Information on 'Soft Tissue' Injuries
SPRAIN, STRAIN, PULL and WHIPLASH... These mean RIP or TEAR.
CONTUSION and BRUISE... These mean SMASH.
The basic injury that occurs in any soft tissue trauma (There are only two types of tissue in the body: Hard tissue, i.e., bone; and soft tissue, i.e., muscle, ligament, nerve, blood, and all organs such as brain, liver, etc.) occurs when either a muscle or a ligament is ripped or smashed.
In the first case, a rip, the muscle fibers are pulled apart, similar to taking a piece of pot roast and jerking it suddenly. The muscle fibers separate and then bleeding occurs, which causes swelling between the muscle fibers. This swelling is what gives you the sense of stiffness; the muscles are literally stiffer with blood that is between the muscle fibers. After the acute episode of bleeding, the muscles ooze fluid, like the serum that comes out after you scrape your hand on concrete.
In the second case, a smash, it is again like taking a piece of pot roast, but this time instead of jerking the meat, it is hit and the muscle fibers split apart and bleeding occurs again, and all the other steps occur with swelling, etc.
WHAT HAPPENS NEXT?
The swelling reaches a peak after about two weeks and then remains at that level for the next two to four months, usually slowly resolving for 80% of people within a five or six month period. The surprising thing about recovery is that you don't get better in a smooth fashion, with each day being better than the prior one. Instead there are good days and bad days and really bad days, during which you really don't think you are ever going to be well again.
A lot of different effects occur to both the mind and the body:
Headaches: These usually occur during the first two weeks and then may last for two to four months. The pains usually occur in the back of the head, go up over the top and then down in front of, or behind, the eyes, or off to the side near the temples. These are almost never permanent, but for a while it may seem so.
Jaw Pain: Where the jaw bone and temple join is called the temporomandibular joint, or TMJ. Pains from that area occur from tears of the joint capsule holding both jaw and head together. Pain from this area is usually noted on chewing or even opting the mouth wide. Usually these pains resolve in one or two months, but occasionally a dentist will need to be consulted.
Eyes: The most common complaint is blurring of vision for fine print or watching television or sustained reading. These pains are due to small tears in the muscles that move the eye and/or damage to the nerves going to the same muscles. This sounds bad, but almost never lasts more than one-two months.
Nerves: Most people who have soft tissue injuries note a level of irritability and inability to tolerate frustration as well as they could prior to the accident. Often accident victims find themselves either yelling or wanting to yell more about "little things". This usually resolves in two to three months unless more serious injuries are involved.
Sleep: There is no good position to get into because the muscles are torn and once they tear they go into spasm, which is like a "Charlie Horse" and, in effect, the muscles cannot rest. In fact, most people wake up feeling worse than they did when they went to sleep. Few people sleep through the night, even with medication, and this usually increases or adds to the level of irritability.
Driving: A fear of driving (or almost paranoia) usually occurs after accidents with people hitting their brakes too soon, or constantly looking in the rear view mirror. This lasts for two to four months. Also turning the head is usually quite painful.
Sex: Often painful and seldom easy for one to three months after accidents.
Pain: There are shooting pains, stabbing pains, burning pains, red hot poker pains, knife like pains, ice pick like pains; neck injuries cause people to say that their head is too heavy for their shoulders, or that there is a four-year old sitting on their shoulders. Back injuries cause a sensation of 'opening' in the lower back, and sitting becomes quite difficult. Mopping, sweeping, vacuuming and other households or strenuous chores or activities can be quite painful.
Concentration: Many people complain of a 'fuzzy' feeling with difficulty in concentration. There is usually a short-term memory loss, with confusion about what was said to them or what they said to someone else. Repeating oneself is common.
What to Do: The muscles and ligaments are torn or smashed. They will heal at their own rate. your doctor can help you with medication for the pain and therapy which decreases muscle spasm. You can help with using a heating pad or hot towels or showers or baths. Try to work if possible and tell us if you need notes for your job, if you find difficulties with your job.
Pains which radiate from the neck to the hands or from the back to the legs, with a tingling or pins and needles sensation represent pressure on the nerves, which may be due to swollen muscles or a pinched nerve. Please be sure to tell your doctor about them.