You’re stopped at red light awaiting a left turn into the grocery store parking lot when out of nowhere, you hear the screeching of tires, you turn your head and look into the rear view mirror and see that you’re about to be hit from behind. Then, “POW!” The sudden force of the impact propels you back into your seat, your head hits the headrest and then bounces forwards, almost hitting the steering wheel. You feel your body twist due to the angle of the seat belt and your sunglasses fly off and anything on the seat next to you flies into the dashboard and lands on the floor. You’re not sure what just happened as it all happened so fast. Is this a dream?

After collecting yourself and calming down, you get out of the car to inspect the damage and talk to the driver who just ran into you. You notice that right now, you don’t really hurt that much… but you feel kind of dazed. When you inspect your car, you notice very little damage, but it sure felt like your car should be totaled based on the way it felt. The other driver said he was checking the station on the radio. He tried to stop and slammed on the brakes but it was too late. He said, “…I couldn’t have been moving more than 5-10 mph when I hit you!” You ask, “how could this possibly feel so…..hard an impact? Was he lying to me?” There certainly wasn’t much damage to your car…maybe he was right??? When he asked you if you would, “…let it go,” and not call the police, you almost agree, but something stops you. Even though there is little car damage and, “…he is a nice guy….,” you just don’t feel right in, “…letting it go.”

Within 15-30 minutes, you’re REALLY HAPPY you didn’t give in and take his advice as by now, your neck is really starting to hurt. You feel kind of nauseated and light headed. Your head is beginning to pound and you feel like you better sit down. When the police officer approaches, he seems distant and you’re having difficulty hearing him. Pretty soon, you notice others helping you onto a stretcher and attaching a neck brace prior to taking you to a local emergency room. At the ER, you are confused about the details of the accident but piece together the best you can the events of the evening. They take x-rays, recommend some Advil and ice, and tell you to contact your primary care physician if you have problems. They tell you that you’re going to hurt for a few days and “…that’s normal.” However, over the next several days, the pain intensifies to a point where neck pain and headaches are constant, you can’t sleep, your memory seems blurry, you can’t seem to concentrate and lose your place during thoughts and conversation… Something is REALLY WRONG!

This scenario is not atypical of a low-speed collision-related injury. In fact, the less the car is damaged, the greater the force on the contents inside the car (this is called “elastic deformity”). That’s because crushing metal absorbs the energy of the force (ie, “plastic deformity) and if the speed is “…too low” and little metal crushing/energy absorption occurs, the G-forces that occurred during the collision are transferred to the contents inside the vehicle and that force can be significantly greater than a crash that occurs at 2-4 times the 5-10 mph speed. In general, when there is less damage to the car, be alert that the force exerted on the contents is greater than when car damage occurs. This is why when cars crash during a car race, the race car basically falls apart, leaving the driver enclosed in a cage that prevents bodily damage and they often walk away from the accident.