There is suspicion among researchers that such ongoing issues are the result of the body’s initial response to injury to the brachial plexus, the network of intersecting nerves that give rise to three main nerves that travel down the arm to the hand. To protect and ease tension on the brachial plexus, the superficial muscles to the side of the injury can become more active and take on the classic “shrugged” position, a posture commonly observed in patients with nerve damage associated with a whiplash associated disorder (WAD) injury.
Over time, this protective mechanism can weaken the deep neck muscles, which are important for maintaining proper vertebral alignment and posture. This may, in turn, result in secondary injury and the long-term problems observed in many WAD patients, even after the initial injury to the brachial plexus has resolved.
In a recent multi-center, randomized controlled trial involving 171 chronic WAD patients with radiating arm pain and associated signs of neurological deficit, researchers found that participants who performed neck-specific exercises for twelve weeks to strengthen the deep neck muscles reported improvements in overall pain, arm pain specifically, and pain frequency, with some neurological recovery. Participants who were instructed to engage in general/non-specific physical activity during the study did not report such improvements.
Two of the authors from the above study collaborated on a similar experiment and found that patients who engaged in neck-specific exercises not only experienced improvements in muscle strength and pain reduction, but they were more satisfied with the approach than participants in a general exercise group.
These studies show that when the deep muscles become the specific focus of neck exercises, the results are superior, AND this includes neurological recovery. Your doctor of chiropractic can help train you in these specific exercise approaches!
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