Pathophysiology of Injury and stages of H-E-A-L-I-N-G

[Doc.Sust]

Pathophysiology of Injury and stages of he****g

What happens when an injury occurs?

Once a tissue is injured, the process of he****g begins immediately. Initially the destruction of tissue results in the inflammatory response. What are the hallmark signs of inflammation? SHARP swelling, heat, altered function, redness, and pain. Inflammation is necessary to bring phagocytic cells to the area of injury to begin the repair process. During the initial 48-72 hours, which comprises what we refer to as the "acute" or "inflammatory response phase", the body's function is damage control. The body must stop bleeding and wall off the area of injury to localize the he****g response. Although inflammation is necessary to bring the different cells and chemical mediators for clot formation, too much inflammation results in severe edema. This resultant increased inflammation causes increased injury to the injured and surrounding tissues. Towards the end of the acute stage is what is called the stage of passive congestion, when active inflammation has stopped but the edema remains. After the initial inflammatory response period ends, the body moves into the subacute phase. It is important to realize that even though you that after 72 hours you are supposed to be in the subacute phase, the truth is you don't enter into the subacute phase until active inflammation stops.

the chronic stage of injury is broken down into two distinct stages, fibroblastic repair/tissue he****g stage and the maturation! remodeling stage. The fibroblastic repair stage usually lasts from day 7 to about-day-14; the remodeling stage lasts from then up until about l year. You can have a chronic condition, which is in an acute inflammatory stage due to re-injury or just constant irritation. Additionally the term's inflammatory phase and tissue he****g phase don't exactly line up with acute! subacute!chronic. During the fibroblastic repair/ tissue he****g stage, which can begin several hours following initial injury, scar tissue begins to form and the signs and symptoms of the inflammatory stage slowly disappear. The initial tissue formed is called "granulation tissue" and
is composed of fibroblasts, which lay down collagen fibers in a haphazard fashion throughout the scar. It normally takes approximately three weeks for the scar tissue to form completely.
If the inflammatory phase continues, excessive fibrogenesis occurs, which results in tissue damage like that found in adhesive capsulitis of joints, muscles, ligaments and tendons. Due to the possible long-term damage caused by prolonged inflammation, it is important to reduce inflammation as much as possible and to prevent it from persisting. The final stage is the maturation remodeling stage. During this time, realignment of the collagen fibers within the scar tissue occurs, based upon the tensile stresses exerted on the tissue.A proper rehab program is imperative to allow the collagen fibers to reform along proper stress lines. This phase may take years to be complete. I want to review some stages here. Again there are two separate ways to describe the stages of an injury: acute (first 72 hours); subacute (next week); chronic (over 2 weeks) or acute inflammatory stage, passive congestion, fibroblastictissue repair stage, and maturation-remodeling stage.

There are several factors, which can affect the ability for the tissue to heal correctly.P.T. application, chiropractic adjustments, and patient education to name a few.

-Extent of injury- microtears will heal quicker that macrotears
-extent of edema or hemorrhage- increased pressure by swelling retards the he****g process by reducing blood flow of nutrition can cause further tissue damage to surrounding tissues. -Poor vascular supply
-separation of tissue- clean edges heal quicker than jagged edges
-muscle spasm- causes traction of injured tissue separating the two ends and preventing he****g, additionally the spasm can cause local ischemia
-use of corticosteroids- early corticosteroid use can inhibit collagen synthesis.
-infection .
-health, age and nutrition
-stress, emotional status.

What can be done to mediate the effect of the above facton?
Chiropractic adjustment can reduce myospasm, clear out excess fluids, relieve stress and improve emotional status through pain control and restore of proper nerve energy. Physiotherapy can reduce edema and hemorrhage, reduce myospasm, increase vascular supply, and reduce stress and emotional status through decreased pain.
In the acute or inflammatory stage, our goals are to relive pain, control swelling and protect the injured tissues as well as promote he****g. The pnenmonic P.R.I.C.E.S-Protect, rest, ice, compression, elevation and support-describes the most basis care during this stage. During the subacute or fibroblastic-repair phase, our goal is to continue pain control, remove any persistent swelling, help increase circulation, increase he****g and begin range of motion and strengthening.


i would like to thank Dr. Melissa Mcmullen for the information and the knowledege.

[canadian meat]

Great post doc

[Doc.Sust]

^^^^thanks sir!

[conehead]

doc i left a post about neck injury ,could u hav a look at it an let me no wat the craic is wit it ,cheers

[Big]

Excellent post as always Doc.

[Doc.Sust]

thanks big

[NiceGuyResearcher]

I hurt my right shoulder and that has somehow led to a sudden lower rep range on my dominant arm when I do standing dumbbell biceps curls

there is no visible swelling as if when one jams their finger catching a basketball pass the wrong way, you notice that sucker fat and warm (swollen)

2 Questions, please
1) Are you saying this swelling does not have to be visible sometimes?
2) It seems for me, very warm, almost hot aqua therapy like a gel pad put in a shoulder sling helps better than an ice pack, does whether hot or cold therapy work better, depend on the individual?

thanks in advance.

[ulyssesmeads]

ArixMed emergency wound closure device, zip sutures butterfly bandaids, repair wounds without stitches, quick clot for cut, incision, tear, post surgery.