So you’ve had a sprain, strain, tear, or tweak? No matter what the cause of a soft tissue injury, your healing is certain to follow a specific series of events in order to heal. The timeframe for each of these events will vary a bit depending on factors including your age, genetics, and current health, as well as the tissue or area injured. It will also be very dependent on treatment and management. However, in general you can expect the healing process to occur as follows:
All soft tissue injuries resolve via 3 important steps:
Acute/inflammatory phase (1 – 3 to 7 days)
This is instantaneous at the onset of the injury and is commonly characterised by pain, swelling, heat, and redness. This phase is all about the inflammatory process taken on by our inflammatory mediators; our cells that actively respond to injury and come to the area via our blood flow to mop up, patch up, and clean up the area on a cellular level. This is the phase where “RICE” treatment (Rest, Ice, Compression, Elevation) is the most effective in order to keep swelling to a minimum and optimise our cellular ability to heal.
Repair phase (1 – 4 to 6 weeks)
Once the area has stabilised, our body then turns its attention to “repair”, where scar tissue (in the form of collagen) is laid down to “glue” the area together. Our bodies tend to lay down scar tissue in a haphazard manner, with the main aim to be patching the area up.
Remodelling (4 to 6 weeks +)
Once we have enough scar tissue down, we then focus on organising the scar tissue. This is where our body will start to break down excessive scar tissue, and re-organise the remaining scar tissue which is needed to be kept for the integrity of the damaged tissue. The remaining scar tissue will start to take on the role of what it is to be (e.g. ligament, muscle, skin) and undergoes further cellular changes to “become” this tissue. If this is done effectively, scar tissue can be as functional as the tissue that was damaged and replaced.
The timeframe of these phases do vary as mentioned previously (e.g. ligamentous tissue will take a lot longer than 6 weeks), but no matter the tissue, the injury, or your own personal factors, these 3 phases all need to take place for healing to be successful. To optimise soft tissue healing and return to function it is important that the right amount of relative rest is given during earlier phases, and the right amount of loading during later phases to promote our bodies response to injury. It is your physiotherapist’s job to guide you through these phases to find the fastest and most effective path to recovery.
Factors that will prolong healing:
- Smoking
- Poor health
- Poor nutrition
- Muscle imbalance
- Overuse
- Infection
- Diabetes
Of course, there is also possibility of re-injury and your physiotherapist will be able to advise you regarding when it is appropriate to return to certain activities. Your physio can also prescribe a rehabilitation exercise program designed to strengthen the region and prevent recurrence.