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An initial study into actual car to car collisions has been performed. The study provides insights into the factors associated with physical complaints in real collisions and identifies those areas requiring greater detail. Data compiled from seventy-two, real world, rear automobile collisions shows that a gap exists between current testing and modeling and the realities of a typical rear impact. Analysis of the data indicates that among the most significant factors associated with physical complaints, in a rear impact, is an occupant’s reported awareness of the impending collision. Awareness of an imminent impact allows an occupant in a struck vehicle to exercise sufficient muscle control to prevent flexion/ extension injuries, of the neck, in many collisions. Other factors identified include gender, occupant position, preexisting injuries, seat belt usage, seat back failure and impact orientation.