mechanics of tissue healing sp09
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Mechanics of Tissue Healing
Pain inflammatory mediatorsTissue injury
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Soft Tissue Healing
•Three Phases▫Inflammatory Phase▫Regeneration Phase (Proliferation)▫Remodeling Phase (Maturation)
• Bleeding Phase ▫Short lived
6-8 hours Vascular (muscular) bleeds longer (24+hrs) Ligament bleeds less
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Inflammatory Phase
• Normal and Essential Component ▫2-3 Days before gradually resolving
• Local Vasoconstriction (shock)▫Zone of Primary Injury▫Necrosis – death of tissue from lack of O2
• Vasodilation▫Zone of Secondary Injury▫Leukocytes
Ingest dead cells/foreign and infectious▫Phagocytosis
Conective tissue carrying heparin/histamine▫Bradykinin
Stimulates nerve endings to cause pain
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Regeneration Phase
• Growth of new tissue• 4th-5th day – weak connective tissue has formed
over injury site.• Production of scar (collagen) tissue
▫Rapid onset 24-48 hrs▫Takes longer to peak
2-3 weeks the more vascular the tissue, the shorter the time
taken to reach peak proliferative. Reduces strength approx. 30% Decreases flexibility
• Runs from the first day or two post injury through to its peak at 2-3 weeks and decreases
• Hematoma size sufficiently diminishes
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Remodeling Phase•Often overlooked in terms of importance•Longest duration
▫Healing occurs for 1 year or more!•Begins at same time as the peak of the
proliferative phase (2-3 wks)▫Possibly even earlier (1-2 wks)
•Chemical levels return to normal
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Cutaneous
Wound Healing
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Muscular Healing
•Healing is similar to other tissues•Hemorrhage/Edema
▫By Phagocytosis•Adhesions inhibit muscle fiber
regeneration•Muscle may only regain 50% pre-injury
strength•Rehabilitation Length
▫Fairly lengthy▫6-8 weeks
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Tendons and Ligaments
•Tendons require less blood supply than muscles to function, they take more time to heal.
•Ligament damage is a lengthy process▫Joint instability▫Atrophy ▫Increased risk of RE-Injury
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ESSAY Questions • 1. Describe goal setting and why it is important
during rehabilitation. (4) • 2. What things can be done to address the
psychological aspects of dealing with an injured athlete? (5)
• 3. Explain H.O.P.S. – Give 2 examples of each (8)
• 4. What is the difference between zone of “primary” and “secondary” injury? (4)
• 5. Why is scar tissue healing less desired? (4)