Walnut Creek
Whiplash & Auto Accident Injuries
The same thorough assessment and supervised rehabilitation we give athletes.
The ER made sure you were not in danger. What remains is finding what actually got hurt, and getting you functioning well again.
What whiplash is
Whiplash is the popular name. The proper term is cervical acceleration-deceleration injury.
When another vehicle hits yours, your body is already against the seat, or held there by the belt. Your neck is not strapped in. For an instant, your body is thrown one way and your head has not yet moved. That mismatch produces shear forces in the neck — like the crack of a whip.
The result is often strain or tearing of joints, ligaments, and muscle in the neck. The same jolt can also move the brain inside the skull.
You were probably told two things after the collision: “your X-rays are normal, and you should feel better in a few days.” One of those is good news. The other is a guess.
About half of people with a whiplash injury still have neck pain a year later. That is not what most people are told.
If you went to John Muir Hospital or Urgent Care, they checked for the dangerous things: a broken bone, a dislocation, bleeding, or a spinal cord injury. Being cleared of those is a relief. But did that tell you enough?
A different question had not been answered: what is actually injured, and what will it take to get your neck, and you, back to where things should be? That exam takes time the ER does not have. And that is exactly why Performance Sport Care in Walnut Creek exists.
Why people come here after a crash
Many crash injuries fall into a gap in medical care. The ER looks for what can kill you or paralyze you. A surgeon looks for what needs an operation. When you need neither, there’s often a missing step: figuring out what was actually injured, why it still hurts, and what it will actually take to rebuild and recover.
That is the work at Performance Sport Care.
This is not a high-volume adjustment clinic. It is not an injury mill that bills your settlement. Dr. Cancel uses the same exam and rehab standard he uses with competitive athletes: a first visit of 60 minutes of face-to-face time, measurements you can check, and a purpose-built supervised exercise facility to rebuild strength in the affected area or areas.
Three things are different here.
You are examined by the doctor who will treat you
Not a technician. Not a rotating associate. Dr. Cancel takes your history, examines you, makes the diagnosis, and builds the plan himself. Follow-up visits last at least 30 minutes. Each time he re-checks how you progress from the findings obtained on day one. You can ask what is different from last week — and get a real answer.
Active care has an ending here
It ends when you are satisfied the injury has healed. Or it ends when more visits here will not make a real difference. That second call is Dr. Cancel’s. He will tell you. You will not have to ask.
Nobody here is paid out of your settlement
We do not treat on a lien. Most patients pay at the time of the visit, so every appointment has to be worth paying for that day. Because we are not paid from your settlement, nobody here has a financial reason to stretch out your care.
Dr. Cancel has practiced in California since 1983. A former national-level competitive bodybuilder, he also knows serious injury from the patient’s side. He has recovered from major car and cycling accidents of his own. You do not have to be an athlete to want your body back, and you do not have to be one to be treated with that goal in mind.
What a normal X-ray cannot tell you
Most people leave the ER after a crash with an X-ray and a sheet of home instructions. A normal X-ray means a broken bone is unlikely. It does not explain your pain.
An X-ray looks for broken bones. It is not a test for pain. About half to six in ten people with lasting neck pain after whiplash have pain coming from the facet joints, the small joints at the back of the spine. The joints can be seen on imaging. The pain coming from them cannot. That is not something a doctor missed on your scan. A scan simply cannot tell you which structure is hurting — the same problem that turns up when an MRI comes back normal and you still hurt.
Disc bulges and “arthritis” on a scan are common in people who have no pain at all. About 3 in 10 pain-free 20-year-olds have a disc bulge. By age 80, about 8 in 10 do. So wear and tear seen on a scan after a crash was usually there before the crash.
A crash also does not appear to make the neck wear out faster. Twenty years later, people who had whiplash and people who did not look much the same on MRI. The changes track with age, not with the crash.
What can matter is where that wear already existed. If the facet joints were already worn, recovery after whiplash is often slower. Worn discs do not predict recovery the same way. The lasting problem is more often a painful joint than arthritis caused or accelerated by the crash.
What actually happens to the neck
The problem is often not something dramatic that appeared on the scan. It is what happened to the joint and its capsule during the crash.
In a rear-end crash, the seat pushes your body forward before your head catches up. For a moment, the neck is not simply thrown backward. It forms an S-shape: the lower neck bends backward while the upper neck is still bent forward. That motion can stretch the capsule around the lower facet joints beyond its normal range.
The facet joint capsule is one of the tissues most vulnerable to this motion. The injury can be real even when routine imaging looks normal.
The direction of the crash does not tell us how well you will recover. It does help tell us which tissues took the load. That is why we ask about the crash in some detail at your first visit.
Three common crash patterns
- Rear-end crash. You are stopped in traffic and hit from behind. This is the classic whiplash pattern. The lower facet joints and their capsules take much of the stretch. A properly positioned head restraint can reduce the motion, but it cannot eliminate it.
- Frontal crash. You are wearing a seatbelt and your head does not hit anything. Your body slows with the car while your head continues forward. The neck can still pass through much the same S-shaped motion described above. About one in three minor neck injuries occur in frontal crashes.
- Side impact. You are struck from the side, often at an intersection. The load through the neck is uneven, with one side taking more of the force. People sitting on the side of the vehicle that is struck are injured more often than those sitting on the far side.
Did you see it coming?
One more thing, because it is almost never asked: did you know the crash was about to happen?
If you did not see it coming, your neck had little or no time to brace for the impact. People who are taken by surprise in a collision tend to report more symptoms, including worse headaches. That is why we ask whether you heard tires, a horn, or anything else that warned you, and how much warning you had.
What happened in the seconds before impact can matter almost as much as the direction of the crash.
Why you might have felt fine at first
Feeling all right at the roadside does not mean you were uninjured. Pain may not begin for minutes or hours after a crash. Soreness and swelling can build over the next one to three days, and muscles that braced during the impact may stay tight afterward.
Two things about those first few days are often misunderstood.
Pain that starts later does not mean a worse injury. In a large study, when the pain began did not predict how people were doing six months later.
Moving is safe, and it helps. People told to move early do better than people told to rest or wear a collar. Fear of movement can slow recovery. You do not need to wait for an appointment to begin gently moving your neck within tolerable limits.
What about a concussion?
A concussion and a neck injury can happen together. Headache, dizziness, tiredness, and trouble concentrating can occur with either one. A symptom checklist alone cannot tell you which is causing them.
Whether a concussion can occur without a direct blow to the head is still unsettled. Anyone who says it always can, or never can, is claiming more certainty than the evidence allows.
The first visit at Performance Sport Care
Plan on 60 minutes of face-to-face time.
Dr. Cancel asks about the crash itself: which way you were hit, where your head was, where the head restraint was, and whether you had any warning. He also asks about your symptoms and your health history. Then he examines you — how far you can turn and bend, nerve tests, posture, and how you move. If you need imaging, he will order it or review what you already have, and work with your primary care doctor.
You leave with an explanation you can repeat to someone else. It will include the extent of your injuries as they are presently known and the recommended steps toward recovery. A written Clinical Evaluation Report follows your initial examination within 24 hours.
Treatment follows what the exam found. First, reduce the pain enough to move. Next, get the motion back. Then rebuild strength in the injured area, step by step, until it can handle ordinary life again.
That last stage happens here in a supervised gym, not as a sheet of exercises handed to you on the way out. The injured area has to get strong again under watch before it is reliable.
We cannot operate. We are not an ER. We cannot tell you on day one exactly how long this will take. If you have a broken bone, an unstable spine, nerve damage that is getting worse, or nerve pain that has not improved, you need a surgeon — and we will help you get to one. Surgeons in this area send people here for the opposite reason: they have already said you do not need an operation, and your neck still hurts and does not move well.
Cleared at the ER, but still hurting? Find out what was actually injured.
Request an Appointment (925) 945-1155What recovery usually looks like
Most improvement happens in the first two to three months. After that, change tends to be slower. People who are doing well at three months usually continue to do well. People who still have significant pain at three months are more likely to have symptoms later.
More care in the first few weeks is not necessarily better care. In large studies, people who received a lot of treatment early did not recover faster and, in some studies, recovered more slowly. In the largest trial, a 20-visit rehabilitation program produced no better outcome than a single session of advice.
The lesson is not “do nothing.” It is not “do more,” either. The amount of care is not the same thing as the right care.
A pill and reassurance do not tell you what was injured. Neither do 60 generic visits. The point is to find what is not working, treat what you find, and keep measuring whether it is getting better — the same way neck pain that will not settle is worked up here.
Go to the ER today if
Some symptoms after a crash need emergency evaluation. Do not wait for an appointment here if you have:
- New weakness in your hands or arms, especially if your arms are weaker than your legs
- Burning, numbness, or an odd feeling in both hands, or new trouble with buttons, keys, handwriting, or other fine hand movements
- New trouble with balance or walking
- A new change in bladder function, including urgency, difficulty urinating, or loss of control
- Loss of consciousness, a memory gap, or confusion at the time of the collision
- A headache that is getting worse or is unlike your usual headaches, or repeated vomiting
The first four can be signs that the spinal cord is involved. In an older or already-stiff neck, a sudden backward movement can injure the cord even when no bone is broken. A clear X-ray does not rule that out.
The last two can be warning signs of a brain injury and also belong in the ER.
In older adults, falls are a leading cause of spinal cord injury. The event does not have to look dramatic for the injury to be serious.
Come to Performance Sport Care if
If none of the emergency signs above apply, but any of these sound familiar, it is reasonable to be evaluated rather than simply wait and see:
- Your X-ray or CT was normal, but your neck, shoulders, or upper back still hurt
- Pain, stiffness, or headache started hours or days after the crash
- You were cleared at John Muir or urgent care but still do not have a recovery plan
- You cannot turn, sleep, drive, work, or do ordinary things the way you did before
- You were told to rest, wait it out, or come back if it still hurts
- You want to know what was injured, not only what was ruled out
- You want care that continues because you are making measurable progress, not because it is being paid out of a settlement
You do not need to wait until you are “bad enough.” If something still hurts or does not work the way it did before the crash, that is enough reason to find out why.
Frequently asked questions
What injuries from a car accident do you treat?
Whiplash and whiplash-associated disorders, neck and low back strain, disc injury, headache and post-concussion symptoms, shoulder injuries, and the soft-tissue and joint problems that surface in the days and weeks after impact.
The list is not what distinguishes the care. What matters is that the examination clarifies which diagnoses and findings best fit your symptoms, what may be contributing to them, and what should happen next before treatment is selected.
What makes Performance Sport Care different from other chiropractic and rehabilitation offices?
We do not build care around repeated adjustments, or hand you a sheet of exercises and call that rehabilitation.
Dr. Cancel examines you himself — 60 minutes of face-to-face time at the first visit — and builds the plan from what he finds. Hands-on care reduces the pain and restores motion. Then you rebuild strength in the injured area in our supervised rehabilitation facility on site, with the load increasing as you improve. We want to see that area work and tolerate load again before we call it reliable.
That combination — examination-based diagnosis, doctor-delivered care, supervised progressive rehabilitation — is unusual in this area. It is why some local surgeons send patients here after ruling out an operation.
I was already seen at John Muir. What are you going to find that they didn’t?
John Muir answered the emergency question: fracture, spinal cord injury, brain injury, or anything else needing immediate medical care.
The recovery question is different. What is still hurting, what is not moving normally, and what has to recover for you to function normally again? That is not what an ER is designed to determine.
Lasting neck pain after whiplash often comes from the facet joints. The joints themselves show on imaging. Whether one of them is the source of your pain does not. That takes a different kind of examination.
I don’t trust chiropractors. Why should I trust this one?
Don’t. Check the things you can check instead.
The concern after a car accident is usually financial: treatment that runs on and on, paid out of a settlement at the end, with more visits producing a larger bill. So here is our arrangement in full. We are not paid from your settlement. We do not treat on a lien. Most patients pay at the visit.
At the first visit we tell you what we found and what improvement should look like, then re-check it as treatment progresses. Dr. Cancel has been licensed in California since 1983 — verifiable with the state board rather than taken on our word.
Are adjustments the only thing you are going to do for me?
No. An adjustment is one tool. It is never the whole plan.
If the examination finds a joint that is painful and not moving normally, an adjustment may restore motion and reduce pain. It does not make the injured area stronger. That is why a “crack and come back” schedule is not what we do.
Care here has three stages: reduce the pain enough to move, restore the motion, then rebuild strength and capacity under direct supervision, with progressively greater load as you improve. Rehabilitation is where we find out whether the injured area can handle real life again.
Aren’t you just going to keep me coming back forever?
No. More visits are not the goal.
We measure how you move at the first visit and re-check it as you recover. Treatment continues while it is producing meaningful improvement.
There are two ways care ends: when you are satisfied that you have recovered, or when Dr. Cancel determines that more treatment here is unlikely to make a meaningful difference. Either way, there has to be a reason for the next visit.
Why can’t I just do exercises at the gym?
Eventually, you probably will. That is the goal.
The difference is knowing where to start, what to load, how much, and when to progress — decisions based on what the examination found and what you can actually tolerate. As you improve we increase the load and watch how the injured area responds, until you no longer need us and can train on your own.
In the meantime, moving is generally better than prolonged rest. You do not need to wait for an appointment to begin gently using your neck within tolerable limits.
The accident wasn’t my fault. Can you bill the other driver’s insurance?
Usually not. The other driver’s insurer generally resolves the injury claim later through a settlement rather than paying our bill after each visit. We do not treat on a lien or wait to be paid from a settlement — most patients pay at the time of the visit.
If you have Medical Payments coverage, or MedPay, on your own auto policy, we can bill that. Many people have MedPay and do not realize it, so it is worth checking.
If you have health insurance, we submit the claim the same day. Depending on your deductible, network, and benefits, your plan may pay some, all, or none of the charge. We would rather you understood that before your first visit than after it.
If cost is the obstacle, tell us when you call.
Where is Performance Sport Care located?
Performance Sport Care is located at 1776 Ygnacio Valley Road, Suite 106, Walnut Creek, CA 94598. Call (925) 945-1155. We serve Walnut Creek, Lafayette, Danville, Concord, Pleasant Hill, and greater Contra Costa County.
The office is on the Ygnacio Valley corridor, across from Heather Farm Park and about a quarter mile from John Muir Medical Center.
Walnut Creek, Concord, Pleasant Hill, Lafayette, Alamo, Danville, Orinda and Moraga.
Request an Appointment (925) 945-1155Selected references
- Carroll LJ, Holm LW, Hogg-Johnson S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders. Spine. 2008;33(4 Suppl):S83–S92. Systematic review of prognosis, Bone and Joint Decade Neck Pain Task Force.
- Lord SM, Barnsley L, Wallis BJ, Bogduk N. Chronic cervical zygapophysial joint pain after whiplash: a placebo-controlled prevalence study. Spine. 1996;21(15):1737–1745. Prevalence study using placebo-controlled diagnostic blocks.
- Barnsley L, Lord SM, Wallis BJ, Bogduk N. The prevalence of chronic cervical zygapophysial joint pain after whiplash. Spine. 1995;20(1):20–26. Prevalence study using comparative local anaesthetic blocks.
- Kamper SJ, Rebbeck TJ, Maher CG, McAuley JH, Sterling M. Course and prognostic factors of whiplash: a systematic review and meta-analysis. Pain. 2008;138(3):617–629. Systematic review and meta-analysis of recovery trajectory.
- Watanabe K, Daimon K, Fujiwara H, et al. The long-term impact of whiplash injuries on patient symptoms and the associated degenerative changes detected using MRI. Spine. 2020;46(9):561–568. Twenty-year prospective MRI follow-up comparing whiplash and non-whiplash cohorts.
- Rydman E, Kasina P, Ponzer S, Järnbert-Pettersson H. Association between cervical degeneration and self-perceived non-recovery after whiplash injury. Spine J. 2019;19(12):1986–1994. Cohort study of pre-existing degeneration as a prognostic factor.
- Grauer JN, Panjabi MM, Cholewicki J, Nibu K, Dvorak J. Whiplash produces an S-shaped curvature of the neck with hyperextension at lower levels. Spine. 1997;22(21):2489–2494. Cadaveric sled study identifying the S-curve phase, rather than full extension, as the injury stage for the lower cervical levels.
- Cusick JF, Pintar FA, Yoganandan N. Whiplash syndrome: kinematic factors influencing pain patterns. Spine. 2001;26(11):1252–1258. Cadaveric head-neck kinematic study timing upper cervical flexion at approximately 60 milliseconds after impact.
- Uhrenholt L, Grunnet-Nilsson N, Hartvigsen J. Cervical spine lesions after road traffic accidents: a systematic review. Spine. 2002;27(17):1934–1941. Systematic review of post-mortem and imaging studies of crash injury.
- Stäbler A, Eck J, Penning R, et al. Cervical spine: postmortem assessment of accident injuries. Radiology. 2001;221(2):340–346. Post-mortem imaging and dissection study of injuries not visible on routine radiographs.
- Siegmund GP, Sanderson DJ, Myers BS, Inglis JT. Awareness affects the response of human subjects exposed to a single whiplash-like perturbation. Spine. 2003;28(7):671–679. Controlled human perturbation study of pre-impact awareness.
- Sutton DA, Côté P, Wong JJ, et al. Is multimodal care effective for the management of patients with whiplash-associated disorders? Spine J. 2016;16(12):1541–1565. Systematic review of combined, multimodal care rather than any single modality.
- Michaleff ZA, Maher CG, Lin CC, et al. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a randomised controlled trial. Lancet. 2014;384(9938):133–141. Randomised trial, n=172, comparing a 20-session exercise programme with a single advice session.
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. Systematic review of imaging findings in people with no symptoms.
The information on this page is for educational purposes and does not constitute legal or medical advice. Each patient’s situation is unique. Figures cited are drawn from the published literature and describe groups of patients, not individuals; they cannot predict any particular person’s outcome. Please contact our office to discuss your specific circumstances.
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Your X-ray was normal. You still hurt.
Find out what actually got hurt.
Your first visit is 60 minutes face-to-face with Dr. Cancel. You leave knowing what he found, what was measured, and what the next step should be.
Performance Sport Care
1776 Ygnacio Valley Road, Suite 106
Walnut Creek, CA 94598
Serving Walnut Creek, Concord, Pleasant Hill, Lafayette, Alamo, Danville, and Contra Costa County.