by Lawrence Herzog

Even as collisions have decreased, whiplash-related claims across Canada have been going up. In Manitoba, for instance, claims have spiked from 7,300 in 2000 to more than 12,000 in 2003. Nationally, the Insurance Bureau of Canada (IBC) says payments for personal injury and rehabilitation comprise more than 80 per cent of annual collision claims. IBC believes a significant portion of the cost could be reduced if more drivers would take the simple step of properly adjusting their head restraints.

Correct positioning brings the middle of the restraint in line with the middle or top of the ears and close to the back of the head to prevent rearward travel of the neck and spinal motion. “Studies indicate that a properly adjusted head restraint can reduce the severity of whiplash injuries by as much as 40 per cent,” says IBC president and CEO Stanley Griffin. “Head restraints aren’t in cars for comfort, they’re there for safety. Fewer whiplash injuries would lead to lower insurance premiums.”

Yet a 2002 study by IBC revealed more than 85 per cent of drivers fail to position their head restraints correctly. Researchers videotaped 7,500 drivers and 1,100 passengers as they approached stop signs and found that 53 per cent of drivers had such poor positioning, their head restraints would have provided virtually no protection in a rear-end collision. The study also found that women were three times more likely than men to have their head restraints properly positioned.

“The forces that cause a whiplash injury are enormous, explains Dr. Neil Craton, Medical Director of Manitoba Public Insurance. “The target vehicle takes the brunt of the energy transferred, which can result in 30 G’s going through the head of those being hit.” Those forces can damage soft tissues around the neck such as muscles, ligaments and joint structures, which in turn may trigger a variety of clinical disorders, called Whiplash-Related Disorders or WAD.

Whiplash usually heals within a few days to a few weeks, and often doesn’t require intensive therapy. But not everybody is so fortunate. “We’ve found that those people who immediately experience arm pain, headaches and dizziness often have a worse prognosis,” Dr. Craton says.

For those who have more serious symptoms, treatment options include athletic therapy, chiropractic, medicine and physiotherapy. The severity of the injury depends on the forces involved in the collision and the fitness and body type of the individual. Women are at greater risk for whiplash injuries because of their physiology, with their smaller neck and bone sizes.

Winnipeg chiropractor Dr. Robert Palaschuk, past president of the Manitoba Chiropractors’ Association, says our bodies are a collection of moving parts and, when one or two parts don’t move properly, it affects the movement of adjacent mechanisms. “That’s why, in a whiplash injury, re-establishing proper movement is so important for recovery.”

Yet despite the importance of proper use of head restraints, most Driver’s Handbooks don’t even mention them. Dr. Craton says there’s a huge need for public awareness and he notes that many people believe head restraints are manufactured to Canadian motor vehicle safety standards and that they have been tested and certified. That’s not necessarily true.

Although head restraints have been required safety features in cars in North America since 1969, advances in protection have been slow in coming. While European countries have long legislated the size and vertical adjustment requirements of head restraints, legislators in Canada and the U.S. have proved sluggish in implementing harmonized national standards. Many automobiles sold in our country don’t have adequate head restraints.

The Canadian Motor Vehicle Safety Standards only requires that a head restraint be provided at each front outboard designated seating position. The standard permits the rearmost portion of the occupant’s head to travel up to 102 mm (four inches) rearward from the torso. Tests show such a degree of travel during a collision from the rear can do extensive damage.

Even without stringent government regulation, good design with safety in mind has been finding its way into models gradually, starting with the luxury models and then trickling down into the less expensive vehicles, the way air bags, anti-lock brakes and traction control have done.

Research conducted by the Insurance Institute for Highway Safety (IIHS), based in Arlington, Virginia, is finding that some new designs of seats and head restraints are reducing neck injuries among car occupants involved in rear-end crashes. The institute reports more automobiles are now offering head restraint systems that provide what it calls “good” protection.

Among the innovative systems now on the market are SAAB’s active restraint and General Motors’ “catcher’s mitt” designs, which both feature a head restraint that moves up and forward as an occupant’s torso loads the seatback in a rear-end collision. Nissan also offers similar active restraint designs in some of its models; Volvo’s whiplash-injury prevention system features a seatback that yields and partially rotates on rear impact. And Toyota’s whiplash-injury lessening system includes a seatback designed to absorb the forces from a rear-end collision.

But whiplash isn’t only caused by rear end collisions and simply raising the head restraint doesn’t guarantee protection from front or side impacts. In fact, Dr. Craton says that while there’s no doubt seat belts save lives and reduce injuries in most collisions, they can also worsen the whiplash effects from a frontal collision. “The seat belt holds the occupant in place and that can save their life, but the jarring motion is much more pronounced and that can cause greater injuries to disks, muscles and ligaments.”

After years of believing that bed rest and restricted movement was the best way to treat whiplash injuries, medical practitioners now understand the quicker an injured person can get back to normal activity, the more effective the recovery. “Exercise and movement plays a large part in rehabilitation,” Dr. Palaschuk says. “Restoring that movement is crucial to reducing the long-term effects.”

Don’t get caught with your head restraints down

A properly adjusted head restraint should be at least as high as the head’s centre of gravity and positioned so that the top edge extends seven centimetres (two-and-a-half to three inches) above eye level. The restraint will not do its job if it is adjusted so low that its height is only neck level. The backset (distance from the head restraint to the back of the head) should ideally be less than five centimetres.

When purchasing a vehicle, check to see that the head restraint is adjustable and that it comes up high enough and close enough to the back of your head to offer protection in the event of a collision. The restraint should also lock in place; if it doesn’t, it could ratchet down to its lowest position during a collision.

Pay particular attention to children in car seats. MPI says if the mid-point of the child’s ears is higher than the top of the seat, the child should be moved to the next level of seat. To prevent whiplash, the upholstered seatback should fully support the child’s head.

When stopped at a red light, keep an eye on the rear view mirror and be prepared to take evasive action if you are about to be hit from behind.

Remember that winter driving conditions mean greater stopping distances and reduced traction and so slow down and give yourself more room to stop.

Sources: Manitoba Public Insurance (MPI), Insurance Institute for Highway Safety (IIHS), Canadian Automobile Association (CAA).

A version of this article appeared in the CAA magazines Going Places, Westworld Alberta and Westworld Saskatchewan.

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