Soft Tissue Injuries from Car Accidents, What Research Tells Us
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.
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
- 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