 1046 shows the damage thresholds for many cars. This is the minimum speed required to cause the car to show visible signs of damage. The smallest, lightest vehicle listed was the 1980 Toyota Tercel, which required a collision of 8.1 mph to become damaged. On the other end of the spectrum was the 1989 Chevrolet Citation, which required 12.7 mph. A Ford F-250 pick up required 11.7 mph.

Cars built today are equipped with rear bumpers designed not to show any damage below 5 mph. In an attempt to reduce repair costs shouldered by insurance companies, crash standards were adopted to mandate rear bumpers must withstand a 5 mph collision into a fixed barrier (wall, pole, etc) without any visible evidence of damage. It should be noted that this standard involves testing of “vehicle to barrier” crashes not “vehicle to vehicle” testing.

Hitting a pole as in “vehicle to barrier” testing yields more damage at lower speeds. The barrier does not move or absorb any energy.

In “vehicle to vehicle” crashes where the bumpers line up well, it takes considerably more force to cause visible bumper damage than a 5 mph collision. Some tests have shown that cars could be crashed repeatedly at 20 mph and not show outer damage. In a “vehicle to vehicle” crash it is estimated that the minimum speed to cause visible damage is approximately 15 mph.

What happens to the occupant in these collisions is what matters. If you are backing up in a parking lot and run into a pole at 6 mph. You will feel a crunch and a bump. You’ll be startled and upset about your bumper, but it is unlikley you’ll be injured.

On the other hand, if you are stopped in a parking lot waiting for a space and another vehicle strikes you at 12 mph (the average speed of a car in a parking lot) you will likely feel a tremendous jolt, hear a loud bang and your car will be pushed forward a few feet. It is probable that your neck will be injured, although it may not show up for hours or days, but your bumper may not even show a dent.

In the first scenario all the energy of the crash was absorbed by the bumper. In the second, some of the energy was bled off into the two vehicles, but much of it was transmitted into your body causing your neck to deform into the “S” configuration resulting in injury.

Another consideration is that while a bumper may look undamaged from the outside after a collision, inside under the skin, the foam or plastic may be crushed or cracked. This is not seen from the outside, so photographs would make it appear as if no damage was sustained. Still further, the bumper may appear intact, but on unibody vehicles, the unibody may be bent or deformed by a collision. This may not be apparent and some auto repair facilities may miss it.

So what does this mean? It means that if you are rear-ended and your bumper is cracked, dented, or misplaced at all, your collision involved speeds in excess of 15 mph. That’s 3 times the human threshold for injury if we use the 5 mph figure. In reality, the proven threshold is only 2.5 mph, so a collision of 15 mph is 6 times the threshold for injury.

Now let’s say your vehicle sustained no visible damage, but your neck hurts after the collision. Does that mean you weren’t really injured? No. It means that the vehicle’s threshold for damage was not exceeded. The impact could have been 10 mph. Too low for bumper damage, but still 4 times the threshold for human injury.

In a low speed collision, the kinetic forces that are transferred from the other vehicle into your vehicle are not dampened or bled off by your bumper. Instead, the force is transmitted through the vehicle, into your seat and to your neck resulting in injury. If your body or neck are jolted or jerked by the impact, an injury could occur.

Another aspect to consider is if your vehicle is moved forward by the impact. An average car weighs close to 4,000 lbs. Let’s say you are hit from behind and your car is pushed forward a few feet, but shows no signs of bumper damage. Is it possible to be hurt? Yes, of course. The force required to move a stationary 4,000 lb object is tremendous. Can you walk up to a car sitting at a red light with its brakes on and shove it forward even an inch? Not likely. A collision that is strong enough to propel a car forward by even inches is plenty enough force to cause a whiplash injury.

So, as you have now learned, there really shouldn’t be any dispute on whether a low speed car accident collision can cause injuries. It has been scientifically proven by several studies. It is also a fact that the speed required to cause bodily injury is quite low, a scant 2.5 mph. It has also been shown that any accident that causes damage to the rear bumper is likely to cause injuries and even in accidents where there is no outward physical damage to the vehicle, there may still be sufficient forces involved to cause bodily injuries.

About North Dallas Chiropractic
They are a car accident injury specialist. They specializes in back pain and neck pain from car accidents. Their opinion is often sought by other doctors, attorneys and insurance companies. You may contact North Dallas Chiropracitc at (972) 392-4476 for a Car Accident Severity consultation. North Dallas Chiropractic



References

Panjabi MM, Grauer JN (1997): “Whiplash produces a S-shape curvature of the neck with hyperextension at lower levels. ” Spine 22 (21): 2489-94.

Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.

Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770

Characteristics of Specific Automobile Bumpers in Low Velocity Impacts, SAE 940916

Low Back Pain

Low back pain is the cause of many patients who limp, hobble or even crawl in to our office. It’s not surprising to learn that Low back pain results in millions of dollars of lost work and untold suffering every day.
Low back pain usually falls in to one of the following categories:

1. Patients have experienced chronic long term pain or discomfort with multiple episodes of increased pain which come and go.
Many of these people either cover the pain with OTC or prescription medications, or decide to just live with it. The problem is that all medications have both short and long term side effects. Only in rare cases should this be considered as a long term treatment option to this typically correctable problem.

As far as just living with the pain, two areas must be considered.
First, pain is NOT normal, so there IS something wrong. Ignoring it or just dealing with it allows the condition to progress undiagnosed and untreated. Lastly, why live with it and the effects it can have on your QUALITY of life, if you don't have to.

2. These patients are the limpers, hobblers and crawlers. Their pain started all at once and hit hard and fast. We typically hear something like "I just reached down to pick up a book and my back went out." Another common statement goes something like "I have never had low back pain before."
This type of condition can stop even the most determined and tough individual in their tracks and literally bring them to their knees. This can be a very scary time for those who have never experienced this before.
Typically our spinal examination reveals long time trauma or misalignment of the Lumbar vertebrae, the sacrum or the hips. The body has gotten to a point where it is overcome by these conditions and literally stops functioning properly.

NOTE: There are a number of causes of low back pain. Most who seek out our office fall into the category of Chiropractic care to fix the CAUSE of the problem. We have great success with these patients. Occasionally, we find that the problem is not musculo-skeletal related and in these cases, they are referred to to another type of Doctor who specializes in their particular condition.

The Docs at North Dallas Chiropractic

BACK PAIN

In addition to whiplash/neck injuries, the mid and lower back are also frequently injured in motor vehicle accidents (MVA's).
The Mid Back
The mid back or thoracic spine is most commonly injured as a result of the asymmetry of most seat belt designs. As the torso moves forward the seat belt locks and the torso is forced to stop at the end of the shoulder strap. Because the shoulder strap crosses only one shoulder (usually the left), the side without a strap (usually right) is able to travel forward further which results in a forward flexing and twisting injury to the mid back. For additional information on mid back pain, see " Mid Back Pain ".

The Lower Back
The lumbar spine is also frequently injured, but the mechanism differs from the above. As the torso and pelvis move forward the pelvis is stopped by the lap belt. However, the torso continues to move forward which producing a shearing force in the lumbar spine. These injuries often result in lumbar disc injuries. For additional information on low back pain and lower back injuries, see " Low Back Pain ".

Pain Sources

Spinal injuries can damage a number of pain sensitive structures located in the spinal region. Some of the more common structures that are damaged and that have innervation which allows them to transmit pain include:

• anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
• outer layers of intervertebral disc (located between adjacent vertebrae)
• posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
• nerve root dura
• capsule of the facet joints
• intervertebral ligaments
• extensor musculature
• flexor musculature: the colli and scalenes

When these tissues are injured, pain is experienced. Damage to these structures also results in tissue inflammation, edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues. In addition, when spinal injury occurs spinal muscles often reflexively spasm to protect the area from further injury - whether or not the muscles are injured. This spasming can lead to muscle ischemia (lack of oxygen) due to increased energy demands.

WHIPLASH

Whiplash is the most common injury sequelae following motor vehicle accidents. Speeds of as little as 5 mph have been documented to result in whiplash injuries. And although whiplash is prevalent in today's society with hundreds of studies on the topic, it is not yet fully understood.
 What is whiplash?
The term "whiplash" was coined by Dr. Harold Crowe back in 1928. It is used to refer to:

1. the hyperextension/hyperflexion injury of the neck, and
2. the resulting symptoms of this injury - sustained from a motor vehicle accident.

This forwards-flexion and/or backwards-extension of the neck essentially results in a soft tissue sprain/strain injury to the structures within the cervical and upper thoracic spinal regions. When the initial impact occurs and the head is forced in either excessive flexion or excessive extension, protective reflexes cause the muscles of the neck to forcefully contract which "whips" the head back in the opposite direction. The resulting injury often leads to numerous symptoms, many of which are confusing and poorly understood.

What symptoms are associated with whiplash?

Symptoms following a "whiplash" accident include:

• neck pain, tenderness, achiness and stiffness
• cervical muscle spasms
• tenderness and nodules in superficial cervical musculature
• cervical reduced range of motion
• post-traumatic headaches (including migraine and muscle-tension headaches)
• shoulder and interscapular pain
• hand and finger pain, numbness and tingling
• blurred vision
• difficulty swallowing/feeling of lump in throat
• dizziness and balance problems
• lightheadedness
• post-traumatic depression and cognitive problems

What structures are damaged in whiplash injuries?

Whiplash injuries can damage just a few structures or many, depending on the severity of the accident and direction of the injurious forces, to name a few.

Some of the more common pain-sensitive structures that are damaged include:

• outer layers of the intervertebral discs
• intervertebral ligaments
• capsule of the facet joints
• anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
• posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
• nerve root dura
• extensor spinal musculature
• flexor spinal musculature: the colli and scalene muscles

Damage to any of these structures results in tissue inflammation, tissue edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues.

How is whiplash treated?

The most important aspect of a successful treatment program involves active patient participation and patient compliance to the agreed upon program. When treatments focus solely on pain-relief and not tissue rehabilitation or when patients fail to comply with the prescribed treatment plan, the chronicity of problems becomes highly likely.

The chiropractic approach to treating whiplash injuries is highly successful compared with other health care professionals because chiropractors focus on rehabilitating the injured tissues and restoring optimal function. This is reflected in the high patient satisfaction scores that chiropractors have received in "patient satisfaction surveys" performed on MVA patients.

Chiropractic care is a safe, natural, noninvasive, and addresses the cause of the symptoms. Our treatments also include active patient participation, and in some cases, lifestyle modifications. While we do focus on eliminating pain early on, we realize that in addition to pain - optimal tissue healing, restoration of normal function, and prevention of future recurrences and reinjuries - are equally important.

Our treatments are highlighted by our use of many gentle and highly effective spinal adjustive techniques. When used properly, these techniques allow us to safely and effectively reduce pain levels, reduce muscles spasms, eliminate inflammation, restore normal joint motion and biomechanics, prevent or minimize degenerative processes, and minimize the likelihood of future recurrences.

We also incorporate many natural and safe adjunctive therapies into our treatment plan to further assist in the healing process. Some common adjunctive therapies include ice therapy, heat therapy, physical therapies like therapeutic ultrasound and muscle stimulation, spinal traction, soft tissue mobilization, spinal exercises and stretches, and nutritional supplementation.

How long do whiplash treatments take?
As with any other injury, there are a number of factors which influence the treatment length of whiplash injuries:

• the severity of the injury
• when treatment was initiated
• patient compliance to the treatment plan
• the nature of the accident
• the size and speed of your vehicle and other vehicles involved
• whether or not seat belts were worn
• whether you were aware of the impending accident
• the height of the head rest
• the age of the individual
• the size and strength of the cervical musculature
• the presence of preexisting spinal conditions

The easiest and most effective way of eliminating pain and preventing residual and chronic problems is to start care immediately following the accident. As you allow time to slip by without seeking appropriate treatment, your injuries become more permanent and far more difficult to manage.

Will I have future problems from my whiplash injury?
Numerous studies show that many whiplash victims have a relatively poor outcome without immediate and appropriate treatment. One such study found that 75% of patients with whiplash still suffer from symptoms 6 months after the accident. Experts agree that individuals with any degree of neck complaints following a motor vehicle accident dramatically improve their prognosis if they seek immediate evaluation and appropriate treatment within hours of the accident.

Interesting whiplash statistics.

• whiplash symptoms last more than 6 months in 75% of patients
• symptoms of whiplash commonly do not appear until weeks or months after the accident
• whiplash victims lose an average of 8 weeks of work
• whiplash is 5 times more common in women than in men
• whiplash occurs most commonly in those aged 30 to 50 years
• rear-end collisions typically cause more cervical spine damage than do frontal or side collisions

What is Personal Injury Protection?

Personal Injury Protection (PIP)

The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.

Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.

What is PIP?

PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.

What will a claim do to my insurance rates and policy renewal?

Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.

Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?

Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.

Why should i get an attorney after an Auto/Car accident for my injuries?

An attorney helps with all aspects of an auto/car accident claim or injury. They keep an individual from spending countless hours on the phone with insurance adjusters that really don't care about your well being. It also helps to keep stress levels down and allow you to concentrate on recovery and getting well. Our office only works with the best attorneys/lawyers in Dallas/Fort Worth. We have learned through trial and error, who best takes care of our patients. They also make sure that all your medical bills are settled. This allows you to be additionally stress and medical bill free at the end. We also help those who are not able to treat in our office, who are in need of an attorney. We are here to help!!! So don't hesitate in calling and making an appointment to get examined and also ask about scheduling a free consultation with a reputable attorney. You only have one body, so you need to take care of it. Call Today!!! (972)215-7720

What is Personal Injury Protection?

The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.

Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.

What is PIP?

PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.

What will a claim do to my insurance rates and policy renewal?

Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.

Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?

Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.