Who are we dealing with?

It might be interesting for you to know that, as an internal quality assessment, we provide a statistical review of our Clients. The majority of cases is dealing with car occupants that are involved in RTAs.

The accident affects men and women equally. The typical Client is 40 years old. He/She was involved in an RTA approximately 10 months prior to her appointment. The Client sustained a rear shunt as driver, which is usually described as moderately severe. The most frequent symptoms occur in the neck, followed by neck and back symptoms.

The Clients are seen by their GP within/after 1 week following their involvement in the accident. Physio starts after 4 weeks with an average of 9 sessions, which are described as helpful. Masages are experienced as painful for the following 2 days. Recommendations include stretching exercises but not physical activities, e.g. Pilates, Thera Band exercises.

80% suffer from fears and anxiety or stress symptoms, which remind of a PTSD.

At the time of the interview, the Client has not recovered from the accident related symptoms. Less than 10% report resolution of part of their symptoms.

Wrist injuries are very common and result from impacts onto the outstretched wrist after trips and falls, motorcycle or bicycle accidents or even in cars. Usually, X-rays exclude bony injuries but in many cases symptoms can persist. We have investigated Clients with ongoing wrist pain and found that in 50% the SL ligament was involved. The relevance of this injury is huge and can result in a carpal collapse of the wrist joint. A stringent approach is required to detect the injury.

See our publications under "Scientific work"

Approx 8% of our Clients present with impingement signs of their shoulders. This is a painful condition of the shoulder joint, which is limiting the Client's range of movement and affects his activities of daily living. On further investigation, several conditions affecting the tendons, e.g. tears or tendinosis can be found. They can be considered as pre-dating. The reason why they can become relevant is most likely a disturbed muscular support as a result of an altered proprioception. Therefore, treatment needs to aim at correction of the muscular balance.

See our publications under "Scientific work"

The Pain Memory: Why do we suffer from prolonged symptoms

In our clinics, we see Clients that suffer longer than expected. Their resolution of symptoms tend to persist. There have been many factors that are being regarded as cofactors influencing the healing time. But in those Clients that we have reviewed (ongoing) there seems to be a history of previous accidents or medical conditions that become relevant after their accident. There is evidence that pain perception is a neuroplastic process that results in our neural structures to be modified if the pain stimulus is not reasonably addressed. That response persists over time and, although the symptoms may fade, the "memory" persists. It can be revived with a new trauma even at a different site. This is responsible that the pre-dating information (pain symptoms) re-occur. The approach in the treatment is more complex and needs to involve contributing cofactors.

The impact of the "Leading Injury"

A significant number of Clients sustain more than just the average neck and back injury after their accident. We see Clients with additional injuries that have an impact on the recovery of their whiplash associated symptoms (WAD). In general, they recover from their WAD much quicker if the additional injury can be rated as significant. On average, they recover from neck and back symptoms within 5 months and do not show chronification in their WAD.

See our publications for further reading under "Scientific work"