1. Mechanics of Tissue Healing Tissue injury Pain inflammatory mediators

3. Inflammatory Phase Normal and Essential Component 2-3 Days before gradually resolving Local Vasoconstriction (shock) Zone of Primary Injury Necrosis – death of tissue from lack of O2 Vasodilation Zone of Secondary Injury Leukocytes Ingest dead cells/foreign and infectious Phagocytosis Conective tissue carrying heparin/histamine Bradykinin Stimulates nerve endings to cause pain

4. Regeneration Phase Growth of new tissue 4th-5th day – weak connective tissue has formed over injury site. Production of scar (collagen) tissue Rapid onset 24-48 hrs Takes longer to peak 2-3 weeks the more vascular the tissue, the shorter the time taken to reach peak proliferative. Reduces strength approx. 30% Decreases flexibility Runs from the first day or two post injury through to its peak at 2-3 weeks and decreases Hematoma size sufficiently diminishes

5. Remodeling Phase Often overlooked in terms of importance Longest duration Healing occurs for 1 year or more! Begins at same time as the peak of the proliferative phase (2-3 wks) Possibly even earlier (1-2 wks) Chemical levels return to normal

7. CutaneousWound Healing

8. Muscular Healing Healing is similar to other tissues Hemorrhage/Edema By Phagocytosis Adhesions inhibit muscle fiber regeneration Muscle may only regain 50% pre-injury strength Rehabilitation Length Fairly lengthy 6-8 weeks

9. Tendons and Ligaments Tendons require less blood supply than muscles to function, they take more time to heal. Ligament damage is a lengthy process Joint instability Atrophy Increased risk of RE-Injury

10. ESSAY Questions 1. Describe goal setting and why it is important during rehabilitation. (4) 2. What things can be done to address the psychological aspects of dealing with an injured athlete? (5) 3. Explain H.O.P.S. – Give 2 examples of each (8) 4. What is the difference between zone of “primary” and “secondary” injury? (4) 5. Why is scar tissue healing less desired? (4)