Why shouldn’t I wear a soft collar?
In the past, a prescription of soft collars for individuals with whiplash used to be common practice. The idea at the time was that treating acute injuries like whiplash, immobilization, and rest were the best options. Over the years, there has been a shift in treatment approaches from immobilization and rest following an acute injury to safe, controlled, active rehabilitation.
In most situations, not only are neck braces/collars not necessary, but they can also negatively affect your recovery. Wearing a soft collar when you don’t need to can weaken your neck muscles, movement dysfunction, and joint stiffness, which ultimately increases your recovery time.
It is now standard practice that participation in active rehabilitation is justified once a medical doctor, physiotherapist, or chiropractor has ruled out a dislocation, fracture, or more severe injury. Active rehab can include several things, such as range of motion, strengthening, and stretching exercises. Studies have shown that early mobilization can help reduce pain, reduce functional losses of your neck (range of motion and strength, for example), and help you recover from your injuries quicker.
Along with active exercises, other pain-relieving techniques are often recommended. These include anti-inflammatories or other pain-relieving medications, heat/ice, and modification of activities.
When is a soft collar appropriate?
Even though soft collars are usually not indicated for people with whiplash, there are a few circumstances in which a soft collar is appropriate. The most common situation is a traumatic accident leading to a cervical or suspected cervical fracture/dislocation. In these cases, the collar provides stability to the spine and avoids further injury.
The other circumstance would be a case in which your medical doctor has prescribed a soft collar. They may prescribe a collar to be safe while undergoing further investigations into your injuries (such as x-rays or other types of imaging). In general, however, collars are not recommended for long-term use as they can lead to the weakening of the muscles, bones, and tendons in the neck.
In summary, despite no established guidelines for prescribing neck braces or soft collars, studies have found that controlled active rehab is the best approach to treating whiplash outside of the circumstances described above.