Individuals suffering from chronic whiplash-associated disorders (WAD) may experience ongoing symptoms beyond neck pain such as dizziness, impaired balance, and difficulty with fine motor control of the upper limbs. It’s suspected that muscle activation patterns can change in response to injury to the soft tissues in the neck, which can hinder the function of the vestibular (balance), eye, and arm movement control systems. To give them the best chance at recovery, a patient’s WAD treatment plan may include exercises intended to restore normal strength and function to the muscles in the neck, including the deep muscles that provide cervical stability and control of intersegmental motion. Here are a few exercises to improve strength and function in the neck muscles:

• Chin tucks: While sitting, look straight ahead and tuck in your chin/head (create a “double chin”), hold ten seconds and rest three seconds, and repeat ten times. Do this one time every hour of your awake day during the first week.
• Deep neck flexor isolation: While laying on your back, place about a half inch- to one-inch-thick folded towel under the back of your head (modify the towel thickness to ensure a good neutral head/neck/trunk posture). The aim is to facilitate (contract) the deep neck flexors while minimizing contraction of the superficial/large muscles. Now, imagine looking up (but don’t move your head) to facilitate the dorsal neck muscle activation reflex. Hold three-to-five seconds, repeat five times. Then, look down with just your eyes. Use your fingers over the front of neck to make sure the superficial muscles do not contract. Hold three-to-five seconds, repeat five times.
• Eye Rotation: Imagine rotating to the right but don’t move your head, only your eyes (to the right); hold 3-5 seconds, repeat 5 times. Then, perform the same process, but now focused on the left side.

Once you’re comfortable with these exercises, introduce resistance. Start by gently using your fingers or hand to push against your movement. Over time, you can increase resistance with the use of resistance bands. You can (and should) also increase holding times and the number of reps as your neck muscles grow stronger.

This routine was featured in an August 2024 study that included chronic WAD patients and healthy age-matched controls. The WAD group exhibited neck strength and function deficits that were not observed in the control group. After three months, the WAD patients experienced a return to normal neck muscle function. If you are continuing to experience ongoing symptoms like dizziness, impaired balance, and difficulty with fine motor control of the upper limbs following a motor vehicle collision, slip and fall, or sports collision, consult a doctor of chiropractic to see if hands-on care in the office accompanied by at-home neck exercises like these can help you return to your normal activities.