How do injuries heal?
Common injries that we see in the physiotherapy clinic are knee injuries, shoulder injuries, rotator cuff injury, hamstring injury, knee injury and many other sports injuries
The body responds to an injury in the following way;
It’s response to injury can be divided into four stages:
1. Soft tissue damage
3. Soft tissue repair
4. Soft tissue remodelling
This process is essentially the same in tendons, muscles, ligaments and all other soft tissues.
1.Soft Tissue Damage
When any of the body’s soft tissues are place under excessise strain this can lead to tissue damage. (see my previous blog on what are the soft tissues of the body and how are they injured?) When this occurs, the small cells which make up soft tissues and the blood vessels situated in between them can be damaged. When this occurs both the fluid contained within the cells and the blood that is contained in the blood vessels, leaks into the surrounding area. This causes swelling and internal bleeding and sometimes bruising.
Your body’s first and immediate response to soft tissue damage is inflammation. Here the body releases certain inflammatory cells, to the area , which help remove damaged or dying tissues cells. During this process you will experience pain, localised heat, swelling and loss of movement. This will limit how much you move the area which in turn protects the damaged tissue from even further injury. The inflammatory process can continue for at least 5 days and at times longer. Inadequate rest can result in re-injury of the tissue which will inturn extend the inflammatory response. This can delay the start of the repair process.
3.soft tissue repair
Repair of the damaged tissue begins to occur after 3 – 5 days. New collagen cells are laid down and damaged blood vessels and nerve endings sprout back into the area. Physical activity stimulates the new tissue formation. The new tissue formed is called Scar tissue and is different form the original tissue. To encourage good quality repair gentle natural tension via the performance of controlled stretching and strengthening exercises should be applied to the scar tissues at this stage. If the scar tissue isn’t exercised regularly it will shrink and shorthen. This would result in reduced flexibility and weakness of the soft tissues which would mean that it would be be less able to cope with normal physical stress. This tissue repair process usually lasts about 3 weeks.
4. soft tissue remodelling
Soft tissue repair is only optimal if remodelling of the healing scar tissue occurs. This involves remodelling the weaker scar tissue into a stronger tissue which is capable of withstanding normal physical activitiy. This involves gradually progressing the force of the exercises, commenced above, coupled with a gradual return to normal physical activity. This should be continued until the injured area has regained its normal flexibility, strength and overall function. This process can take anywhere from several weeks to several months.
I hope the above has better informed you about how injuries heal .