Soft Tissue Injuries After a Car Accident: Documented From Day 1

Muscles react to a crash by contracting hard to protect the joints, and they do it a fraction of a second too late. The fibers are stretched while they are contracting, which is how a strain happens. Ligaments, which hold bone to bone, are stretched past their limit as the joints move farther than they are built to. That is a sprain. In the neck and back, the facet joint capsules and the small ligaments between vertebrae are the usual victims.

Contusions come from direct contact: the seat belt across the chest and shoulder, the door against the arm or hip, the dashboard against the knee. Low-speed rear-end hits in the stop-and-go traffic on Federal Highway and Sample Road produce mostly strains and sprains. Side impacts add contusions.

Dr. Carol McNamara-Krauss is a Florida-licensed chiropractic physician (DC), license CH5281. A soft tissue injury is diagnosed by exam, which is exactly why the exam has to be thorough and recorded. She palpates each muscle and ligament for tenderness, spasm, and swelling; measures range of motion of the involved joints; performs orthopedic tests that stress each ligament; and completes a neurological screen. Findings are documented the same day, with the location and grade of each injury.

X-rays are ordered when a fracture or joint instability is possible, and an MRI when a significant tendon or ligament tear is suspected. Most soft tissue injuries need neither, and we say so rather than ordering imaging that will come back normal. Referrals go through our imaging and specialist referral process.

Soft tissue is where the widest set of tools applies. Massage therapy with Dawn Marie Teufel, LMT, works the strained muscles directly, releases spasm, and moves fluid out of the injured area. Class IV laser therapy on the LightForce system reduces inflammation deep in the tissue. Therapeutic ultrasound targets ligament sprains and tendon strains where heat and micro-vibration help the fibers realign.

Electrical stimulation interrupts the spasm cycle so the muscle can rest. Shockwave therapy on the Chattanooga system is used on tendon and soft tissue injuries in the extremities that have plateaued, never on the spine and never on the same area as laser. Chiropractic adjustments restore motion to joints that have locked because of the surrounding spasm.

Mild strains and sprains improve over a few weeks. Moderate ones take longer, and ligaments heal slowly because their blood supply is poor. Soft tissue that is not treated tends to heal short and stiff, which is why untreated crash injuries turn into chronic ones. We re-measure range of motion and re-palpate at set intervals.

For the claim, the file contains the initial palpation findings by location, the grade of each strain or sprain, range-of-motion measurements, orthopedic test results, the treatments applied at every visit including which tissue received which modality, and your reported pain and function, in a proprietary case documentation system built in consultation with personal injury attorneys. Narrative reports are available on request and the file is sent as one PDF. See medical documentation for attorneys.