Healing Soft Tissue

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Healing Soft Tissue

• Chapter 2

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Stages of Soft Tissue Healing

• When soft tissue is injured, it progresses
  through three stages of healing
• Acute Inflammatory
• Repair
• Remodeling

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Acute Inflammatory

• Stage 1 Acute Inflammatory
• When a body part is injured, cells within the
  area die
• This occurs because they are ripped apart and
  also are being cut away from their food and
  oxygen supply

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Acute Inflammatory

• In this stage, an increased flow of blood to the
  injured area brings cells and chemicals to begin
  the healing process.
• This increased flow causes the swelling that is
  often found in the injured area

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Acute Inflammatory

• There are three main components found in these
  chemicals and cells
• Phagocytes.
• Which are specialized cells that engulf and eat
  up the dead cells
• Leukocytes
• Which are infection fighting white blood cells
• Platelets
• Which carry blood clotting materials

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White Blood Cells
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Acute Inflammatory

• The acute stage lasts for about two days after
  the initial injury

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Repair

• Stage 2 Repair
• The area is now filled with the blood, cells, and
  chemicals to rebuild the area to as near normal
  as possible
• The fibroblasts (fiber building cells) begin
  building fibers across the area of injury

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Repair

• Fibroblasts form the scar, which takes from six
  weeks to as long as three months, depending on
  the extent of the injury
• The fibroblasts also bring in scar tissue that
  builds around the injured area
• These form around the area and allow the athlete
  to move and regain physical activity despite the
  fact that injury hasnt completely healed

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Scar Tissue
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Remodeling

• Stage 3 Remodeling
• Remodeling takes up to a year or more to
  accomplish
• It is the bodys way of building tissue strength
  in the tendons, ligaments, and muscles to
  withstand the stress applied to the body during
  activity

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Remodeling

• The length of time it takes to remodel an injury
  depends on the extent of the injury
• For an injury to be completely healed it takes
  much longer than expected to not feel the effects
  of the injury on the body

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Healing Time

• The greater the injury to the tissue, the longer
  the healing time
• Healing time depends on the following
• The degree of the injury
• The location of the injury
• The blood supply to the injury
• The age of the athlete

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Healing Time

• If blood supply to an area is poor the healing
  process will take longer
• Ex the eye and the meniscus
• Other factors that slow the healing process are
  poor nutrition, illnesses like diabetes,
  medications, and infections

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Healing Time

• One complication of healing is scar tissue, if
  more tissue is laid down than is necessary to
  repair the wound
• Excessive scar tissue can delay healing time and
  decrease the range of motion that a joint or area
  can move
• Some scar tissue forms deep within joints, and
  may have to be surgically removed so that proper
  movement can occur

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Healing Time

• Large wounds, whose edges are far apart, take
  longer to heal
• Keeping the wounds closed with stitches or skin
  closures will help healing

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Healing Time

• If activity is resumed too soon after an injury,
  healing time will be longer because the early
  activity can cause more cellular injury
• It becomes important that the ATC takes into
  consideration the risks of having an athlete take
  part in an activity to early

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Re-Injury
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Healing Time

• Corticosteroids
• These are chemicals made in the body that help
  reduce inflammation
• Synthetic corticosteroids can be used as
  medications to help reduce inflammation
• It can however, increase healing time

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Healing Time

• Skin Closures
• A skin closure is a thin, tough piece of material
  that can bring together the edges of the wound
  and close a deep wound effectively.
• These are often called butterfly band-aids or
  steri-strips