After Neck Injuries, How Soon Can You Begin Motion?

June 23, 2017 in STSMPT

Auto accidents rank as the most common source of neck injuries, and research in whiplash gives us one of the best answers to this question. After most neck injuries, you want to get to a physical therapist right away, without waiting. After assessment, the therapist will prescribe some level of motion in most cases. If you begin motion after a neck injury too late, your neck may never reach full recovery.

We can see this demonstrated very well in the research of Mark Rosenfeld published in the journal Spine. Rosenfeld and colleagues divided people with whiplash injuries into three groups. One group received physical therapy within four days of the accident. Another group received physical therapy within two weeks of the accident. Finally, a third group didn’t receive physical therapy at all. They received advice from a doctor on restricted activity and for stretching to begin after several weeks. At both six-month and three-year follow-up, the physical therapy groups experienced significantly less pain and sick leave. After three years, only the four-day group had flexibility in their necks anywhere close to that of an uninjured control group. Getting active physical therapy introduced as early as possible, made functional differences that were evident even three years later. Waiting longer meant patients had a less functional recovery. Interestingly, when you count the cost of time off work, the people who got physical therapy the fastest, had the lowest cost of injury – even compared to people who only received a advice from a doctor.

One of the main reasons you want to introduce motion as soon as possible after an injury is the way tissues heal. Bodies lay down strands of healing tissue over injuries. If the tissues heal down in the wrong direction, movement becomes constricted. The body only has one blueprint for how those tissues should lie down: movement. Joints in motion cause tissues to heal in the most functional patterns. Of course, too much movement, the wrong movement, or movement at the wrong time can make some injuries worse. A physical therapy assessment will help you get on the right track for introducing safe movement on the correct pace.


  • Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders. Spine; 25 (14): 1782-87.
  • Rosenfeld M, Seferiadis A, Carlsson UJ, et al. Active intervention in patients with whiplash associated disorders improves long term prognosis. A randomised controlled clinical trial. Spine; 28: 2491-2498.
  • Rosenfeld M, Seferiadis, Gunnarsson. Active involvement and intervention in patients exposed to whiplash trauma in automobile pressures reduces costs. A randomised controlled clinical trial and health economic evaluation. Spine; 31: 1799-1804.
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