No dents, no injury? The top five myths about car accidents and your health

car crash injuryIt is a myth that you cannot be injured in a car crash if there is no damage to the car.  And that’s just one of the myths that keep patients from taking care of themselves after a car crash and seeking the care they need.  We seem to think that the car is a steel womb protecting us from serious injury. In real life, that view is just wrong.

MYTH NUMBER ONE: No damage to the car means no damage to the passenger.

Wrong! Cars are designed to resist damage in low speed collisions- in fact the federal government requires it – but studies have shown that there is actually no “safe” speed below which a person cannot be injured.  Even in very low speed accidents, injuries can occur. Age, prior medical conditions, position in the car, lack of awareness of the impending crash,  whether your head is tunred –  human factors – are far more important in determining whether a person is injured than the speed of the collision.

MYTH NUMBER TWO: If you feel okay right after a car crash, you are fine.

Wrong! I have seen this over and over in my 30 years of practice: Victims of low speed car accidents  refuse to believe that they could possibly have been hurt, and then they hurt themselves even more  by acting as though nothing has happened to them.

Immediately after trauma, chemicals like adrenaline flood into our bodies. Adrenaline acts like speed or cocaine, numbing us from pain and giving us wondrous energy so we can run from a lion despite a broken leg. Flush with these powerful chemicals people can feel fine and power on with their lives for a day or two. They work long hours, go to the gym and lift weights. All of these activities pound more and more trauma into their injured body. So even if you feel fine – take it easy – rest, do not exercise or go to the gym – and sleep!

MYTH NUMBER THREE: I have no visible bangs or bruises  so I couldn’t be really hurt

Wrong again. While a lot of people can have bruises on their torso because of the force with which they were thrown against the seat belt, lots of force can be pounded into your body without any visible sign of injury. Some people don’t bruise easily. Other bruises can be hidden behind your hair if you hit the headrest hard. And though the brain is often bruised in car crashes – even low-speed ones – you certainly can’t see that and it won’t show up on MRI’s or CAT scans. An autopsy study of people who died in low-speed collisions from other causes like a heart attack showed that their brains bled. That study further confirms my experience that brain injury often occurs with car crashes, including so called low-speed collisions.

MYTH NUMBER FOUR: The crash was too slow to cause injury.

The studies have repeatedly shown that there is no “safe” speed below which no injury can occur.  A car is a big, heavy instrument of steel and power, and it takes a mighty shove to move it even a little bit.  At low speeds, the unique factors involved in the crash – such as the angle of impact, the relative sizes of the two vehicles, the passengers’ awareness or lack of awareness of the impending crash, the mechanics of the headrest, pre-existing medical conditions, even gender -all  have a profound impact on whether a person will be injured. And even at low speeds, in the milliseconds after impact, different parts of our bodies are thrown about in different directions, creating  shearing forces in the neck and upper torso. In a rear-end collision, the braking foot pushes tremendous forces up into the hip, jamming the hip socket and rotating the pelvis at the same time that the seat shoves the pelvis forward. That impact can tear ligaments, discs and muscles in the low back.

MYTH NUMBER FIVE:  The seat belt, headrest, and air bag will protect me from injury.

Seat belts, shoulder harness, air bags and headrests do protect us from injury. They help save lives, but in many kinds of collisions they can increase certain kinds of  injuries. We should all wear seatbelts. They keep us from being thrown from the car or slamming our heads into the windshield. However, they do create a risk of other kinds of injuries. On impact, our torso rotates around our shoulder harness, creating dangerous shearing forces that attack the torso, pelvis, ribs and internal organs like our liver and heart. Race car drivers have a shoulder harness on each side crossing their body in an X to prevent this rotation. But car designers for passenger vehicles decided this would make people feel too constrained in their cars and not want to buy such vehicles.

Headrests only protect the back and neck if at the time of impact our heads are within two inches of the headrest (some cars, such as Volvos, Mercedes and other newer cars reflect the importance of this positioning). Race car drivers’ helmets are attached to the headrest to keep the head from being flung forward and back. If our heads are further away than two inches from the headrest, on impact the head rest can become a battering ram to our head and brain.

Airbags, critical in high-speed collisions, also present risks. They explode at approximate 210 mph. If your hands are in the way because you’ve laced them through the steering wheel, then your hands, wrists and arms can suffer significant injuries.

All in all the first step in recovering from car crashes is acknowledging their potential for damage to the people inside the car. For only by respecting the potential for serious injury can we truly begin our recovery.