Biomedical
As stated I didn’t really have any idea of the force involved in the incident, there had been no scan or X-ray to clear for fracture or nerve impingement and I had no clear picture of neurological status. This was priority one. I often look at whiplash as multiple sprained ankles. Ten days down the line healing processes are ongoing and I needed to find out is it ok to start loading the area. Whiplash injuries are slow and complicated recoveries involving ‘yellow flag’ complications that need attention. However, a big bonus is seeing the client early and steering her back to function, life and work. The main aim is to create confidence, pass this to the client and get going.
Biopsychosocial
The client already had thoughts she hasn’t been properly assessed, no scans and little time given by medical professionals. She has had previous neck episodes and chiropractic visits that may have changed her view of spinal strength, stability and vulnerability. Her attitude to the problem is very passive, she is resting to manage pain and believes movement and exercise will worsen it. In addition, she believes she cannot work until feeling 100%. There were also hints of catastrophising.
Mismanagement
I would love to hear the doctor say “My best advice is seeking guidance from your physiotherapist. They should help with your pain but more importantly get you going again”. My biggest issue is with the rest, do not do anything you enjoy and “see how you go” approach. To be fair I have dealt with some brilliant doctors and surgeons recently who are really looking at the big picture with long term recovery.
Emotion
She is distressed, angry, fearful and irritable. These are all completely understandable. They are also stalling recovery and should and can be improved through good clinical skills. We must also remember the lack of family and work support. The ‘mother-toddler’ approach can be very effective. The mother (clinician) asks some important early questions to alleviate major worries while also have a good thorough look and feel. There is also the distraction aspect. This is not to insult the client but through chat and movement to being to alleviate concerns while getting things going. A skilled practitioner will begin to listen, acknowledge the situation but change the narrative, instill confidence, understanding, positivity and show a route to recovery.