The Three Stages of Healing
The three stages of healing are:
- Primary Inflammation
- Reparation and Cell Proliferation
- Soft Tissue Remodeling
1) During the initial inflammatory stage, which typically lasts three to five days, prostaglandins initiate multiple tasks:
- to stimulate the immune system, in order to ramp up the machinery used to fight infection.
- to build up platelets around the lesion, which help to seal any punctures or breaks in the wound, and to
- attract white blood cells that protect against infections and clean up the damaged tissue.
- Specialized cells called fibroblasts produce disorganized fibrous (scar) tissue.
2) During the second stage, Reparation, which lasts four to six weeks,
- cells proliferate to replace the damaged cells and
- scar tissue becomes organized. Physical activity eliminates unnecessary scar tissue that has inadvertently adhered to neighboring tissue. This is a critical time in the injury repair process. A person must be actively moving the injured body part. This is part of the reason why chiropractic care is so important. Through proper chiropractic joint mobilization, the scar tissue formation is reduced.
3) During the remodeling stage, lasting about six months or more,
- the repaired tissue remodels itself. The cheap get-the-job-done-quick patch that was laid down in the 2nd stage is remodeled and replaced with stronger tissues. The existing lattice is reinforced.
Interestingly forensic anthropologists and archeologists observe changes in bone structure, for example, to determine the types of work a person performed based on the fact that remodeling is an automatic process accompanying use. During the third stage of healing this process can restore damaged tissue so it is stronger than it was before the injury. If remodeling doesn’t occur, it leads to weakened tissue prone to reinjury.
Injuries are an opportunity to become stronger. When the three stages proceed normally, tissue becomes stronger and less prone to injury. This principle is used by performance athletes. Likewise, pain is rare if the damage heals quickly and thoroughly, without abnormal adhesions.
During all three stages of healing, proper movement of the injured tissue is important. In 1980, a medical researcher by the name of Salter looked at the effect of continuous passive motion on fractured joints. The study looked at wound healing, joint healing, and cartilage health. The results showed that the joints which were not casted, but allowed to have some movement healed better. With respect to chiropractic care, our primary focus is in restoring proper motion and alignment to the joints during the three phases of wound healing. You can read about the landmark study here: http://www.ncbi.nlm.nih.gov/pubmed/7440603.
One result of Dr. Salter’s study is the boot-cast. We see black velcro-strap boot casts for most ankle injuries. This is because the boot allows for some motion in the joint and it promotes better healing of the injured tissues.
As a population, we seem to be lagging behind a little with proper back pain care. Too many of us think that with a back injury, we need to lay in bed for a few days. Research has clearly shown that bed rest actually makes the back injury worse. Light activity is superior to bed-rest. Life is motion, and motion is life. Adding appropriate chiropractic care, like the style applied at Innova Pain Clinic, adds movement to the joints and rehydrates the cartilage and disc through imbibition.
When you have an acute back injury or suffer trauma, like a whiplash, consult an expert chiropractor in the field. You can ask the experts in St George at Innova Pain Clinic, (435) 652-4322. We will provide a consultation, examination, digital x-rays (if needed), and comprehensive treatment plan suited for your specific need.
Dr. Andrew White | St George Chiropractor
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