Soft Tissue Healing

Soft Tissue Healing

How Long Does It Take to Recover from An Injury?

People are often surprised when they are not back to normal and fully recovered a couple of weeks after injuring a muscle, ligament or tendon.  This is in fact perfectly normal. Unfortunately, your body takes much longer than this to complete the tissue healing process.

So, what actually happens?

Any soft tissue injury, such as a sprained ankle, twisted knee or muscle tear triggers the body’s tissue healing process.  This process involves four main stages which we will explore in more detail.  However, as you can see from the below picture, these stages all overlap and are not actually distinct.
Soft Tissue Healing

Phase 1: Bleeding

The amount of bleeding that occurs depends on both the type of injury and the type of soft tissue involved.  Muscles have very good blood supplies, so they tend to bleed more and for a longer period, resulting in a larger bruise.  Ligaments do not have such a good blood supply, so they bleed less.

Gravity can have a significant impact on where the bruise appears.  If you injure your thigh, you may find that a bruise occurs lower down your leg away from the injury site.  This because gravity can cause the bleeding to track downwards through your tissues.

Bleeding will normally stop after approximately 4 – 6 hours.  It is important to rest during this time to allow the bleeding to stop. 

Phase 2: Inflammation

Inflammation occurs within the first 1 – 2 hours after injury, peaks at around 1 – 3 days, and generally lasts for a couple of weeks.
 
During inflammation you may experience some swelling and heat around your injury.  This is a completely normal and natural part of the healing process.  Inflammation is needed because it helps to trigger the next stage of tissue healing.  This is a normal and necessary phase and you should not try to prevent it.

To help your body recover as quickly as possible, try following the PEACE and LOVE management strategies.

Protect – do not push through the pain or the swelling. Try to apply the No HARM protocol: no heat, no alcohol, no running/strenuous activity and no massage. This will help to minimise bleeding and prevent further injury. Try to continue with activities as pain allows but rest as required and do not push through the pain.

Elevate – try to keep the injured area raised and supported when you are resting. You can also try some ice to help reduce the pain. Wrap an ice pack in a towel and apply to your injury for 15 minutes. Do not place the ice on any open wounds and remove the ice if the area goes numb. This can be repeated 2 – 3 times per day.

Avoid anti-inflammatories – try not to take anti-inflammatory medication such as ibuprofen or naproxen in the first few days after injury as this can delay the healing process. If you require pain control, stick to simple analgesics such as paracetamol.

Compress – when you are moving around you can apply gentle compression using a tubigrip, compression bandage or tape.

Education – speak to your physiotherapist! They can provide advice and guidance on optimal recovery, help you to understand any restrictions in loading/activities and guide you on rehabilitation time frames.

AND

Load – keep the injured area moving regularly within a comfortable range.  This will help to maintain flexibility and strength, and it will also trigger the next phase of healing.

Optimism – research has shown that fear about an injury and depression and negatively affect outcomes.  Staying positive is important! Speaking to a physiotherapist can help to keep your expectations on recovery time realistic.

Vascularisation – this is basically blood supply to an area of your body.  The better the blood supply, the more oxygen and nutrients will reach the tissue, which will optimise healing.  Gently moving injured the area and loading the surrounding muscle increases blood flow, therefore assisting with the healing process.  Make sure you don’t overdo it though, too much movement and loading early on can increase bruising, swelling and pain.

Exercise – right from the start of your recovery, gentle exercise within pain limits is very important.  Exercise will help to restore mobility and build strength which will in turn help you recover faster and prevent further injury.

Phase 3: Proliferation

In the proliferation stage, your body creates scar tissue to repair your injury.  This phase of healing starts within 24 – 48 hours, peaks at around 2 – 3 weeks after your injury and stops after around 4 – 6 months.  This is the reason why you will still be experiencing symptoms a couple of weeks after your injury.  Tissue healing is still in full flow and your body is busily creating new scar tissue.

The most important message during this stage of healing is to gradually exercise the area without pushing through pain.  You want to build strength and flexibility without overloading the new scar tissue.

Phase 4: Remodelling

New scar tissue is not good quality or very functional.  It therefore has to be taught to behave like the structure it has repaired.  When proliferation is at its busiest (around 2 – 3 weeks after injury), your body begins to remodel the new scar tissue to get it as close as possible to the function of the original tissue.  This process can last for up to 2 years.

It is very important to continue to build strength, flexibility and function throughout this stage of healing.  Following a targeted rehab program will reduce the risk of reinjury.  A physiotherapist can help you with this. 

Key Message:

Inflammation and swelling are completely normal after an injury.  The full process of tissue healing takes much longer than most people expect so don’t panic if you are not 100% back to normal after a few months.  If you suffered a more severe injury, you may still be experiencing a few minor problems a year down the line. 

If you would like further advice on the treatment and exercises you should be doing for your stage of healing, give us a call on 07702 847036 and speak directly to a Senior Chartered Physiotherapist, or click the ‘Book Online’ button to make an appointment.  We can also get you back on track if your symptoms are lingering longer than expected.

The Nebula Physio and Wellbeing Team
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