Soft tissue injury in the workmans' compensation patient population has been previously poorly understood. Injuries that do not show up easily on radiographs are often undertriaged and undertreated. With the advent of improved imaging techniques, an enhanced understanding of soft tissue injuries has evolved over the past few years. Coupled with improved surgical and rehabilitation techniques, severely injured patients are able to experience remarkable recoveries. Many cannot return to previous function. These patients pose challenges to the astute clinician with regards to psychosocial issues relative to secondary gain. In addition, State-to-State variations in the workmans' compensation laws can confuse clinicians. Because of the protections and laws set in place in the United States, these patients can frequently be returned to the workforce as grateful and productive members of society.