The Soft Tissue Injury & Healing Process

In my previous article you learned how scar tissue builds up and what the symptoms are. Now it’s time to learn what actually happens when your body is healing from an injury. This will get you a better understanding of why rehabilitation is so important.

Your body always goes through the same process when it’s repairing itself. This is regardless of how severe it is and if it’s muscles, tendons, ligaments or bone that’s gotten damaged. This process always happens in three stages:

1. Inflammation Stage

You’ve torn a muscle, sprained your ankle, gotten punched in the stomach, broken a bone, stepped on a piece of glass.. This is where it all starts. You’ve injured yourself and now it’s time for your body to fix itself by finding the damage, reduce further risk of damage and lay the first foundation of repair.Inflammation-Woman-Shoulder

When something gets injured, it causes blood vessels to break; this is how the injured body part gets inflamed. This can be identified by blood on the skin or bruising or swelling under the skin. Your body’s first job is to stop the bleeding. It does this by triggering a blood cloth, Platelets, to form to ‘plug the hole’.

Step number two is to reduce the risk of any infection. Your body will send a signal up to the brain telling your body to release white blood cells to the area. This can be seen very quickly as the area will swell up. The swelling forms a sticky gluey mess that will start the healing process. The swelling will limit your movement in the damaged area, thus limiting further damage.

On top of this your body will excrete a chemical that stimulates nerves fibers and make the area painful, this will protect the area even more. This only happens if there is a risk of infection. If you pull a muscle there is little risk of infection. Whilst if you step on a piece of glass in a nightclub, the risk of infection is very high!

The inflammation stage takes about 3-5 days and will always be the first thing your body does, regardless of your injury.

I mostly deal with clients who suffer from both old and newly pulled, strained and sprained muscles. In cases like this I find that starting treatment as close as 48h after injury is very beneficial. Treatment during this stage will be light mobilizations movements, gentle massage to increase blood flow and possibly some Trigenics strengthening protocols. This all does depend on the severity of the injury!

2. Proliferation Stage

Now it’s time to grow and produce new cells and tissue. Your body will start replacing the Platelets to cells called Fibroblasts. The fibroblasts create a framework of collagen for new cells to develop. Collagen is the universal building material for most tissues in the body. In soft tissue injuries, the collagen is called ‘scar tissue’.

Acute pain in a woman hand. Isolation on a white background

Acute pain in a woman hand. Isolation on a white background

At this stage your body doesn’t lay the collagen down is a neatly fashion. Instead, the collagen strands runs in all kinds of directions, instead of with the muscle fibers, as it should be. This leaves the tissue weak and more susceptible to further injuries.

Over the next 7-14 days the scar tissue will contract and pull the damaged parts together. In addition to this your body will bring fresh blood to the damaged are, thus giving the area the nutrients it needs.

At this stage the pain should be much less, swelling should have reduced and bruises become darker.

Treatment during this stage is highly recommended. You want someone to break down the scar tissue, mobilize the area, strengthen weak muscles, lengthen short muscles and bring blood down to the area.

You want to find a therapist (such as myself) that has the knowledge of: Manual Adhesion Release, Instrumental Adhesion Release, ART, Trigenics and Swedish Massage. An additional bonus is finding a practitioner that has a FSM Unit as well; such as the one we have here at Winning Health Solutions.

All of the above combined will help your body out to arrange the newly formed collagen (scar tissue) in a neat fashion, so the strands go with the other muscle fibers, thus making the muscle strong and less susceptible to another injuries.

3. Re-modelling Stage

This is the stage where your body completes the reorganization of scar tissue and the forming collagen and the tissue becomes fully ‘matured’. The scar tissue will now begin to shrink due to its contractile nature.

The remodeling stage continues from around day 14 onwards. This process is greatly influenced by external factors such as movement and exercise.

The ‘non training’ rehabilitation part should consist of further scar tissue break down, Trigenics, FSM, `Swedish Massage and Stretching.

The training part should be about getting the muscles strong again, correct possible ‘faulty’ movement patterns, correct possible ‘wrong’ techniques, training the muscle/joint in full range of motion or toward full range (depending on severity of injury) and some hypertrophy work.

To Summarize:

Stage 1: 3-5 days. Start blood flow treatment and light mobilization 48h post injury (deepening on severity of injury)Ankle_arthritis

Stage 2: 5-14 days. Manual adhesions release, instrumental adhesion release, Trigenics, FSM, Stretching and Mobilization of tissue and joints can begin

Stage 3: 14 days onward. Same as above, only now you can get back onto the gym floor again. You want to get the muscle strong, get back to full range of motion, correct technique and movement patterns