How to help whiplash
Whiplash - Diagnosis and treatment
Your doctor will ask questions about the event and your symptoms. You also may be asked questions that help your doctor understand how severe your symptoms are and how often they occur. Your doctor will also want to know how well you can perform normal everyday tasks.
During the exam your doctor will need to touch and move your head, neck and arms. You will be asked to move and perform simple tasks so that your doctor can check the:
- Range of motion in your neck and shoulders
- Degree of motion that causes pain or an increase in pain
- Tenderness in your neck, shoulders or back
- Reflexes, strength and sensation in your limbs
A whiplash injury isn't apparent on imaging tests. But your doctor will likely order one or more imaging tests to rule out other conditions that could be making your neck pain worse. Imaging tests include:
- X-rays. Fractures, dislocations or arthritis can be identified by X-rays of the neck taken from many angles.
- Computerized tomography (CT). This special type of X-ray can produce cross-sectional images of bone and show possible bone damage.
- Magnetic resonance imaging (MRI). This imaging test uses radio waves and a magnetic field to produce detailed 3D images. In addition to bone injuries, MRI scans can detect some soft tissue injuries, such as damage to the spinal cord, disks or ligaments.
The goals of whiplash treatment are to:
- Control pain
- Restore normal range of motion in your neck
- Get you back to your normal activities
Your treatment plan will depend on the extent of your whiplash injury. Some people only need over-the-counter medication and at-home care. Others may need prescription medication, specialized pain treatment or physical therapy.
Your doctor may recommend one or more of the following treatments to lessen pain:
- Rest. Rest may be helpful for a day or two after your injury, but too much bed rest may delay recovery.
- Heat or cold. Either heat or cold applied to the neck for 15 minutes every three hours or so can help you feel better.
- Over-the-counter pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), often can control mild to moderate whiplash pain.
- Prescription medications. People with more-severe pain may be given certain antidepressant drugs that have been shown to relieve nerve pain.
- Muscle relaxants. Short-term use of these drugs may be recommended to loosen tight muscles and soothe pain. The medicine also can make you feel sleepy. It may be used to help restore normal sleep if pain prevents you from getting a good night's rest.
- Injections. An injection of lidocaine (Xylocaine) — a numbing medicine — into painful muscle areas may be used to decrease pain so that you can do physical therapy.
Your doctor will likely prescribe a series of stretching and movement exercises for you to do at home. These exercises can help restore range of motion in your neck and get you back to your normal activities. Applying moist heat to the painful area or taking a warm shower may be recommended before exercise.
Exercises may include:
- Rotating your neck in both directions
- Tilting your head side to side
- Bending your neck toward your chest
- Rolling your shoulders
If you have ongoing whiplash pain or need assistance with range-of-motion exercises, your doctor may recommend that you see a physical therapist. Physical therapy can help you feel better and may prevent further injury. Your physical therapist will guide you through exercises to strengthen your muscles, improve posture and restore normal movement.
In some cases, transcutaneous electrical nerve stimulation (TENS) may be used. TENS applies a mild electric current to the skin. Limited research suggests this treatment may temporarily ease neck pain and improve muscle strength.
The number of physical therapy sessions needed will vary from person to person. Your physical therapist can also create a personalized exercise routine that you can do at home.
Soft foam cervical collars were once commonly used for whiplash injuries to hold the neck and head still. However, studies have shown that keeping the neck still for long periods of time can decrease muscle strength and interfere with recovery.
Still, use of a collar to limit movement may help reduce pain soon after your injury, and may help you sleep at night. Recommendations for using a collar vary though. Some experts suggest limiting use to no more than 72 hours, while others say it may be worn up to three hours a day for a few weeks. Your doctor can instruct you on how to properly use the collar, and for how long.
- Chiropractic adjustment
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Nontraditional therapies have been tried to treat whiplash pain, but research about how well they work is limited. Some include:
- Acupuncture. Acupuncture involves inserting ultrafine needles through specific areas on your skin. It may offer some relief from neck pain.
- Chiropractic care. A chiropractor performs joint manipulation techniques. There is some evidence that chiropractic care may provide pain relief when paired with exercise or physical therapy. Manipulation of the spine may cause minor problems, such as numbness or dizziness, and rarely damage to spinal tissues.
- Massage. Neck massage may provide short-term relief of neck pain from whiplash injury.
- Mind-body therapies. Exercises that incorporate gentle movements and a focus on breathing and mindfulness, such as tai chi, qi gong and yoga, may help ease pain and stiffness.
Preparing for your appointment
If you've been in a car accident, you might receive care on the scene or in an emergency room. However, a whiplash injury may not cause symptoms immediately. If you have neck pain and other symptoms after an injury, see your doctor or an urgent care center as soon as possible.
Be prepared to describe in detail the event that may have caused your symptoms and to answer the following questions.
- How would you rate your neck pain on a scale of 1 to 10?
- Does movement make the pain worse?
- What other symptoms do you have?
- How long after the event did the symptoms appear?
- Have you had neck pain in the past, or do you experience it regularly?
- Have you tried any medications or other treatments to relieve the pain? If so, what was the effect?
- What medications do you take regularly, including dietary supplements and herbal medicines?
By Mayo Clinic Staff
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Pain, Treatment, Symptoms, Causes, and More
Written by WebMD Editorial Contributors
In this Article
- What Are the Symptoms of Whiplash?
- What's the Treatment for Whiplash?
- When Will My Whiplash Feel Better?
- How Can I Prevent Whiplash?
Neck strain is often just called whiplash. Although it's usually associated with car accidents, any impact or blow that causes your head to jerk forward or backward can cause neck strain. The sudden force stretches and tears the muscles and tendons in your neck.
Neck strain afflicts many amateur and professional athletes. People who play contact sports like football are especially prone to neck strain.
Neck strains are often confused with neck sprains. They're a bit different. Neck strains are caused by damage to the muscle or the tendons, bands of tissue that connect muscles to bones. Neck sprains are caused by tearing of the ligaments, the tissues that connect the bones to each other.
However, the differences between these strains and sprains probably won't mean much to you. The causes, symptoms, and treatment of neck sprains and neck strains are usually the same.
What Are the Symptoms of Whiplash?
The pain of whiplash is often hard to ignore. The symptoms may include:
- Pain, decreased range of motion, and tightness in the neck. The muscles may feel hard or knotted.
- Pain when rocking your head from side to side or backward and forward.
- Pain or stiffness when moving your head to look over each shoulder.
- Headaches at the base of the skull that radiate towards the forehead.
Sometimes, the pain of a neck strain is immediate. In other cases, it can take several hours or days before your neck begins to hurt.
The blow that causes neck strain can sometimes cause a concussion, too. Since concussions can be serious, you need to see a doctor right away. You need emergency medical care if you have a headache that worsens or persists, have weakness or trouble talking, or are confused, dizzy, nauseous, excessively sleepy, or unconscious.
To diagnose neck strain, your doctor will give you a thorough examination. You may also need X-rays, CT (computed tomography) scans, and other tests, to rule out other problems.
What's the Treatment for Whiplash?
Here's the good news: given time, whiplash should heal on its own. To help with recovery, you should:
- Ice your neck to reduce pain and swelling as soon as you can after the injury. Do it for 15 minutes every 3-4 hours for 2-3 days. Wrap the ice in a thin towel or cloth to prevent injury to the skin.
- Take painkillers or other drugs, if recommended by your doctor. Medications like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin) or naproxen (Aleve), will help with pain. However, these medicines can have side effects. Never use them regularly unless your doctor specifically says you should. Check with your doctor before taking them if you take other medicines or have any medical problems. If over the counter medications do not work, prescription painkillers and muscle relaxants may be necessary.
Use a neck brace or collar to add support, if your doctor recommends it. However, they are not recommended for long-term use, because they can actually weaken the muscles in your neck.
Apply moist heat to your neck -- but only after 2-3 days of icing it first. Use heat on your neck only after the initial swelling has gone down. You could use warm, wet towels or take a warm bath.
- Other treatments, like ultrasound and massage, may also help.
When Will My Whiplash Feel Better?
Recovery time depends on how serious your whiplash is. Most cases resolve in a few days. But other neck strains may take weeks or longer to heal. Remember that everyone heals at a different rate.
Once the acute symptoms of neck strain are gone, your doctor will probably want you to start rehabilitation. This will make your neck muscles stronger and more limber. It will help you both recover and reduce the odds of straining your neck again in the future.
You might start with gentle stretching exercises and do more as you get better. But don't start exercising without talking to your doctor first.
Whatever you do, don't rush things. People who play contact sports need to be especially careful that they are fully healed before playing again. Your doctor will clear you to resume your activity when you are ready. Do not try to return to your previous level of physical activity until you can:
- Look over both shoulders without pain or stiffness
- Rock your head all the way forward and all the way back without pain or stiffness
- Rock your head from side to side without pain or stiffness
If you start pushing yourself before your neck strain is healed, you could end up with chronic neck pain and permanent injury.
How Can I Prevent Whiplash?
There's not much you can do to prevent whiplash caused by an accident, of course. But there are some things you can do to improve your odds:
- Practice strengthening exercises to keep your neck muscles strong and limber, especially if you have had neck strain before.
- People who sit in the same position all day, like office workers, should take regular breaks to stretch and exercise their necks.
HOW TO USE WHIPS WITH A FREE HORSE
furzikova , Usefulness, gentle methods in working with horses, working in a barrel, working with a horse on the ground, working with a free horse ,
Having mastered the basics in working with a free horse , you can move on and learn how to use whips. First of all, it is important to realize that the whip in this case is not a punishment, but an extension of your hand, a kind of guide. Introduce the whips to the horse, let them sniff, gently touch each part of the horse's body. The animal must understand that the whip is not dangerous.
Hold a whip in each hand. Both whips are in the neutral position when the horse has reacted to the signal or if you do not require anything from him. In the neutral position, both whips are directed away from the horse towards the center of the barrel. If you are asking for a command, slightly raise the whip you need at that moment.
If you want to get your horse into a faster gait, raise the whip closer to the horse's hind legs. In this case, give a command by voice. If the horse doesn't respond, point the whip closest to the horse's hind legs forward and use it as you would when lunging.
If you want to bring the horse to a slower gait, put both whips back into neutral position and first try to change the gait using the already known commands of voice and body position. And only if the horse does not respond to such a message, use the whip, which is located closer to the horse's head, as during lunging. To do this, turn the whip forward and thereby make it clear to the horse that he must slow down.
The stop is carried out in the same way, and in this case the message must be extremely clear.
First try to make the walk out turn as it is the easiest to do. The whip closest to the horse's head is placed in the neutral position.
When approaching the turning point, move the whip forward, working it like a lunge when making an outward turn, while using it in the same way as when lunging.
If the horse slows down and “fits” into the turn, the second hand with the whip handle should be in a new position and clearly indicate the horse's direction of movement.
As soon as the turn is completed, both whips are moved to the neutral position.
Consider turning from left to right. Walk 2-3 steps towards the horse with eyes downcast and keep the whips in neutral for now. Then take both whips in your left hand, pointing them forward.
Step back a few steps, as if "pulling" the horse in.
Now make eye contact with the horse, raise your left hand with both whips and thus send it to the right.
So the horse moves out again. As soon as it reaches the wall, move the whips to a neutral position.
Change of direction through the middle
The main condition for a successful change through the middle is the free execution of the turn inside. Consider turning from left to right.
Get the horse's attention by "flicking" the left whip to the side for the upcoming change.
Move quickly to the center of the circle and pull the horse inward. Remove the left whip as soon as the horse has clearly turned inward, so that he does not turn too much, but enters the turn in an arc. In the best case, the horse will approach the center of the circle.
With the whip in your right hand, clearly indicate the direction in which you would like to steer the horse. The whip, which is in the left hand, is simultaneously pushed forward and thus sends the horse to the right.
Now the horse turns out again. To keep her from rushing straight into the line on the outer circle, guide her in a very large arc. This will leave enough room for the horse to return to the outer circle in an arc rather than in a straight line.
As soon as the horse is back on the outer circle, lower both whips back to neutral and allow the horse to walk 1-2 circles calmly. At the same time, leave the whips in your left hand so that the horse does not think to offer you a new change and so that he feels free before moving on.
Based on Karine Tillisch’s book “From cask to work in freedom”
Tags: soft methods in working with horses working in a barrel working with a horse on the ground working with a free horse
what laws the stock market lives today and how it changes the future
The whip effect: what laws the stock market lives today and how it changes future
About the sentimental mood, the maneuverability of the Fed and the recipe for disinflation this and next year. Why should the Fed write a personal Guinness World Record in 2022? From what rooftop should you watch the pendulum of the stock market? How can a time machine help? The answers to all these questions, as well as SharesPro's secret contingency plan, are in this material.
Factors of market dynamics
To understand the current situation, let's take three points of water data that affect the market:
1. The growth of EPS (earnings per share) of companies. Here, for 2022-23, the recession factor is decisive.
2. Market assessment, through P/E multiplier. Here the determining factor is the cost of capital and, as a consequence, the Federal Reserve's monetary policy.
3. Net positions of market participants, including margin positions. Here, sociodynamics and the sentiment of moods are decisive.
1.EPS. Earnings per share.
At the end of Q1 2022, we had an average EPS return of $54 for Sp500, with a median return of $35 over the past years (excluding the pandemic), as seen in the chart below:
Annual EPS is at $220, for 2018 -19 years it was about 160 dollars.
So we have an increase of 220/160 or +37.5%, and if we look at the SIPI values from an average of 2800 in 2018-2019, we showed about the same increase - up to 3800 (current values).
That is, in terms of profits, the market is valued correctly at the pre-pandemic paradigm level.
2. P/E, the fall of the market from 4800 to 3800 was caused by the reassessment of the availability of capital due to tighter monetary policy, and expectations of rising interest rates in particular. The main forecasts for rates in June were at the level of 3.5-3.75%.
However, by the beginning of July they have already corrected to 3.25-3.5% and tend to further decline.
This is due to the implementation of our thesis that in the current economic conditions the Fed does not have much room for maneuver, since private debt, plus government plus corporate debt, is about 370% of BB, which is a record amount in history. And the faster the Fed raises rates (it was 75 bp at the last meeting), the faster they will have to lower them, as the economy is not able to digest the rising cost of capital with such debt. In addition, at the end of June, we saw that the US economy was already in recession, so the data for the 1st quarter of 2022 were revised down both times (to -1. 6%).
The forecast for the 2nd quarter of 2022 from the Atlanta Fed, based on purely mathematical models, showed a catastrophic drop to -2.1% by the beginning of July.
According to the US Census Bureau report, personal consumption expenditure decreased from 1.7% to -13.2%. And private investment from 0.8% to -15.2%! Obviously, we already have two negative GDP in a row - as mentioned, we are already in a recession, a recession is already a reality.
There is an analogy between raising rates in 2018 and 2022. The market is laying the rate at 325-350 bp. at the end of 2022, but given the current dynamics, we can expect that the rate will not go above 300 bp.
In 2018, a level of 2.5% would have been reached, which is slightly below the target for the end of 2022-beginning of 2023. However, it can be said that the market has already priced in the revaluation of the cost of capital, correcting by 25-30% from the highs, similar to the dynamics of the markets in 2018.
3. Sociodynamics, on the other hand, shows extremes both in sentiment and in no long-short positions.
Fund positions close to record net negatives in 10 years.
Thus, we have a market fairly valued in terms of P / E in the pre-pandemic paradigm with negative sociodynamic sentiment, which indicates the possibility of a short-term and medium-term trip up in the second half of 2022.
Market risks and monetary policy forecasts for 2022-23
The main risk for the market in the second half of 2022 is the Fed's monetary vs recession dilemma. If the Fed’s reaction to recessionary mechanisms is belated, then we may see a negative revaluation of companies’ EPS in 2022-23, which may drive the market lower – up to levels in the 3200 region. However, before that, we should expect the pendulum to swing up – here it is worth looking at the data on inflation and in particular for such things as the price of energy, food and supply chains. Falling prices on these three indicators will have a clear disinflationary impact. Market dynamics are also affected by 10-year yields and the level of DXY. The fall of both indicators will be a positive signal to the markets.
A) Oil price hike above $119 will mean the cancellation of the SI wave in the current scenario.
In the event of a fall, this is a good disinflationary signal.
B) SH production shows a rather strong decline from the May peaks.
Falling oil and food prices are powerful disinflationary factors.
C) Post-2022 highs supply chains continue to unload
Another disinflationary factor at this point could be the stock-to-sales ratio. Sales are flat in 2022, with companies ordering a significant number of items in 2021 with congested supply chains, leading to an increase in the Inventories to sales ratio. An increase in values to 1.5 will be a strong disinflationary factor, as history shows.
(The graph shows data for April, data for May will be released in mid-July).
In retail stocks, the situation is even more obvious - stocks grow when sales stagnate: to confirm it:
1. Commodity market dynamics - slowdown:
Reuters Crb Index:
2. 5-year TIPS (Inflation Protected Bonds) – decline in yields and supply chains – lower transportation costs here (post-pandemic logistic bottlenecks clear up).
3. 10-years and expectations of inflation in 5-year TIPS:
10-years dropped sharply below 3, the key level of 2.7%, breaking through which will make it possible to go to 1-2%.
Average 5-year inflation based on 5-year TIPS is estimated at 2.57% (decreasing), Treasury 10-years still yield above this value (which is a signal to buy them).
4. Inventory for sales - unsold products accumulate in warehouses, the transfer of price costs cannot be transferred to the final consumer without new QE and receipts.
We observe the so-called whiplash effect: due to the impossibility of growth in consumption by the end customer, a large number of goods accumulate in retail warehouses. In turn, the same effect with greater volume affects wholesalers - where stocks are even higher - and ultimately the same effect affects manufacturing companies, leading to a drop in demand for commodities and will result in disinflation as supply chain congestion resolves.
5. Goldman Sachs predicted Fed rate and rotation in value-growth stocks.
The expected rate has dropped from 4% to 3.5%, causing Russel 1000 growth stocks to rise relative to Russel 2000 value stocks since May of this year.
So far, this rotation is small, but there are many indications that inflation peaks have been passed, and this rotation (albeit not without kickbacks) will continue - and has a good potential for implementation in the medium term.
This confirms the thesis of buying 7+ year Treasuries and growth stocks as the main assets for the second half of 2022-2023.
However, there is a reasonable possibility that the Fed will rely on lagging indicators in its monetary policy - PCE inflation and the labor market, which may eventually break the system, so the main schedule for the coming year remains this way:
Based on the fairness of the assessment market in the current conditions and negative sentiment, we can assume a market rebound (X wave) to the 4200-4300 area (in the most positive scenario B to the 4500 area, which looks unlikely so far) in the second half of 2022, then the final fall to the 3200 area due to lagging actions of the Fed, a recession and, as a result, a drop in the EPS of companies, which will force the Fed to start cutting the rate and soften the monetary policy.
In general, the current fiscal and monetary problems, as well as the movement of indices, is reminiscent of the second half of the 40s.
Finally, let's look at the action plan in case our short-medium-term forecast for the second half of 2022 is not realized.
If we do not see a significant increase in indices (especially in growth stocks) and treasury bonds 7+ in 2022, then we can sit out the drawdown in these securities. Our profitability will be fully realized already in 2023.
As mentioned earlier, the inversion of the euro futures curve continues to shift to the left, and if at the beginning of the year the rate cut was in the 3rd-4th quarter of 2023, then by June 2022 it was already in March April 2023, and after raising the rate by 0.75% (higher than forecasts ), since June 16, this inversion has shifted to December 2022!
As of June 30, the inversion continues to grow. And this means that steps to quickly raise the rate are expected to lead to its equally rapid reduction.