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When people ask why I pursued or persist in sociology, I sometimes say that the world just makes no sense without it. With a few basic concepts, some systematic observation, and a little analysis, however, we can at least begin to fathom the unfathomable. Our new TSP feature on genocide by Hollie Nyseth Brehm offers a grim example, but my favorite physical therapist offered another illustration this weekend. She had just attended a conference on understanding pain and injury—a big part of any PT’s job—and came across some cool studies on the social construction of these phenomena.

My favorite new example is “Neck Pain in Demolition Derby Drivers” by Alexander Simotas and Timothy Shen in Archives of Physical Medicine and Rehabilitation. In the general population, about 10 percent of people who have a car collision will develop chronic severe neck pain. Doctors Simotas and Shen surveyed 40 demolition derby drivers, who had undergone a median of 1,632 lifetime collisions at an average estimated speed of 26 miles per hour, 55 percent of which were rear-end, with no special safety equipment. Yet only 3 of the derby participants (7.5 percent of the sample) reported even mild chronic neck pain and none reported moderate or severe chronic pain.

In short, the “accidents” experienced on the street appear to exact a much greater toll than those at the county fairground, even though the events involve the same biomechanics: an “acceleration-deceleration mechanism of energy transfer to the cervical spine.” The sampling strategy and response rate are not ideal in this study, but I suspect that the basic pattern of results is likely to hold up to a more rigorous analysis.

In my view, the question is less about whether these injuries are socially constructed than about the relative contribution of various social determinants. From a sociolegal or economic perspective, one might look to financial incentives (e.g., it appears that chronic neck pain after car accidents is far less prevalent in nations (such as Greece) where victims receive little financial remuneration). From a sociology of sport perspective, one might explain the denial of injury among participants in terms of the culture of risk surrounding contact sports. Finally, the fact that offending drivers (the “hitters”) experience far fewer symptoms than the targets (or “hittees”) suggests that playing social roles as aggressors or victims might also be important. The emotions of the events are obviously quite different as well, with derby likely invoking fun or thrilling feelings, while car accidents tend to invoke fear or worry.

Of course, the fact that whiplash injuries are socially constructed doesn’t mean that myriad other physiological and  psychological mechanisms are not also in play. In fact, my personal explanation for these results is a biopsychosocial theory developed to account for my immoderate pie-eating behavior:  anything this wonderful has just got to do a body good.