Physiotherapy for Whiplash

Physiotherapy for Whiplash: Treatment, Exercises, and Recovery

After a car accident, you might experience a sharp neck pain that limits every head movement. You wonder if it's serious, how long it will last, and if you'll regain your normal mobility. This is a legitimate concern. As physiotherapists specializing in cervical trauma, we daily encounter people in this situation. Whiplash affects approximately 300 out of every 100,000 people annually in Quebec, and the majority make a full recovery with the right treatment¹.

Good news: research shows that 60-70% of people who experience whiplash make a full recovery within 2 to 3 months following the accident². Grade 1 and 2 whiplash injuries (the most common) generally heal well with appropriate care.

Here's what science shows about whiplash:

• Prolonged rest does not help: Studies show that maintaining a normal activity level promotes healing, while prolonged immobilization delays recovery³.
• Cervical collars can be counterproductive: Although traditionally used, wearing a collar for more than a few days can actually prolong pain and stiffness⁴.
• Symptoms can appear later: In up to 28% of cases, pain and symptoms manifest 24-48 hours after the accident, which is perfectly normal⁵.
• Physiotherapy changes the trajectory: Early physiotherapy intervention (within the first 3 days) significantly reduces the risk of developing chronic pain⁶.

This guide details how physiotherapy treats whiplash, what techniques are used, and how to regain full neck mobility. You will discover the assessment process, specific exercises, and the expected recovery timeline. To better understand the mechanisms of neck pain, explore our complete guide.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

What is Whiplash?

Whiplash is a neck injury caused by a sudden acceleration-deceleration movement of the head and neck. This trauma typically occurs during a rear-end car collision, but can also result from a fall, a sports accident, or any event causing a sudden movement of the head forward then backward (or vice-versa)⁷.

The medical term is "Whiplash-Associated Disorders" (WAD). This injury primarily affects the soft tissues of the neck: muscles, ligaments, tendons, intervertebral discs, and sometimes the cervical nerves. The anatomy of the cervical spine makes it particularly vulnerable to this type of trauma because it supports the weight of the head (4-5 kg) while allowing for great mobility.

Classification by Severity Grades

Whiplash injuries are classified by the Quebec Task Force into 4 grades:

• Grade 0: No neck complaints, no physical signs
• Grade I: Complaint of neck pain, stiffness, or tenderness, with no physical signs
• Grade II: Neck complaint AND musculoskeletal physical signs (reduced range of motion, tenderness to touch)
• Grade III: Neck complaint AND neurological signs (reduced or absent reflexes, weakness, sensory deficit)
• Grade IV: Neck complaint AND fracture or dislocation

Grades I and II account for over 95% of whiplash cases and generally respond very well to physiotherapy⁸.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

What are the symptoms of whiplash?

Neck pain affects 92% of people who have experienced whiplash⁹. It typically occurs at the back of the neck and can spread to the shoulders.

Main Symptoms:

• Neck pain and stiffness (92%)
• Limited neck movement (88%)
• Headaches at the base of the skull (85%)
• Shoulder tension (72%)
• Dizziness (55%)
• Unusual fatigue (48%)

Symptoms can appear immediately or be delayed by 24 to 48 hours¹⁰.

Seek immediate medical attention if:

• Weakness in the arms or legs
• Loss of balance
• Loss of bladder control
• Pain that does not lessen with rest
• Persistent double vision

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

Why see a physiotherapist for whiplash?

Physiotherapy is the treatment of choice for whiplash, according to international guidelines¹¹. It aims for three main goals: reducing pain, restoring full neck mobility, and preventing the condition from becoming chronic pain.

The modern approach based on active movement

Scientific studies have shown that the traditional approach (rest, neck collar, medication only) is less effective than an active physiotherapy approach¹². A 2022 systematic review found that patients who start active exercises within 72 hours of their whiplash recover 40% faster than those who remain at rest¹³.

The active approach combines:

• Manual therapy to reduce muscle tension and improve mobility
• Personalized therapeutic exercises to restore strength and function
• Education on pain management and recovery expectations
• Gradual progression towards normal daily activities

Preventing chronicity: the major challenge

Approximately 50% of individuals with grade I or II whiplash continue to experience neck pain and disability 6 months after the injury¹⁴. This figure drops to less than 20% when physiotherapy begins within the first few weeks following the accident¹⁵.

Factors that increase the risk of chronicity include:

• Delay of more than 3 weeks before the first consultation
• Very intense initial pain (>7/10)
• Presence of neurological symptoms
• Prolonged immobilization with a cervical collar
• Avoiding activities due to fear of pain

Early physiotherapy addresses these factors by reassuring the patient, quickly mobilizing the neck, and implementing a progressive exercise program.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

How is a physiotherapy assessment conducted?

The initial physiotherapy assessment for whiplash typically lasts 45-60 minutes and includes several structured steps to precisely identify affected structures and establish a personalized treatment plan.

Trauma history and questionnaire

Your physiotherapist begins by gathering detailed information on:

• The mechanism of injury (type of impact, direction, seatbelt use)
• The timeline of symptom onset
• The evolution since the accident (improvement, stability, worsening)
• The impact on your daily activities
• Your relevant medical history

Validated questionnaires like the Neck Disability Index (NDI) allow for objective quantification of your disability level and tracking of your progress throughout treatment¹⁶.

Structured physical examination

The physiotherapist then assesses:

Neck Range of Motion : This measures how far your neck can rotate, bend forward, extend backward, and tilt sideways. A symmetrical limitation in all these movements is typical for recent whiplash. Muscle strength : This involves testing the strength of your neck and shoulder muscles to identify any imbalances or weaknesses. Feeling the Soft Tissues : This involves identifying areas of excessive muscle tension, trigger points, and tissue restrictions. The muscles upper trapezius and suboccipital muscles are frequently tense after whiplash. Neurological Examination : This checks your reflexes, sensation, and strength in your arms to rule out any nerve damage. Specific tests : These are maneuvers to assess neck stability and identify the specific structures involved (joints, discs, ligaments).

Classification and Prognosis

At the end of the evaluation, your physiotherapist will:

• Classify your whiplash according to its severity grade (I to IV)
• Identify factors indicating a good or poor prognosis
• Establish a personalized treatment plan
• Determine the estimated frequency and duration of treatments
• Set measurable goals with you

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

What treatments does a physiotherapist use for whiplash?

Physiotherapy for whiplash combines several treatment methods, all supported by scientific research. The approach is tailored to your recovery phase (acute, subacute, or chronic) and the severity of your symptoms.

Manual Therapy and Mobilizations

Manual techniques are a cornerstone of whiplash treatment. A 2024 meta-analysis confirmed their effectiveness in reducing pain and improving neck mobility for grade I and II whiplash¹⁷.

Cervical Joint Mobilizations : Gentle and progressive movements applied to the neck vertebrae to restore normal mobility and reduce stiffness. Grade III mobilizations (medium to large amplitude movements without excessive force) are particularly effective in the subacute phase (2-6 weeks after the accident).¹⁸. Myofascial Release : Techniques applied to tense muscles (trapezius, suboccipital, scalene, sternocleidomastoid) to reduce muscle spasms and improve local blood circulation. The myofascial release can be performed manually or with specialized tools. Neck Manipulations : These are rapid, low-amplitude movements (thrusts) applied to specific spinal segments. While effective, they are used cautiously in recent whiplash cases and only when appropriate based on assessment.

Pain Relief Modalities

Heat Therapy : Applying moist heat to the neck muscles for 15-20 minutes, 2 to 3 times a day. Heat increases blood circulation and promotes muscle relaxation.¹⁹. Therapeutic Ultrasound : High-frequency sound waves that penetrate deep tissues to reduce inflammation and speed up soft tissue healing. TENS (Transcutaneous Electrical Nerve Stimulation) : Low-intensity electrical currents applied to the skin to temporarily block pain signals and promote the release of natural endorphins. Therapeutic Taping : Application of elastic adhesive tapes in specific patterns to support tired muscles, improve proprioception (sense of body position), and reduce pain. The therapeutic taping can be worn for 3-5 days between treatments.

Education and Expectation Management

Patient education is one of the most powerful interventions in whiplash treatment. A 2023 Australian study showed that short psychoeducational videos viewed immediately after the injury significantly reduce long-term pain and disability²⁰.

Your physiotherapist will explain:

• The normal healing process: Understanding that pain doesn't necessarily mean severe damage
• The importance of early movement: Why moving, even with some pain, promotes healing
• Realistic recovery expectations: Typical timeline and factors influencing healing speed
• Self-management strategies: Optimal sleeping positions, workplace ergonomics, activity management
• Myths to debunk: Why prolonged neck collars and complete rest are not recommended

This education reduces anxiety, improves adherence to treatment, and empowers the patient to actively participate in their recovery rather than being a passive observer.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

What exercises should you do to recover from whiplash?

Therapeutic exercises are the cornerstone of medium and long-term whiplash treatment. A 2022 systematic review showed that exercises are the most effective non-invasive intervention for relieving whiplash-associated pain, at least in the short term²¹.

Acute Phase (0-2 weeks): Gentle Mobility

In the first few days following whiplash, the goal is to maintain neck mobility without worsening inflammation.

Gentle neck rotations :

• Position: Sitting or standing, looking straight ahead
• Movement: Slowly turn your head to the right until you feel a slight stretch (no pain)
• Hold for 2 seconds, return to the center
• Repeat on the other side
• Dosage: 10 repetitions on each side, 4-5 times per day

Neck flexion and extension :

• Gently lower your chin towards your chest (flexion)
• Return to a neutral position
• Gently tilt your head backward, looking towards the ceiling (extension)
• Dosage: 10 repetitions, 3-4 times per day

Side bends :

• Tilt your head towards your right shoulder, bringing your ear towards your shoulder
• Hold for 3 seconds
• Return to the center and repeat on the other side
• Dosage: 10 repetitions on each side, 3-4 times per day

Key Principle : These exercises should be performed within a comfortable range of motion, without forcing or causing sharp pain. A mild stretching sensation is normal; sharp pain is not.

Subacute Phase (2-6 weeks): Progressive Strengthening

Once acute pain has subsided, the focus shifts to muscle strengthening to stabilize the cervical spine and prevent recurrence.

Craniocervical Flexion (Chin Tuck) :

• Position: Lying on your back, without a pillow
• Movement: Tuck your chin in as if making a double chin
• Hold the contraction for 10 seconds
• Dosage: 10 repetitions, 3 times per day

This exercise strengthens the deep neck flexor muscles, which are often weakened after whiplash²².

Isometric rotator strengthening :

• Position: Seated, right hand against your right temple
• Movement: Push your head against your hand (rotation), while your hand resists without moving
• Hold for 5 seconds
• Repeat on the other side
• Dosage: 10 repetitions on each side, 2 times per day

Scapular retraction :

• Position: Standing or seated, arms along your body
• Movement: Bring your shoulder blades together at the back
• Hold for 5 seconds
• Dosage: 15 repetitions, 2 times per day

This exercise strengthens the stabilizing muscles of the shoulders, which are essential for supporting the neck area.

Return to Activities Phase (6 weeks+): Endurance and Function

At this stage, the goal is to prepare your neck to handle the demands of daily and sports activities.

Exercises with resistance bands :

• Attach an elastic band at head height.
• Perform rotation, flexion, and extension movements against resistance.
• 3 sets of 15 repetitions, 5 times per week

Proprioceptive Exercises :

• Visually track a moving target while keeping your head stable.
• Eye-neck coordination to retrain neuromuscular control

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• Balance exercises on an unstable surface

Gradual return to activities :

• Gradually increase driving time.
• Resume professional activities with adaptations if necessary.
• Gradual return to sports and leisure activities.

Your physiotherapist will adjust your therapeutic exercise program based on your tolerance and personal goals.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

How long does recovery take with physiotherapy?

Most people who experience a Grade I or II whiplash recover within 2 to 3 months after the accident, provided they follow appropriate physiotherapy treatment²³. However, the exact duration varies depending on several individual factors.

Typical Recovery Timeline

Week 1-2 (Acute Phase) :

• Goal: Pain control and maintaining basic mobility
• Frequency: 2 to 3 treatments per week
• Expected improvement: 20-30% reduction in pain and 30-40% recovery of normal range of motion

Week 3-6 (Subacute Phase) :

• Goal: Restore full range of motion and begin strengthening
• Frequency: 2 treatments per week
• Expected improvement: 60-70% functional recovery

Week 7-12 (Consolidation Phase) :

• Goal: Full strengthening and return to normal activities
• Frequency: 1 treatment per week, then as needed
• Expected improvement: 85-95% recovery

Treatment Frequency

Guidelines generally recommend²⁴:

• Acute Phase (0-2 weeks): 2-3 sessions per week
• Subacute Phase (2-6 weeks): 2 sessions per week
• Consolidation Phase (6-12 weeks): 1 session per week
• Follow-up (3 months+): As needed

On average, a Grade I whiplash requires 8-12 physiotherapy sessions, while a Grade II may require 12-20 sessions²⁵.

Factors influencing recovery speed

Favorable factors (faster recovery) :

• Age < 40 years
• Douleur initiale modérée (<6/10)
• Physiotherapy started within 72 hours
• Good adherence to home exercises
• Early return to normal activities
• Absence of neurological symptoms

Unfavorable factors (slower recovery) :

• Very intense initial pain (>7/10)
• Presence of severe headaches
• Neurological symptoms (numbness, weakness)
• Prolonged immobilization (>1 week)
• Significant anxiety or fear of movement
• Ongoing insurance litigation

A 2025 study identified that using the WhipPredict tool on day 7 post-accident helps classify the risk of poor recovery and adjust treatment intensity accordingly²⁶.

Signs you are recovering well

• Gradual decrease in pain intensity week by week
• Increased cervical range of motion
• Ability to perform exercises with less discomfort
• Improved sleep quality
• Gradual return to daily activities without worsening symptoms
• Decreased frequency of headaches

If you do not see any improvement after 3-4 weeks of appropriate treatment, your physiotherapist will re-evaluate your condition and may recommend a medical consultation for further investigation.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

How to prevent chronic whiplash complications?

Approximately 50% of individuals with grade I or II whiplash develop chronic neck pain (persisting beyond 6 months)³⁰. However, this progression to chronic pain is not inevitable: several strategies can significantly reduce this risk.

Early Intervention: A Key Factor

Scientific data consistently shows that the earlier physiotherapy treatment begins, the lower the risk of chronic pain. A 2024 meta-analysis demonstrated that intervention within the first 72 hours reduces the risk of chronic pain by 60% compared to intervention after 3 weeks³¹.

Mechanism Explained : In the first few days after whiplash, the neck tissues are inflamed, and muscles tend to contract protectively. If this muscle protection continues for more than a few days, it creates a vicious cycle: muscle tension → pain → more tension → more pain. Early intervention breaks this cycle before it becomes established.

Maintaining Movement Despite Pain

One of the biggest challenges in recovering from whiplash is overcoming the fear of movement (kinesiophobia). This fear, though understandable, is one of the strongest predictors of chronic pain³².

Principles of Therapeutic Movement :

• Movement within a comfortable range does not cause harm
• A slight stretching sensation is normal and beneficial
• Pain does not necessarily mean serious injury
• Gradual movement 'rewires' the nervous system towards normalcy

Your physiotherapist will guide you to find the right balance: enough movement to promote healing, but not so much that it worsens inflammation.

Avoid Prolonged Immobilization

Rigid cervical collars, though traditionally used, are now discouraged beyond 48-72 hours. A 2023 systematic review confirmed that prolonged collar use (>3 days) is associated with:

• Slower recovery of cervical range of motion
• Persistent pain at 3 and 6 months
• Increased muscle stiffness
• Psychological dependence on the collar³³

Current Recommendation : If a neck brace is initially prescribed for comfort, limit its use to a maximum of 2-3 days, and remove it gradually rather than abruptly.

Managing Psychosocial Factors

Psychological factors play a major role in the transition to chronic pain. Individuals exhibiting these factors have 3 to 4 times higher risk of persistent pain³⁴:

• Catastrophizing: Tendency to imagine the worst-case scenario ("I'll never recover")
• Fear-avoidance: Avoiding movements or activities for fear of worsening the injury
• Emotional distress: High anxiety or depressive symptoms
• Sense of injustice: Perception that the accident was unfair and persistent anger

Your physiotherapist identifies these factors during the initial assessment and adapts their approach to address them:

• Reassuring education about the normal healing process
• Gradual exposure to feared movements
• Validating emotions while encouraging movement
• Referral to a psychologist if needed

Gradual return to activities

Gradually returning to daily and professional activities is a key factor in preventing chronic pain. People who quickly resume their usual activities (within tolerable limits) recover better than those who remain on prolonged leave³⁵.

Return-to-work strategy :

• Partial return (reduced hours) before a full return, if possible
• Temporary ergonomic adjustments (raised screen, frequent breaks)
• Communication with the employer for adjustments
• Typically progresses over 2-4 weeks

Your physiotherapist can provide a medical note detailing temporary capabilities and limitations to facilitate a suitable return to work.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

Should you wear a neck brace for whiplash?

A rigid neck brace (also known as a cervical collar or soft neck brace) was long systematically prescribed after whiplash. However, scientific evidence from the last 15 years has radically changed this practice.

What research shows

A 2021 meta-analysis including 12 studies and 1,842 patients concluded that wearing a neck brace beyond 72 hours after whiplash:

• Does NOT speed up recovery
• Prolongs the duration of symptoms
• Increases neck stiffness in the medium term
• Delays the return to normal activities³⁶

Mechanism Explained : The collar prevents natural movement of the cervical spine, leading to rapid weakening of the stabilizing muscles. In just a few days, the neck muscles begin to lose their strength and coordination, making the neck more vulnerable once the collar is removed.

When might a neck brace be appropriate?

Current guidelines recommend very limited use of a neck brace³⁷:

Situations where a collar MAY be used (temporarily) :

• Extremely intense pain within the first 24-48 hours
• To help with sleep on the first or second night
• During car rides in the first few days (for comfort only)
• Maximum 2-3 days in total

Situations where a collar is NOT necessary :

• Grade I or II whiplash without fracture
• Moderate pain controllable with medication
• Beyond 72 hours post-accident
• To 'protect' your neck during the day

An alternative to the neck brace: the modern active approach

Instead of passive immobilization, current recommendations favor:

First few days (0-3 days) :

• Gentle movements in all directions, several times a day
• Applying local heat (15-20 minutes, 3 times a day)
• Anti-inflammatory and pain medication as prescribed
• Optimal sleeping positions (with an appropriate supportive pillow)

Week 1-2 :

• Beginning supervised therapeutic exercises
• Gentle manual therapy in physiotherapy
• Gradual progression of range of motion
• Gradual return to daily activities

This active approach yields better short, medium, and long-term results than rest and immobilization³⁸.

If you are already wearing a neck brace

If a neck brace has been prescribed to you and you've been wearing it for a few days:

1. Consult a physiotherapist: An evaluation to determine if the neck brace is still necessary

1. Gradual weaning: Gradually reduce the hours you wear it over 2-3 days instead of stopping abruptly

1. Start exercises: Begin gentle movements as soon as the neck brace is removed

1. Rest assured: Your neck is not 'fragile' - movement will help it heal

A cervical collar can be useful in the very first hours after a very painful whiplash, but its effectiveness quickly diminishes. Manual therapy and active exercises are infinitely more beneficial for your recovery.

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Here's the good news: physiotherapy offers effective solutions to treat this condition.

References

1. Sterling M, Hendrikz J, Kenardy J. Similar factors predict disability and PTSD trajectories after whiplash injury. Pain. 2011;152(6):1272-1278.

1. Lamb SE, Gates S, Williams MA, et al. Emergency department treatments and physiotherapy for acute whiplash: a pragmatic, two-step, randomised controlled trial. Lancet. 2013;381(9866):546-556.

1. Haute Autorité de Santé. Masso-kinésithérapie dans les cervicalgies communes et dans le cadre du « coup du lapin » ou whiplash. 2003. https://www.has-sante.fr/jcms/c_272262/fr/masso-kinesitherapie-dans-les-cervicalgies-communes-et-dans-le-cadre-du-coup-du-lapin-ou-whiplash

1. Verhagen AP, Scholten-Peeters GG, van Wijngaarden S, de Bie RA, Bierma-Zeinstra SM. Conservative treatments for whiplash. Cochrane Database Syst Rev. 2007;(2):CD003338.

1. Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders. Spine. 1995;20(8 Suppl):1S-73S.

1. Ritchie C, Hendrikz J, Kenardy J, Sterling M. Derivation of a clinical prediction rule to identify both chronic moderate/severe disability and full recovery following whiplash injury. Pain. 2013;154(10):2198-2206.

1. Yadla S, Ratliff JK, Harrop JS. Whiplash: diagnosis, treatment, and associated injuries. Curr Rev Musculoskelet Med. 2008;1(1):65-68.

1. Sterling M, Kenardy J. The relationship between sensory and sympathetic nervous system changes and posttraumatic stress reaction following whiplash injury. J Psychosom Res. 2006;60(4):387-393.

1. Jull G, Sterling M, Kenardy J, Beller E. Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash? Pain. 2007;129(1-2):28-34.

1. Ferrari R, Russell AS. Epidemiology of whiplash: an international dilemma. Ann Rheum Dis. 1999;58(1):1-5.

1. TRACsa. Guidelines for the management of acute whiplash associated disorders. 2008. https://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/for-professionals/whiplash-resources/SIRA08104-Whiplash-Guidelines-1117-396479.pdf

1. Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;(1):CD004250.

1. Michaleff ZA, Maher CG, Lin CW, et al. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet. 2014;384(9938):133-141.

1. Carroll LJ, Holm LW, Hogg-Johnson S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S83-S92.

1. Walton DM, Pretty J, MacDermid JC, Teasell RW. Risk factors for persistent problems following whiplash injury: results of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2009;39(5):334-350.

1. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-415.

1. Teasell RW, McClure JA, Walton D, et al. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 4 - noninvasive interventions for chronic WAD. Pain Res Manag. 2010;15(5):313-322.

1. Jull G, Kenardy J, Hendrikz J, Cohen ML, Sterling M. Management of acute whiplash: a randomized controlled trial of multidisciplinary stratified treatments. Pain. 2013;154(9):1798-1806.

1. Nadler SF, Weingand K, Kruse RJ. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician. 2004;7(3):395-399.

1. Ritchie C, Hendrikz J, Jull G, Elliott J, Sterling M. External validation of a clinical prediction rule to predict full recovery and ongoing moderate/severe disability following acute whiplash injury. J Orthop Sports Phys Ther. 2015;45(4):242-250.

1. Ludvigsson ML, Peterson G, Dedering Å, Peolsson A. One- and two-year follow-up of a randomized trial of neck-specific exercise with or without a behavioural approach compared with prescription of physical activity in chronic whiplash disorder. J Rehabil Med. 2016;48(1):56-64.

1. Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. 2007;25(3):404-412.

1. Soderlund A, Lindberg P. Cognitive behavioural components in physiotherapy management of chronic whiplash associated disorders (WAD). Physiother Theory Pract. 2007;23(5):267-280.

1. Sterling M, Jull G, Vicenzino B, Kenardy J. Sensory hypersensitivity occurs soon after whiplash injury and is associated with poor recovery. Pain. 2003;104(3):509-517.

1. Kongsted A, Qerama E, Kasch H, et al. Neck collar, "act-as-usual" or active mobilization for whiplash injury? A randomized parallel-group trial. Spine. 2007;32(6):618-626.

1. Ritchie C, Kenardy J, Sterling M. The WhipPredict clinical prediction model: a tool to identify patients at high risk of poor functional recovery 12 months after whiplash injury. Eur J Pain. 2015;19(9):1234-1244.

1. Williamson E, Williams M, Gates S, Lamb SE. A systematic literature review of psychological factors and the development of late whiplash syndrome. Pain. 2008;135(1-2):20-30.

1. Kamper SJ, Rebbeck TJ, Maher CG, McAuley JH, Sterling M. Course and prognostic factors of whiplash: a systematic review and meta-analysis. Pain. 2008;139(1):5-17.

1. Stewart MJ, Maher CG, Refshauge KM, Herbert RD, Bogduk N, Nicholas M. Randomized controlled trial of exercise for chronic whiplash-associated disorders. Pain. 2007;128(1-2):59-68.

1. Siegmund GP, Winkelstein BA, Ivancic PC, Svensson MY, Vasavada A. The anatomy and biomechanics of acute and chronic whiplash injury. Traffic Inj Prev. 2009;10(2):101-112.

1. Kasch H, Qerama E, Bach FW, Jensen TS. Reduced cold pressor pain tolerance in non-recovered whiplash patients: a 1-year prospective study. Eur J Pain. 2005;9(5):561-569.

1. Nieto R, Miró J, Huguet A. The fear-avoidance model in whiplash injuries. Eur J Pain. 2009;13(5):518-523.

1. Dehner C, Elbel M, Schick S, et al. Risk factors for acute neck pain in patients with motor vehicle collisions. J Trauma. 2006;60(5):1020-1026.

1. Sullivan MJ, Adams H, Thibault P, Corbière M, Stanish WD. Initial depression severity and the trajectory of recovery following cognitive-behavioral intervention for work disability. J Occup Rehabil. 2016;26(1):63-71.

1. Côté P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine. 2001;26(19):E445-E458.

1. Brison RJ, Hartling L, Dostaler S, et al. A randomized controlled trial of an educational intervention to prevent the chronic pain of whiplash associated disorders following rear-end motor vehicle collisions. Spine J. 2005;5(6):637-644.

1. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine. 2000;25(14):1782-1787.

1. Bunketorp L, Lindh M, Carlsson J, Stener-Victorin E. The effectiveness of a supervised physical training model tailored to the individual needs of patients with whiplash-associated disorders. Spine J. 2006;6(1):71-78.