Issue link: https://www.massageandbodyworkdigital.com/i/68174
WORKING WITH WHIPLASH, PART 2 Cold Whiplash In the previous article, I wrote that whiplash has metaphorically "hot" and "cold" phases, and described some approaches for working with hot patterns. Here, I will describe two techniques from Advanced-Trainings. com's Advanced Myofascial Techniques seminars that are particularly effective for working with cold whiplash. I will also share some of our instructors' advice and best practices for strategizing whiplash sessions. A brief review of our hot/cold distinction: hot whiplash is usually (but not always) more recent, generally less than six weeks since being injured. Hot whiplash is characterized by sympathetic nervous system ("fight or flight") arousal, inflamed and hypersensitive tissues (anywhere in the body), and immobilization and guarding via muscular contraction and spasm. Once some time has passed, an older but still unresolved whiplash can show the "cold" pattern of hard, dense connective tissue restrictions (versus muscular spasm), especially deep around the joints, which also limits mobility. Hot whiplash needs to be worked very carefully to avoid increasing the tissue inflammation and further aggravating the client's autonomic arousal. While cold whiplash can usually be approached more directly, we're not out of the woods yet: cold whiplash can easily be reactivated into a hot pattern if worked too much, too deeply, or too fast. Go slowly until you learn how your client responds. The primary goals in working with hot whiplash are to calm the aggravated nervous system responses and to encourage whole-body motility (self-generated movement), which minimizes connective tissue scarring and adhesion. Only when whiplash has progressed to the cold stage do we add the additional primary goal of restoring local mobility (the ability to move or be moved) by directly addressing movement and tissue restrictions.1 CERVICAL CORE/ SLEEVE TECHNIQUE As shown in Image 1, a sudden backward acceleration of the head, such as that caused by a rear-end impact or a backward fall, will Cervical Core/Sleeve Technique: Gently use the backside of a soft, semi-open hand to ease the outer layers of the neck posteriorly. Do not put any pressure on the underlying structures of the throat and neck—the styloid process, lymph nodes, carotid artery, and vagus nerve are all in this region and merit special care. violently overextend and injure the soft tissues of the anterior neck2 . Once the inflammation of the hot stage has diminished and the rest of the body has been prepared (see Strategizing Your Sessions, page 111), you can begin addressing the tissues of the anterior neck by working the neck's outer "sleeve"—the superficial cervical fascia and the sternocleidomastoids (SCM). Since we're beginning with superficial layers, the tool we'll use is the soft fist, as the drier texture of the skin on the dorsum of the hand is better suited for superficial work than the palm. Rather than a hard, closed fist, the soft fist is open, easy, and relaxed, with both the fingers and thumb out and comfortable (Image 2). It is important to keep the wrist and metacarpals aligned with the forearm— this protects your wrist from strain and connect with your colleagues on massageprofessionals.com 109