Category Archives: Car Accident Soft Tissue Injury

Car Accident Soft Tissue Injuries

Car Accident Soft Tissue Injuries

Car accident soft tissue injuries (injuries of the brain, nerves, ligaments, discs) are not merely nuisances as insurance adjusters may try to make you believe. These injuries are far worse than breaking a bone. Bones heal completely, but connective soft tissues never completely heal leading to long term pain and impairment.

Hard tissue vs Soft tissue myths

Myth: Accidents involving hard tissue damage are serious.
Fact: A broken arm or leg in a car accident recovers faster and better than soft tissue injuries
Why? When we break a bone, the bone heals itself with new bone tissue. The fracture site usually is thickened with new bone and is actually stronger than prior to the fracture.

Myth: Soft tissue injuries are not serious, only nuisance issues
Fact: Soft tissues include the brain, discs, nerves, and ligaments. Does an injury to those structures really seem harmless?
Why? The brain and nerves control the function of the entire body; if they are damaged wide ranging problems can occur. Disc and ligament injuries cause instability in the spine that leads to degenerative arthritis within a few years of the injury

Myth: Ligaments heal just fine
Fact: Ligaments do not repair with new ligament tissue. Bones and muscles regrow new bone and new muscle cells, but discs and ligaments cannot do that.
Why? We are born with all the ligament, disc and cartilage cells we will ever have. Once damaged, these tissue cannot heal. Instead they are repaired with scar tissue. Scar tissue is a cheap, weak tissue that renders the new ligament weaker, less flexible and unable to keep the joints in proper alignment.

The best analogy for a ligament injury is socks and underwear. If you stretch out the elastic in your socks or underwear no matter what you do, they will fall down. Ligaments are the same. Once over stretched or torn, they can never hold a joint together properly again.

Soft tissue injuries are serious and never completely heal leading to future problems. Do not allow an insurance adjuster to perpetrate that fraud on you by saying your injury is not serious.

To have your injuries properly documented and treated call Dr Barry Marks car accident chiropractor at (714) 938-0575

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Ligament Damage After Car Accident in Orange County

Ligament Damage After a Car Accident in Orange County

I am often asked how can I prove that bodily injury has occurred after a car accident.  Soft tissues such as ligaments and discs do not actually show up on x-ray, but we can demonstrate dysfunction of these structures on x-ray.

Longitudinal Ligaments of the Spine

The anterior and posterior longitudinal ligaments run up and down the front and back of the vertebral bodies (the large block-like parts of the spinal bones). The ligaments keep the spinal bones aligned. When damaged, the spine will straighten out or lose it's natural curve. See this previous post about loss of neck curve after a car accident for more info.

The longitudinal ligaments also keep the spinal bones aligned while bending. If one or both of these ligaments are damaged, which is common after a car accident, then they will not be able to keep the bones aligned when the spine is bent forward or backward.

Motion X-rays Are Needed to Properly Assess Ligament Damage in the Neck After a Car Accident

X-rays are taken while the patient is looking straight ahead and then while bending forward as far as possible (flexion), then backwards as far as possible (extension). The spinal bones are then marked and measurements are taken to see if any of the vertebrae are moving beyond what is normal.

The anterior longitudinal ligament (ALL) is in the front of the bones and prevents the bones from sliding backwards too far when the neck is bent backwards. If the ligament is damaged and weakened, you will note one or more of the vertebrae slides backwards too far compared to the bone below.

The posterior longitudinal ligament (PLL) attaches to the back of the bones and prevents excessive forward movement on flexion or forward bending. A damaged PLL will be noted by one or more spinal bones sliding forward past the bone below.

Ligament Damage After a Car Accident is Serious

Excessive motion forwards or backwards is known as an "Alteration of Motion Segment Integrity" or "AOMSI." Any excess translation is a serious and permanent injury that will eventually lead to premature osteoarthritis of the spine. If the AOMSI is large enough (>3.5 mm in the neck) it is rated for impairment purposes the same as an amputated limb, roughly 24% whole person.

Have You Had Proper X-rays After Your Car Accident? Has Your Doctor Looked for AOMSI? Does Your Doctor Know What AOMSI Is?

Sadly, many doctors have no idea what alterations of motion segment integrity are, let alone how to document them. Even doctors who claim to treat a lot of car accident cases, may not be specialized or sophisticated enough to routinely perform this analysis.

This is Why You Need a Car Accident Doctor Who is Specializes in Auto Accident Whiplash Injuries.

A true specialist will know this and much more to ensure that all of your injuries are properly documented and provide the type of treatment needed to address your unique injuries.

Dr Barry Marks Car Accident Chiropractor
1745 W Orangewood Ave #114
Orange, CA 92868
(714) 938-0575

Dr Barry Marks, Chiropractor Orange CA specializing in car accident injury treatment and fast relief of headaches, neck and back pain since 1986. Former Associate Clinical Professor, Author and Lecturer to doctors and lawyers on whiplash, brain injury and MRI interpretation. Extensive post-doctorate specialty training in orthopedics, whiplash, brain injury, MRI, functional neurology.  

Abnormal Neck Curve After Car Accident

Orange County, California
Abnormal Neck Curve After a Car Accident

If you have suffered a straightened or reversed or "S" shaped curve to your neck following a car accident, this is proof that the longitudinal ligaments in the front or back of your neck have been damaged.

cervical spine ligaments damaged in car accidentResearch has shown that damage to either the anterior or posterior longitudinal ligament is common in rear-impact motor vehicle car crashes. Surprisingly, a fairly low speed collision (less than 10 mph) can generate enough kintetic energy to the spine to cause these ligaments to become overstretched and tear. This releases the normal tension the ligaments have on your neck and cause it to "unwind" or straighten out causing what is known as a "hypolordosis."

Ligament injuries are serious.

This is a serious problem because medical researchers have also shown that once a ligament has been over stretched or torn, it will never resume its normal strength, flexibility or function again. This results in chronic joint malfunction and eventually osteoarthritis of that affected joint occurs. This is true of any ligament whether it is in a an ankle, wrist or knee, but is more troubling in the spine because of the importance of the spinal cord. The spinal bones must be aligned properly to protect the nerves and spinal cord. Malfunction due to ligament damage results in arthritis of the spine and compromise of the nerve system which has far reaching affects on your overall health.

"But I was told 'soft tissue injuries' aren't serious"

That is certainly not true. As you can see in the above, a ligament is a soft tissue and when it is damaged it never goes back to normal. How is that not a serious problem? The statement that soft tissue injuries are not serious is patently false and goes against all of the accumulated medical research over the past 50 years.

The only place you will hear this erroneous statement is from auto insurance companies who are trying to minimize damages of a claim. There is not a single article in a scholarly, peer-reviewed medical or scientific journal to support this claim. Yet it is purported thousands of times each day nationwide by auto insurance companies to save money.

Don't be mislead, an abnormal curve on x-ray caused by a car accident is proof of ligament damage. That damage is serious and permanent.

Car Accident in Orange County California? Call Dr Barry Marks Car Accident Chiropractor (714) 938-0575. He will help assess your problem.  He has been Orange County's Car Accident Doctor since 1986.

Dr Barry Marks Chiropractor
1745 W Orangewood Ave #114
Orange, CA 92868
(714) 938-0575


Leahy PD, Puttlitz CM, Th effects of ligament injury in the lower cervical spine, Journ Biomech, 45 (2012) 2668-2672

Hauser RA,Dolan EE,Phillips HJ,Newlin AC, Moore RE and Woldin BA Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics, The Open Rehabilitation Journal, 2013, 6, 1-20

Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): "[Biomechanics of whiplash injury]." Orthopade 1998 Dec; 27(12): 813-9.

Schofferman, Wasserman, Successful Treatment of Low Back Pain and Neck Pain After a Motor Vehicle Accident Despite Litigation, Spine Vol. 19, No. 9, 1994, pp. 1007-1010


Soft Tissue Injuries: What the Research Says


Soft Tissue Injuries from Car Accidents, What Research Tells Us

soft tissue injuries from car accidents

Anyone involved in personal injury, will be very familiar with the phrase "...soft tissue only injury..." followed by statements minimizing the magnitude of the injury and impairment. The truth of the matter is however, as a doctor, I will take a so-called "hard tissue" injury over a "soft tissue" injury any day of the week.

Here's why:

First, what is a "hard tissue injury"?

This refers to a broken bone. Of course I would never want to suffer from a bone fracture, but the fact is, a broken bone will heal back to a state that is stronger than before within 4-8 weeks. You see, bones heal with new bone tissue. It is solid and strong and covers the fracture site and all around it to make sure it is mended as good as new. There are exceptions, when a fracture occurs in a joint or the bone breaks through the skin risking serious infection, but those are more rare fractures. Basically, bone heals with bone and is fine afterwards. This is why when little Johnny falls out of a tree and breaks his arm, he will usually fully recover... and have a great story to tell.

So what about "soft tissue" injuries?

A soft tissue injury is an injury to the supporting structures of the joints such as ligaments that tie the joints together, tendons that attach muscles to the bones to make the joints move, the muscles themselves, the discs that separate the spinal bones and the linings and cartilage of the joints. Muscles repair themselves with new muscle cells and therefore, most of the time they fully recover. Ligaments, tendons, discs and joint linings however, cannot produce new connective tissue to repair themselves. Instead we repair with scar tissue.  Scar tissue is an inferior tissue that is less strong, less flexible and cannot function as the original tissue did. This is why a sprained ligament in a shoulder or knee can end an athlete's career and why if you've ever sprained an ankle, you have a tendency to sprain it over and over again. Soft tissue injuries are permanent injuries; they will never return to their pre-injury state.

In an article examining the healing of soft tissues, in particular ligaments, researchers found the following:

  • Women suffer ligament injuries more than males
  • Ligaments may take years to remodel
  • Ligaments never retain their pre-injury length, strength or elasticity
  • Osteoarthritis ensues due to joint instability after a ligament injury within approximately 10 years
  • Ultrasound and digital motion x-ray are the diagnostic tools of choice to locate and document ligament injuries

Conclusion about soft tissue injuries:

  • Soft tissue injuries take a long time to heal
  • Soft tissue injuries heal incompletely
  • Soft tissue  injuries lead to osteoarthritis

Do you know what else is considered a "soft tissue"?

  • Your nerves
  • Your spinal cord
  • Your brain
  • All your internal organs
  • Your eyes

And did you know that the following are diseases of "soft tissues"?

  • Heart attack
  • Stroke
  • Cancer (of anything but the bone)

So What Would You Rather Have, a Hard Tissue Injury or a Soft Tissue Injury?

Not a tough one to answer is it?This is why I said I'd prefer a hard tissue injury over a soft tissue one any day.

Then why do auto insurance companies make statements like "this is a soft tissue only injury..." and "...soft tissues heal with or without treatment in 4-6 weeks..."

Plain and simple. They are telling a lie to protect profits. They know the research. They know the truth. They have a duty to defend their company despite the truth. Unfortunately, car accident victims and even their personal injury lawyers, fall prey to this tactic. Jurors are fed a line of bull and often fall for it. With education however, I believe people can come to realize the truth. Truth that is borne out in the medical and scientific literature that tells us that"soft tissue" injuries are serious, never completely heal and often results in long term impairment.


R.A. Hauser, E.E. Dolan, H.J. Phillips, A.C. Newlin, R.E. Moore and B.A. Woldin, Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal, 2013, 6, 1-20