The insurance companies spend millions of dollars each year to make sure their adjusters are trained to evaluate injury claims. Part of this training involves giving the adjusters the mindset that all soft tissue injuries are minor and all soft tissue injuries heal within four to six weeks.This mindset is dangerous because it is black and white, and, unfortunately, the vast majority of adjusters believe it is true. It is also dangerous because it “pigeonholes” every soft tissue injury case into a minor injury category, which simply goes against the medical facts. It also excludes age, sex, weight and other important factors that help explain the severity of a soft tissue injury.
The Differences Between Soft Tissue and Hard Tissue Injuries
First and foremost, it is important to understand the differences between a “soft issue injury” and a “hard tissue injury.” To do this, one must understand the two classes of tissue found in the human body: bone and soft tissue. This means that every tissue in the body apart from bones -- muscles, tendons and ligaments -- are soft tissue. A soft tissue injury is generally an injury to ligaments (known as a sprain) or to muscles and tendons (known as a strain). For example, a neck sprain/strain is generally known as a whiplash soft tissue injury. In contrast, hard tissue injuries are injuries to the bone. Examples of these are fractures, which tend to heal better with no motion and when they are set in casts. Soft tissue injuries, on the other hand, tend to heal better with proper motion, which is why they respond well to physical therapy and chiropractic treatment. Bones tend to take longer to heal because the blood supply is lower compared to soft tissue injuries, which have the potential to heal quicker. But, bone breaks tend to heal stronger than they were before the break. Not so for soft tissue injuries, which almost never bounce back to where they were. Soft tissue injuries also cause scar tissue and need to be treated right away with proper motion. This will help to prevent the scar tissue from causing stagnation of the blood supply to joints of the spine or elsewhere in the body.
Loss of Range of Motion
One example I frequently like to use is an often over-looked medical diagnosis related to a soft tissue injury known as “loss motion segment integrity.” This is a loss of range of motion of the vertebrae in the neck (cervical) or lower back (lumbar) to a specific measurement. The injury is severe enough to produce this loss of motion and stagnation and can lead to permanent symptoms that eventually cause or accelerate early arthritis or early bone degeneration. This is terrible for the spine because a loss of motion also means a loss of blood supply, which is important in transferring oxygen and nutrients to the joints. One of the techniques I follow when this diagnosis is given by the treating physician is to have the physician-run extension/ flexion digital X-rays on the affected part of the spine. Digital X-rays leave less than a 2% margin of error in determining the diagnosis. The physician then has to measure what is called the “angulation” and “translation” of the affected segment or vertebrae, which must be within the medical range to obtain the official diagnosis.