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Orange County Chiropractic Tissue Healing Information

Whether we are playing it safe during our work or daily activities, injuries happen.

That doesn't mean we should ever give up on preventing injuries - safety first! But it is important to know that all tissues in our bodies have a breaking point making an injury simply unavoidable when the unexpected happens.

Injury occurs when loading exceeds the capacity of the tissue, and every tissue in the body has different loading capacities. Athletes are mainly concerned with musculoskeletal tissues, which include muscle, tendon, ligament, and bone. Although all of these tissues have different breaking points and different recovery times and processes, there is a general guideline for healing.

Stages of Tissue Healing

Tissue healing can be divided into 3 main stages, each having multiple phases:

1. Inflammation:
- Vascular (day 0-14): Covers the wound and injured blood vessels. The wound can be an actual cut or damage to a muscle/ligament/tendon.
- Cellular (day 0-14): Removes bacteria and dead tissue to prevent injury
2. Proliferation (AKA Reparative)
- Re-epithelization (first 48 hours): Forms scab over wound
- Fibroplasia with neovascularization (day 2-5): Scar tissue formation and new blood vessels
- Wound contracture (day 4-21): Closure of the wound
3. Maturation (AKA Remodeling)
- Consolidation (day 21-60): Conversion of cells to fibrous tissue (collagen)
- Maturation (day 60-360): Strengthening of scar tissue

The idea of tendons, ligaments, and muscles returning to their original state after injury is not strongly supported by research literature. (When we say muscle injury, we're referring to a large muscle tear, not a small one or the little tears that occur when you workout). This is because scar tissue fills the injured area, and it does not have the same strength as the original tissue. However, tissues still have the ability to repair, and the goal is to help normalize them as much as possible in order to re-gain the maximum amount of function.

How do we normalize them? Listen to your body and take care of you injuries. Take a few days to rest, but don't sit on your butt and complain that you are injured. Moving during recovery is key, but don't over do it!

Most people with injuries usually want to know how long it will take to heal and what they can do to speed up the healing process. Below are other factors (besides tissue type and mechanism of injury) that can affect how fast your tissues recover:

1. Age: The older you are the longer it takes for your tissues to heal. Sorry, not much you can do about this one.

2. Nutrition: This is huge and you can control this one! A few vitamins and minerals that can slow tissue healing when you are deficient are vitamin A, vitamin C, iron, calcium and copper.

3. Sleep: Sleep is actually when the most healing occurs! Also, a decrease in sleep leads to number 4…

4. Stress: Increased levels of stress hormones decreases your tissues' ability to heal. Exercise reduces stress!

5. Doing nothing: Inactivity is the worst thing to do when you are injured. Some injuries must be immobilized for a period of time, but you can still move the other parts of your body to keep the blood flowing and continue the healing process. Rest for a few days and then get back out there.

6. Health: Conditions such as diabetes tends to slow the healing process. Smoking also has the same effect.

7. Anticoagulents: This is a type of drug used to help treat and prevent heart conditions, AKA blood thinners. This is another one that you may not be able to change, but just be aware that you may need to rest a little longer to allow your injury to heal if you are taking this medication. Please listen to your doctor and don't stop taking these just so you can heal faster!

8. Corticosteroids: This type of drug is commonly found in asthma medications, so another one to just be aware of (also listening to your doc). Cortisone injections also have the same effect. They are usually a temporary fix to reduce pain and actually weaken your tissues! Along with slowing down tissue healing.

9. NSAIDs (i.e. ibuprofen): The main thing to understand is that this type of drug stops inflammation. If you go back to the normal healing process described above you will see that inflammation is an ESSENTIAL part of tissue healing! Some inflammation is good, so try to avoid it and use ice to control the inflammation if necessary.

Take the time to visit us at Gateway Rehab and Wellness Center for Orange County and Mission Viejo Chiropractic care! We can help you with the tissue healing process after any injury!

Reference: Dutton, Mark. Orthopaedic Examination, Evaluation, and Intervention. Second edition. The McGraw-Hill Companies, Inc, 2008.

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