Women with Whiplash Are Not More Anxious Than Men

By Melissa D. Carter, Attorney at Law

An acute whiplash injury results from the sudden hyper-extension, hyper-flexion of the neck with an acceleration-deceleration type traumatic insult, and it is the most common soft tissue injury sustained in motor vehicle collisions.[1]  Most cases of whiplash occur after a rear-end motor vehicle collision, and most case presentations include neck pain and stiffness, occipital headache, thoracic back pain and/or lumbar back pain, as well as upper extremity pain and paresthesia.[2]  Each year, there are 3 million new whiplash injuries in the U.S. alone.[3]  Whiplash is such a significant public health issue that an international consortia of automobile insurers—from North America to Europe, and Japan to Australia—are all actively engaged in whiplash-related research, as are multiple private coalitions, such as the European Whiplash Consortium, International Insurance Whiplash Prevention Group, the Insurance Institute for Highway Safety, and the National Highway and Traffic Safety Administration.

Whiplash injuries can often lead to long-lasting pain and disability and can be costly.  When this pain persists over time, whiplash-type trauma can have a psychological component, including post-traumatic fear, anxiety, adjustment reaction, and even depression.  A 2001 study confirmed a positive association between whiplash traumas and anxiety disorder and depression.[4]

One very significant risk factor for whiplash is gender.  Women are twice as likely as men to suffer whiplash injuries when hit from behind, and studies suggest that this is due to the differences in muscular bulk and the female’s smaller bony structures.  These factors likely result in less protection of the cervical spine to certain forces, such as those that occur in a whiplash-type injury.[5]  Given their greater predisposition for whiplash injury following a trauma, many medical providers have assumed that women are more likely to suffer from post-traumatic fear, anxiety, adjustment reaction, and/or depression than men who suffer from whiplash.  A 2014 published study [6] tested the theory and negated this oft-referenced assumption.

The researchers in this study, from Vrije University and Ghent University in Belgium, looked at 117 patients who all suffered from a whiplash injury, including 24 men and 93 women.  They evaluated neck pain, as well as emotional and psychological conditions following a whiplash producing injury.  Researchers found no major differences in fear, somatization, bodily pain, disability or overall health between men and women.  Interestingly, women in this study actually reported seeking out social support more frequently than men to help cope with emotional dysfunction.

The researchers noted, “This opens the perspective to look for sex differences in chronic [whiplash-associated disorders] in a broader sense.”  Researchers concluded that, while psychosocial factors play a role in the development of chronic whiplash, they are “unlikely to be the cause for sex differences in chronic [whiplash.]”

Regardless of the gender of your patient, anyone who is suffering from whiplash and who is dealing with longer-term physical, cognitive, and/or emotional consequences following trauma most definitely needs access to quality health care as well as obtaining second opinions to help assess and treat an injury.  Additionally, given the aggressive nature of how insurers deny bills for treatment or outright attempt to block access to appropriate care, it is important to consider having legal counsel assist the patient with insurance-related matters so that the patient can focus exclusively on health and wellness. After all, health is the greatest wealth for any patient and it is our highest goal to assist in that mission.



[1] 4th European Dyna Conference: “Biomechanical Analysis of Whiplash Injuries: Women are Not Scaled Down Men,” Modaka J.

[2] J Bone Joint Surg Br. 2009 Jul;91(7):845-50. doi: 10.1302/0301-620X.91B7.22639 Bannister, G; Amirfeyz, R, Kelley.

[3] Spine Research Institute of San Diego.

[4] J. Psychosomatic Research.  September 2002, Vol 53, Iss 3, p. 831-835.  “A population study of anxiety and depression among persons who report whiplash traumas.”  Wenzel, Haug, Mukletun, Dahl.

[5] http://www.spine-health.com/conditions/neck-pain/what-whiplash h/t: Nordhoff L: “Motor Vehicle Collision Injury for the 1990’s Doctor/Attorney”, Automotive Injury Research Institute, 1994.

[6] See comment in PubMed Commons belowPain Pract. 2014 Sep 27. doi: 10.1111/papr.12244. [Epub ahead of print] Malfliet, A, et a. Sex differences in patients with chronic pain following whiplash injury: The role of depression, fear, somatization, social support, and personality traits. Pain Practice 2014. Doi: 10.1111/papr.12244.

New Concussion Study on High School Players’ Brains Shows Changes in White Matter after One Season

By: Richard H. Adler & Arthur D. Leritz, Attorneys at Law

A recent study established what many have suspected for some time –namely, that repetitive hits to the head in athletes can cause cellular changes to the brain, even in the absence of a diagnosed concussion.[1]   The study involved 24 high school football players aged 16-18.  These players were equipped with the Head Impact Telemetry System (HITS) for all practices and games.  HITS was first developed by equipment manufacturer Riddell in 2003.[2]  Since that time, HITS has analyzed more than 1.3 million impacts.[3]

Prior to the first practice of the season, each player in the study group received an MRI of the brain, including Diffusion Tensor Imaging (DTI), to measure fractional anisotropy (FA).  FA can be a useful measure of connectivity in the brain and visible decreases in FA as seen on DTI have been associated with traumatic brain injury.   The data collected during the study enabled the researchers to further separate the study group:  one group consisted of players who regularly received hard hits (9) and the other group included those players who received light hits (15).  Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT, a computerized concussion evaluation system) was also conducted throughout the season.

After the season, the players again underwent MRIs with Diffusion Tensor Imaging and the imaging results were compared to the pre-season MRIs with DTI.  The post-season imaging revealed that there was a widely distributed and statistically significant decrease in FA, especially when comparing the heavy hitters to the light hitters.  The areas of the brain affected included the splenium of the corpus callosum and the deep white matter tracts.  The clinical and potential long-term significance of the changes to the cells of the teenager’s brain remains to be seen and further study in required.  However, the researchers did find a strong correlation between DTI measures and changes in the verbal memory subscore of the ImPACT.


"Diffusion Tensor Imaging-Based Research on Human White Matter Anatomy,"  Scientific World Journal, Volume 2012 (2012), doi: 10.1100/2012/530432

“Diffusion Tensor Imaging-Based Research on Human White Matter Anatomy,”
Scientific World Journal, Volume 2012 (2012), doi: 10.1100/2012/530432





We have the privilege to represent many individuals and their families following a traumatic brain injury (TBI).  There is a far greater incidence of TBIs occurring from motor vehicles injuring occupants of cars, pedestrians, and bicyclists than TBIs from sport-related concussions. However, the recent and growing interest in brain injury research can be tied to the concern for player safety in all contact sports, particularly boy’s football, ranging from youth athletes to elite professionals. The research study discussed above is one example of many that is ongoing and tied to the increased awareness and concern about preventing preventable brain injuries in youth athletes.

The attorneys at Adler ♦ Giersch PS remain a strong voice and advocate for those with traumatic brain injuries. We are dedicated to staying focused on developments in research, treatments, and advocacy approaches for those with traumatic brain injuries caused by the fault of another.  The attorneys at Adler ♦ Giersch PS know what it takes to prove these injuries to insurers during negotiations and to judges and juries in a courtroom.   We are ready to assist when the need arises. Simply give us a call.

[1] http://rsna2014.rsna.org/program/details/?emID=14011727; http://www.ncbi.nlm.nih.gov/pubmed/24786802.

[2] http://www.momsteam.com/health-safety/impact-sensors-riddell-insite-impact-response-system-uses-head-impact-telemetry-system-HITS

[3] Ibid.

Annual BIAWA Gala Bigger Than Ever in 2014

NFL Commissioner Roger Goodell, Victor Lystedt, Zackery Lystedt, and Richard H. Adler (photo credit: Nate Gowdy)

NFL Commissioner Roger Goodell, Victor Lystedt, Zackery Lystedt, and Richard H. Adler (photo credit: Nate Gowdy)

The eighth annual benefit auction for the Brain Injury Alliance of Washington (BIAWA), the Brain Injury Gala, was held on November 1, 2014 at the Westin in Downtown Seattle.  This was the largest attended with over 600 guests.  The Honorary Chair for the event was NFL Commissioner, Roger Goodell, who accepted the Leadership Award on behalf of the NFL for their commitment to passing components of Washington’s Zackery Lystedt Law in all 50 states and the District of Columbia.  The law firm was a sponsor for the event and hosted eight tables.  The auction rose over $550,000, a new record for the organization.