Inflammation & The Elephant In The Room.
STEPHEN M SWARINGEN, DC 08/21/18
In the body healing occurs as a response to a stimulus like acute trauma (new) and/or overuse/chronic (old) injuries. When we experience an injury of a tissue, the body releases several chemical and neurological messages to the brain initiating the healing process.
Inflammatory Phase (1-3 days)
The healing of an injury begins with the inflammatory phase. Our body responds by releasing a substance called transudate that causes localized swelling. This initial response imports white blood cells, growth factors, and other vital nutrients to aid in protecting and repairing the injured tissues. During this phase the injured tissues are swollen, hot, and painful. The focus of treatment aims to promote the evacuation of stagnant inflammation from the injured area and promote the importation of new inflammation to that area. We achieve this with active and passive range of motion, isometric muscle activation, appropriate tissue mobilization, and passive modalities such as ultrasound, electric stimulation, heat/ice.
Rebuilding Phase (1-12weeks+)
The rebuilding phase begins as the body starts to mend the injured tissues. As new connective tissue cells are transported to the site of injury, the tissues begin patching together like your grandmother’s quilt. As this rebuilding of tissues progresses, the body also focuses on repairing the complex vascular network supplying these new tissues with oxygen and nutrients. The focus of treatment in this phase is the continued decrease of inflammation, increasing range of motion, initiating muscle activation, and reducing pain utilizing Static Stretches, Isometric Exercise, Eccentric Loading, Dynamic Mobility, Neuro Re-education, and joint mobility.
Remodeling Phase (3 weeks-3 months+) 2
During the remodeling phase the body stops laying down connective tissues and begins transforming the new tissue to its specific type in order to fully repair the injury. This process organizes the new mended tissue into long aligned fibers. The focus of this phase is to restore full range of motion, stability, strength, while eliminating all pain. We call this the “return to competition” phase. Our goals are to move away from passive modalities with most of the focus now being on joint and tissue mobilization and with sport specific programming. The rehabilitative programming varies greatly due to injury and severity, however during this phase we typically utilize eccentric/concentric loading, strength/power resisting training, and plyometics/agility drills.
In part 2 we will explore the components of each phase of healing and how proper care plan programming is essential to recovering from an injury.