Stages in healing

Question 1

What are the stages?

Answer 1

inflammatory process
repair phase
remodelling phase

Question 2

inflammatory process

Answer 2

this follows trauma to the collagen fibres
lasts 3-5 days
chemicals are released which produce pain and there is bleeding in the tissues
this and fluid from damaged cells produces swelling
this puts pressure on the nerve endings causing more pain

Question 3

Repair phase

Answer 3

blood clotting over the damaged tissue
blood platelets from the mesh initiate the healing
present in the blood clot are fibroblast cells, which proliferate and begin to lay down Type 3 (immature) collagen tissue, between 3-21 days after the injury.

Question 4

Remodelling phase

Answer 4

can last up to a year
maturation of collagen tissue from Type 3 to Type 1 and realignment of collagen tissue.
When it is first laid down, the collagen tissue is haphazard and does not possess a lot of tensile strength. The ligament gradually becomes stronger through being subjected to controlled strain in a functional pattern, which aligns the fibres in a longitudinal fashion.

Because the remodelling phase lasts for up to a year, there is a potential weakness in the ligament and a risk of re-injury. This risk is reduced by providing additional stability with a strapping, increasing the strength of muscles which also provide support to the joint, and by doing proprioceptive exercises to increase the patient’s sense of joint positioning.