Patient Mechanisms of Injury in Whiplash-Associated Disorders

Whiplash-associated disorders constitute a large proportion of cervical injuries. The posteroanterior acceleration loading from rear-end motor vehicle crashes results in motions of the head–neck complex. This manuscript describes the various mechanisms of injury, including hyperextension kinematics, hydrodynamic forces (pressure gradient in the spinal canal), eccentric contraction (muscle focus), and combined axial and shear loading (local variations in the kinetics of different segments of the cervical spinal column). The anatomic components of the cervical spine that may be involved in functional alterations and that result in acute and chronic symptoms are discussed along with demographic and vehicular factors.