A total of 108 consecutive patients presenting to our hospital following a soft tissue injury of the neck from a road traffic accident were included in a prospective trial. Each patient was randomised to either early mobilisation using an exercise regime or 3 weeks treatment in a soft collar followed by the same exercise regime. Patients were assessed clinically at 3, 12 and 52 week intervals from injury. No differences were found between the two groups for pain, range of movement or activities of daily living at any of the follow up intervals. The collar treatment group took significantly longer to return to work after injury (17 days) compared with the early mobilisation group (34 days), P < 0.05. Treatment with a soft collar was found to have no obvious benefit in terms of functional recovery after neck injury and was associated with a prolonged time period off work. This study supports the use of an early mobilisation regime following soft tissue injuries of the neck.