Common Injuries from Car Accidents: How Physiotherapy Can Help
Car accidents cause injuries affecting virtually every body system. Understanding common injury patterns and how physiotherapy addresses them is essential for making informed decisions after a collision. Recognizing symptoms early and accessing appropriate treatment significantly impacts both your recovery and long-term outcomes.
The Biomechanics of Car Accident Injuries
Car accidents generate forces that exceed normal physiological tolerances. The sudden acceleration, deceleration, and impact create injury through multiple mechanisms: direct trauma from contact with vehicle components, indirect injury from rapid body movement, and delayed injuries from inflammatory responses and protective muscle spasm.
Even seemingly minor collisions can produce significant injuries. Low-speed impacts, particularly rear-end collisions, may not damage vehicles substantially but can generate forces sufficient to injure occupants. Factors influencing injury severity include impact direction, speed differential, occupant awareness, head position, body position, and individual anatomical variations.
Research in Traffic Injury Prevention demonstrates that injury patterns vary significantly based on collision characteristics, with rear-end impacts producing different injury profiles than frontal or side collisions.
Whiplash and Neck Injuries
Whiplash-associated disorders represent the most prevalent car accident injury, affecting approximately 80% of collision victims. The term "whiplash" describes the mechanism—rapid forward-backward head and neck movement—rather than a specific diagnosis.
What Actually Gets Injured in a Car Accident
During rear-end impacts, the torso accelerates forward while the head initially remains stationary due to inertia, creating cervical spine extension. The head then accelerates forward as the vehicle decelerates, causing flexion. This rapid movement injures multiple structures:
Muscles and Ligaments: Cervical muscles and ligaments strain beyond normal capacity. Anterior neck muscles sustain eccentric loading during extension, while posterior structures strain during flexion.
Facet Joints: The small joints connecting vertebrae experience abnormal loading and may develop capsular tears, inflammation, or internal derangement.
Intervertebral Discs: Discs between vertebrae may tear, bulge, or herniate from the shearing forces.
Nerve Structures: Nerve roots may become compressed or irritated, causing radiating pain, numbness, or weakness into the arms.
Vascular Structures: Though rare, arterial injuries can occur with severe mechanism.
Symptom Presentation
Whiplash symptoms often don't appear immediately. Delayed onset over 24 to 72 hours is typical as inflammation develops and protective muscle spasm intensifies. Common symptoms include:
Neck pain and stiffness
Headaches originating at the skull base
Shoulder and upper back pain
Reduced neck range of motion
Dizziness and balance problems
Visual disturbances
Jaw pain and clicking
Arm pain, numbness, or tingling
Difficulty concentrating and memory problems
Fatigue
Sleep disturbances
The symptom constellation varies considerably among individuals based on injury severity and location, pre-existing conditions, and psychological factors.
How Physiotherapy Treats Whiplash
Your physiotherapist uses multiple evidence-based interventions for whiplash:
Manual Therapy: Joint mobilization restores normal cervical spine movement. Techniques range from gentle oscillations to more aggressive mobilizations based on injury stage and patient tolerance. Soft tissue techniques including massage, myofascial release, and trigger point therapy reduce muscle tension and improve tissue quality.
Exercise Therapy: Specific exercises target impaired muscle function. Deep cervical flexor training addresses the muscles that stabilize the neck, which are consistently weak after whiplash. Scapular stabilization exercises correct shoulder blade positioning and control. Range of motion exercises restore normal cervical mobility.
Postural Correction: Forward head posture commonly develops after whiplash, perpetuating symptoms. Postural retraining through exercise, ergonomic modification, and awareness training reduces ongoing strain.
Pain Neuroscience Education: Teaching patients about pain mechanisms reduces catastrophizing, improves coping, and facilitates engagement with active treatment. Understanding that pain doesn't always equal tissue damage empowers patients to move confidently.
A systematic review in The Cochrane Database concluded that multimodal physiotherapy incorporating manual therapy, exercise, and education provides superior outcomes compared to single interventions or passive treatments.
Concussion and Traumatic Brain Injury
Head impacts or rapid acceleration-deceleration can cause concussion even without direct head trauma. The brain moves within the skull, causing neurometabolic changes that disrupt normal function.
Recognizing Concussion
Common concussion symptoms include:
Headache
Dizziness
Nausea
Balance problems
Visual disturbances
Light and noise sensitivity
Cognitive difficulties (memory, concentration, mental fog)
Emotional changes (irritability, anxiety, depression)
Fatigue
Sleep disturbances
Many individuals don't recognize they've sustained a concussion, attributing symptoms to stress or other injuries. Your physiotherapist screens for concussion during initial assessment after car accidents.
Physiotherapy's Role in Concussion Management
Modern concussion management emphasizes active rehabilitation over prolonged rest. Physiotherapy addresses multiple systems commonly affected:
Cervical Spine Treatment: The neck is almost always injured alongside concussion. Treating cervical dysfunction often dramatically improves headaches and dizziness attributed to brain injury.
Vestibular Rehabilitation: Balance and dizziness problems respond to specific vestibular exercises that retrain the balance system and reduce motion sensitivity.
Oculomotor Training: Eye movement problems causing reading difficulties and visual fatigue improve with targeted vision exercises.
Graded Aerobic Exercise: Carefully prescribed cardiovascular exercise at subsymptom threshold intensities accelerates recovery and prevents prolonged symptoms.
Return-to-Activity Protocols: Systematic progression through graduated stages ensures safe return to work, school, driving, and sport.
Research in the British Journal of Sports Medicine demonstrates that comprehensive physiotherapy-based rehabilitation significantly improves concussion outcomes and reduces persistent symptom risk.
Lower Back and Pelvic Injuries
Lumbar spine injuries occur frequently in car accidents due to seatbelt forces, bracing reactions, and compression loading through the spine during impact.
Common Lower Back Injuries
Muscle Strains: Lumbar muscles sustain strain from sudden, forceful contraction or stretch. Pain typically worsens with movement and improves with rest initially.
Facet Joint Sprains: The small joints in the lower back experience abnormal forces, causing capsular inflammation and pain. Facet joint injuries typically cause localized back pain that worsens with extension (bending backward) and rotation.
Disc Injuries: Intervertebral discs may tear, bulge, or herniate. Disc injuries can cause back pain alone or radiating leg pain if nerve compression occurs. Symptoms often worsen with sitting, forward bending, and lifting.
Sacroiliac Joint Dysfunction: The joints connecting the spine to the pelvis commonly become irritated or misaligned. Sacroiliac pain typically localizes to the lower back or buttock and may radiate into the thigh.
Compression Fractures: Though less common in younger patients, vertebral compression fractures can occur, particularly in older adults with osteoporosis.
Physiotherapy Interventions
Your Surrey physiotherapist develops individualized treatment plans based on specific injury patterns:
Manual Therapy: Spinal mobilization, manipulation (when appropriate), and soft tissue techniques reduce pain and restore mobility. Muscle energy techniques and joint mobilization address sacroiliac dysfunction.
Core Stabilization: Progressive exercises rebuild deep abdominal and back muscle function. These muscles provide essential spine protection during daily activities.
Directional Preference Exercise: Many disc injuries respond to specific directional movements. The McKenzie method identifies beneficial directions and prescribes exercises accordingly.
Functional Training: Task-specific training ensures you can safely perform work activities, household tasks, and recreational pursuits without symptom recurrence.
Ergonomic Modification: Adjusting workstation setup, lifting techniques, and daily activity mechanics reduces back strain and prevents aggravation.
Shoulder and Upper Extremity Injuries
Upper limb injuries result from bracing against the steering wheel or dashboard, airbag deployment, or seatbelt forces across the shoulder.
Common Shoulder Injuries
Rotator Cuff Injuries: The rotator cuff muscles stabilize the shoulder during movement. Strains or tears cause pain with overhead activities, reaching, and lifting. Severe tears may cause weakness and night pain.
Shoulder Impingement: Trauma can create or worsen impingement where rotator cuff tendons become compressed between bones. Pain typically occurs with arm elevation and overhead activities.
Acromioclavicular (AC) Joint Sprains: The joint at the top of the shoulder where the collarbone meets the shoulder blade commonly sustains injury from direct impact or compression. AC joint injuries cause localized pain at the top of the shoulder.
Shoulder Dislocations: Severe trauma can dislocate the shoulder, requiring medical reduction. Subsequent rehabilitation prevents recurrent instability.
Nerve Injuries: Traction on the brachial plexus (nerve bundle supplying the arm) can cause temporary or persistent symptoms including numbness, weakness, and pain.
Rehabilitation Approaches
Shoulder rehabilitation requires careful progression to restore full function:
Early Phase: Pain management, gentle range of motion exercises, and strategies to reduce inflammation while protecting healing tissues.
Intermediate Phase: Progressive strengthening of rotator cuff and scapular stabilizers. Improving shoulder blade control is crucial for shoulder function.
Advanced Phase: Sport-specific or work-specific training ensuring the shoulder tolerates the demands placed on it.
Manual Therapy: Soft tissue techniques, joint mobilization, and neural mobilization address specific impairments limiting recovery.
Elbow, Wrist, and Hand Injuries
Distal upper limb injuries include:
Elbow sprains and strains
Tennis elbow (lateral epicondylitis) from bracing reactions
Wrist sprains from dashboard impact or airbag forces
Carpal tunnel syndrome from wrist trauma or inflammation
Hand and finger injuries from steering wheel impact
Physiotherapy addresses these injuries through splinting, exercise progression, manual therapy, and gradual return to activities requiring fine motor control and grip strength.
Knee and Lower Extremity Injuries
Dashboard impact and floor bracing commonly injure the lower extremities.
Common Knee Injuries
Ligament Sprains: Medial collateral ligament (MCL), lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) injuries occur from abnormal knee forces during impact or bracing.
Meniscus Tears: The cartilage cushions in the knee can tear from twisting forces or direct trauma.
Patellar Injuries: Kneecap injuries include contusions, dislocations, or tracking problems (patellofemoral syndrome).
Muscle Strains: Quadriceps and hamstring strains cause pain with knee movement and difficulty with stairs or squatting.
Physiotherapy Treatment
Knee rehabilitation follows structured protocols:
Protection Phase: Managing pain and swelling while protecting healing structures. May include bracing, ice, elevation, and gentle range of motion.
Strengthening Phase: Progressive resistance training for quadriceps, hamstrings, hip muscles, and calf muscles. Strength deficits significantly impair knee function and increase reinjury risk.
Functional Phase: Balance training, agility drills, and sport or work-specific activities prepare for full return to demands.
Manual Therapy: Joint mobilization, patellar mobilization, and soft tissue techniques address mobility restrictions and pain.
Ankle and Foot Injuries
Brake pedal forces and foot positioning during impact commonly injure ankles and feet. Sprains, fractures, tendon injuries, and muscle strains require appropriate diagnosis and structured rehabilitation.
Chest and Rib Injuries
Seatbelt restraint across the chest, steering wheel impact, or airbag deployment can injure the chest wall.
Common Injuries
Rib Fractures: Broken ribs cause severe pain with breathing, coughing, and trunk movement. While fractures require medical management, physiotherapy supports recovery.
Costochondral Injuries: The cartilage connecting ribs to the sternum can separate or inflame, causing localized chest pain that worsens with movement and breathing.
Intercostal Muscle Strains: Muscles between ribs may strain, causing pain with breathing and trunk rotation.
Sternum Injuries: Breastbone fractures or contusions cause central chest pain.
Physiotherapy Management
Treatment emphasizes maintaining respiratory function while managing pain:
Breathing Exercises: Deep breathing maintains lung capacity and prevents complications like pneumonia.
Gentle Mobility: Careful trunk movement exercises prevent excessive stiffness while respecting healing constraints.
Postural Support: Strategies to reduce pain during daily activities and sleep.
Progressive Return: Gradual reintroduction of activities requiring trunk rotation, lifting, and reaching.
Temporomandibular Joint (TMJ) Disorders
Jaw injuries from airbag deployment, direct impact, or muscle tension during collision frequently go unrecognized but cause persistent problems.
Symptoms and Impact
TMJ dysfunction causes:
Jaw pain, especially with chewing
Limited mouth opening
Clicking, popping, or grinding sounds
Jaw deviation or locking
Headaches
Ear pain or fullness
Difficulty eating hard or chewy foods
These symptoms significantly impact quality of life but respond well to physiotherapy.
Treatment Approaches
Specialized TMJ physiotherapy includes:
Manual Therapy: Intraoral and extraoral techniques release muscle tension and improve joint mobility.
Exercise Prescription: Specific exercises restore normal jaw movement patterns and strengthen weakened muscles.
Education: Teaching protective strategies like avoiding hard foods, managing stress-related clenching, and optimal jaw positioning.
Postural Correction: Forward head posture contributes to TMJ dysfunction. Cervical and thoracic postural training reduces jaw stress.
Soft Tissue Injuries Throughout the Body
Beyond specific joint injuries, car accidents cause widespread soft tissue trauma including muscle contusions, hematomas, and strain patterns affecting multiple body regions simultaneously.
Muscle Contusions and Hematomas
Direct impact causes bruising and bleeding within muscles. While painful initially, these injuries typically heal well with appropriate management including ice, gentle movement, and progressive loading as healing allows.
Myofascial Pain Syndromes
Widespread muscle pain and trigger point development commonly follow car accidents. Trigger points—hyperirritable spots in tight muscle bands—refer pain to distant areas, creating complex pain patterns.
Your physiotherapist identifies and treats trigger points through manual pressure techniques, dry needling, and stretching programs combined with addressing perpetuating factors like postural dysfunction and stress.
Psychological Trauma and Its Physical Manifestations
The psychological impact of car accidents manifests physically through multiple mechanisms:
Muscle Tension: Anxiety and fear increase muscle tension throughout the body, particularly in the neck, shoulders, and jaw. This tension perpetuates pain and restricts movement.
Pain Amplification: Psychological distress reduces pain tolerance and increases pain perception. Addressing emotional aspects of recovery is essential for physical healing.
Fear-Avoidance: Patients who avoid movement due to fear of pain or reinjury develop weakness, stiffness, and functional limitations that far exceed the actual physical injury severity.
Post-Traumatic Stress: Flashbacks, hypervigilance, and anxiety directly impact physical recovery. Physiotherapists recognize these connections and coordinate psychological support when needed.
Research in Pain demonstrates that addressing psychological factors alongside physical impairments significantly improves outcomes compared to treating physical injuries alone.
Special Population Considerations
Pregnant Women
Pregnant women injured in car accidents require special consideration:
Immediate Medical Evaluation: Ensuring fetal wellbeing is paramount. Even seemingly minor accidents warrant obstetric assessment.
Treatment Modifications: Physiotherapy techniques are adapted for pregnancy, avoiding supine positions after the first trimester and modifying exercise intensity appropriately.
Pregnancy-Related Complications: Hormonal changes, altered biomechanics, and pre-existing pregnancy discomforts complicate injury recovery. Your physiotherapist addresses these interconnected issues.
Postpartum Recovery: Women injured during pregnancy who continue treatment postpartum face challenges balancing rehabilitation with infant care. Realistic home programs accommodate these demands.
Children and Adolescents
Young patients require developmentally appropriate assessment and treatment. Growth patterns influence injury healing, and age-appropriate explanations reduce anxiety. Parent education and involvement optimize compliance and outcomes.
Older Adults
Older adults often have pre-existing conditions affecting recovery. Osteoporosis increases fracture risk, arthritis complicates rehabilitation, and medical comorbidities require careful consideration. Fall prevention becomes crucial as injuries impair balance.
The Importance of Early Physiotherapy Intervention
Timing of physiotherapy initiation significantly influences outcomes. Early intervention (within the first week) provides multiple benefits:
Preventing Chronic Pain: Early active treatment reduces the risk of developing persistent pain syndromes that are more difficult to treat.
Maintaining Mobility: Gentle early movement prevents excessive stiffness and loss of range of motion.
Reducing Fear: Early education about expected recovery and safe movement reduces fear-avoidance behaviors that impede healing.
Identifying Complications: Early assessment detects problems requiring additional medical intervention before they worsen.
Research in The Lancet demonstrates that early, active physiotherapy significantly improves outcomes and reduces healthcare costs compared to delayed intervention or passive treatments.
Conclusion
Car accidents cause diverse injuries affecting virtually every body system. Understanding common injury patterns helps accident victims in Coquitlam, Port Moody, Port Coquitlam, and Surrey recognize symptoms requiring professional attention and make informed treatment decisions.
Physiotherapy provides comprehensive, evidence-based treatment addressing the full spectrum of car accident injuries. From whiplash and concussion to shoulder injuries and soft tissue trauma, skilled physiotherapists guide patients through structured rehabilitation restoring function and preventing chronic problems.
Early intervention, active treatment approaches combining manual therapy with therapeutic exercise, and addressing both physical and psychological aspects of injury optimize recovery outcomes. While individual recovery timelines vary, most car accident victims achieve substantial improvement through dedicated rehabilitation.
If you've been injured in a car accident, seeking physiotherapy assessment within the first week provides the best opportunity for optimal recovery. With comprehensive care addressing all aspects of your injuries, you can overcome the trauma of car accidents and return to full function and quality of life.
Don't Wait to Get Help
If you've been in a car accident, the first week matters. Early physiotherapy intervention prevents chronic pain, maintains mobility, and catches complications before they worsen.
At Capria Care Collective in Coquitlam, we have a special interest in ICBC claims and understand the full spectrum of car accident injuries—from whiplash and concussion to TMJ disorders and soft tissue trauma. We'll work directly with ICBC so you can focus on recovery.
Book your ICBC assessment: Call (604) 764-9839 or book online.
What to bring to your first visit:
ICBC claim number
Any medical imaging or reports
List of symptoms (even ones that seem unrelated)
We're located at 101-1060 Austin Ave in Coquitlam, easily accessible from Port Moody, Port Coquitlam, and throughout the Tri-Cities.
References
Croft, A. C., & Vohra, K. P. (2014). Whiplash injuries: Recent advances in prevention, diagnosis, and treatment. Traffic Injury Prevention, 15(7), 681-687. https://www.tandfonline.com/doi/abs/10.1080/15389588.2014.937804
Gross, A., Paquin, J. P., Dupont, G., et al. (2016). Exercises for mechanical neck disorders: A Cochrane review update. The Cochrane Database of Systematic Reviews, 1, CD008160. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008160.pub2/full
Schneider, K. J., Leddy, J. J., Guskiewicz, K. M., et al. (2017). Rest and treatment/rehabilitation following sport-related concussion: A systematic review. British Journal of Sports Medicine, 51(12), 951-959. https://bjsm.bmj.com/content/51/12/951
Lamb, S. E., Gates, S., Williams, M. A., et al. (2013). Emergency department treatments and physiotherapy for acute whiplash: A pragmatic, two-step, randomised controlled trial. The Lancet, 381(9866), 546-556. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60572-4/fulltext
Sterling, M., Hendrikz, J., & Kenardy, J. (2011). Similar factors predict disability and posttraumatic stress disorder trajectories after whiplash injury. Pain, 152(6), 1272-1278. https://journals.lww.com/pain/Abstract/2013/09000/Post_traumatic_stress_symptoms_maintain_chronic.27.aspx
Rebbeck, T., Sindhusake, D., Cameron, I. D., et al. (2006). A prospective cohort study of health outcomes following whiplash associated disorders in an Australian population. Injury Prevention, 12(2), 93-98. https://injuryprevention.bmj.com/content/12/2/93