What's a soft tissue injury?

     Every now and then a patient will mention that an insurance adjustor or agent had made the comment that their injury is only a "soft tissue" injury, as if that is not a real or serious injury.  Apparently this is a way some people try to minimize injuries sustained in car wrecks.  They want to paint a picture of a "victim" pretending to be injured; that any treatment is not needed and fraudulently provided by a clinic/doctor.
     Again, as I have said many times about aspects of injuries sustained in car wrecks, nothing could be further from the truth.  Of course injuries like concussions, lacerations, open or gaping wounds and broken bones are by far the most serious and even life threatening, but in low speed impacts and many high speed impacts, they are the exception rather than the rule.  In fact, technically, many of those life threatening injuries are, themselves, soft tissue injuries.
     What are soft tissues anyway?  They are the tissues in the body which are not bone although cartilage, as in the knee, might not be considered soft tissue.  They are the ligaments, which hold the bones together, muscles and tendons, which attach to bones and provide the forces needed to move and, of course, all the other "soft:" stuff like skin and other connective tissues.  We are made of much more "soft" tissue than we are of "non-soft" tissue.
     In car wrecks, the tissues most susseptible to injury are the ligaments, tendons and muscles as well as the cartilages of the joints like the knee or shoulder.  The big problem with these tissues is that they tend to heal rather slowly if at all.  In most cases damage to these tissues is replaced not with healthy tissues but with scar tissue which is not as flexible or strong as the original. 
     After an injury to these tissues the body surrounds them with an inflammatory process which promotes the formation of this scar tissue form of healing.  Therapies provided in our clinic help to promote repair with more normal, functional tissues rather than stiff, inflexible scar tissue.  These same therapies also help restore normal motion and function to joints associated with these tissues.
     To the "non-believer" I simply point to the treatment of athletic injuries by sports teams with millions of dollars invested in the performance of their athletes.  The injuries these athletes sustain are, for the most part, soft tissue injuries.  The treatments they receive for their injuries are essentially the same treatments we provide for our patients injured in car wrecks.  No one questions the need for treatment of the athletes injuries and thus I don't think anyone should question the need for the treatment of soft tissue injuries sustained in car wrecks; nor should they question or try to minimize these types of injuries either.