Do seatbelts always work?

• Author: Sutherland, John A.

Most car and truck drivers and their passengers assume that injuries cannot occur if a seat belt is worn at time of impact. While injuries from being thrown out of a vehicle are eliminated, many injuries can and do occur to a restrained occupant.

Extensive research on and treatment of occupants of vehicles involved in crashes confirm that neck and back injuries not only occur, but in some cases are made more severe because of the use of lap and shoulder restraining devices. These injuries occur even in what could be described as low speed impacts. Dr. Lawrence M. Elson, an anatomist and noted researcher and lecturer has stated that "despite involving forces insufficient to cause tissue injury many low-velocity collisions result in pain and sometimes disability". His underlying thesis in his article The Jolt Syndrome - Muscle Dysfunction following Low-Velocity Impact is that "Myofascial (or muscle) structure can be made painful without injury when stretched into the supra-physiologic realm (i.e. beyond normal limits) or suddenly, reflexly contracted, as might occur when jolted during a motor vehicle collision".

How do injuries occur when the driver and passengers are properly restrained by the standard lap and shoulder belts? The heads and upper bodies of drivers wearing lap and shoulder seat belts at time of impact, especially in rear end collisions, tend to rotate to the left around the shoulder harness resulting in injuries to the muscles of the shoulder and neck. Studies of seat-belted drivers reveal that after effects often involve pain primarily in the area of the right shoulder radiating to the base of the skull causing headaches, right sided neck stiffness and right arm pain. The shoulder belt has caused the driver to rotate in this manner while only his left side is restrained. Dr. Stuart Donaldson of Myosymmetries pain clinic has done hundreds of electromyographic studies which show a consistent pattern of injuries to the neck and shoulder muscles of a seat-belted driver.

Front seat passengers especially in rear end impacts show a mirror image of injuries to those suffered by the seatbelted driver. Pain is complained of in the left shoulder and neck areas as left side of the passenger's head and upper body consistent with it having rotated to the right around the shoulder harness.

Lap and shoulder seat belts as well allow a degree of forward movement of the upper body. In addition, they provide no support for the neck and head...