Canadian Association of Occupational Therapists

Practising Restraint

Occupational therapists believe that injury prevention is important so that people can continue to participate in their valued occupations. Did you know that proper use of your headrest in your car can prevent injuries, such as whiplash?

The message from safety experts today is that a properly adjusted headrest can reduce the risk of whiplash-related injuries, often by as much as 40 per cent. The problem is that many drivers don’t know much about headrests. Most people hop into their cars without a second thought as to what’s behind them — literally.

Whiplash and related disorders account for 60-70 per cent of all reported injuries in accidents, according to insurance sources. With more than 200,000 auto accident-related injuries each year in Canada, that’s a lot of lives disrupted by something so preventable.

Most people are familiar with the term whiplash – the motion of the neck snapping back from a sudden movement – but there is considerable confusion about its exact medical definition. A Quebec Task Force on Whiplash-Associated Disorders in 1995, defined whiplash as “an acceleration-deceleration mechanism of energy transfer to the neck. It may result from rear end or side impact motor vehicle collisions, but can also occur during driving and other mishaps. The impact may result in bony or soft-tissue injuries (whiplash injury).”

The next time you get into your car take a minute before turning the key in the ignition. Draw a line straight back from the top of their ears to the headrest.

  • Is there anything that would stop your head from moving back if the car was suddenly jolted?
  • Is there minimal space between your head and the actual restraint?
  • Have you noticed if your seat has an adjustable or fixed restraint?

If the answer to any of these questions is no, you could suffer a serious whiplash-related injury in a rear or side collision, even at low speeds.

But what exactly is the proper position? Experts say there are two measurements – how high your headrest is and how far it is from the back of your head (back set).

The generally accepted measurement for the proper height is the ear. Researchers have rated headrests good if they are above the ear, marginal if between the top and bottom of the ear, poor if below the ear and very poor if the headrest is not visible at all. The other factor is how far the head is horizontally from the restraint. The acceptable to good rating for proper back set is two to four inches; if the distance is more than half the width of the head, restraints are rated poor and if greater than a full head’s width, very poor.

Given that about 75 per cent of the headrests in vehicles today are adjustable, as opposed to fixed, can mean a huge difference in the rate of whiplash injuries. A poorly adjusted headrest can actually worsen the effects of a rear-end collision on the neck and spine.
Victims of whiplash can experience anything from stiffness or tenderness to decreased range of motion to fracture or dislocation. Aside from neck and joint pain, symptoms may include headaches, deafness, memory loss, dizziness and difficulty in swallowing. Whiplash clearly has a significant impact on peoples’ lives, families and jobs.

Taking that extra minute to properly adjust your headrest may mean the difference between walking away from an accident or living with the pain and disruption of whiplash.

This article is excerpted from ‘Practising Restraint’ by Mary Lou O’Reilly, Vice President, Public Affairs and Marketing, Insurance Bureau of Canada. For further information on car headrests, go to the web-site for the Insurance Bureau of Canada at:

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