Which exercise is recommended early in WAD rehabilitation?

• A. High-load neck extensions
• B. Aggressive ROM without precautions
• C. Gentle cervical isometric exercises
• D. Complete immobilization of the neck

Answer: (C)

In the early phase of whiplash-associated disorder rehabilitation, protecting healing tissues while preserving muscle function is key. Gentle cervical isometric exercises fit this goal because they activate neck muscles without moving the head and neck through painful ranges, providing a safe, controlled stimulus that maintains strength and proprioception. This approach helps reduce pain and fear of movement, supports gradual progression to full ROM, and prevents deconditioning. Avoid high-load neck extensions or aggressive ROM early, as they can irritate injured tissues and slow healing, and complete immobilization is not ideal because it leads to stiffness and weakness. Start with mild isometric contractions in a neutral neck position, holding for about 5–10 seconds, in multiple directions within pain-free limits, and progress as tolerated.