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Understand
how your body heals-part 1
Understanding the Healing process-part 1
A critical step in
developing this ability is deepening your
understanding of how the body repairs damaged
tissue. You must recognize specific events that
occur following an injury and common signs and
symptoms associated with tissue damage and
repair. This will help you identify where
clients fall in the healing continuum, what
sensations and functional changes they might
expect, and ways you can both support the
restoration of optimal function.
Phases of Healing:
We can break tissue healing into three
phases: the inflammatory response, repair phase,
and remodeling phase. Each phase has a specific
purpose and is characterized by common signs and
symptoms.
INFLAMMATORY RESPONSE Healing begins
immediately following a traumatic injury with the
inflammatory response. The magnitude of this
response depends on the severity of tissue damage
and may vary from one person to another. In this
phase, injured tissues release chemicals that draw
resources to the area, alert the body that damage
has occurred, and inhibit function to prevent
further injury. Five cardinal signs characterize
inflammation and can be remembered with the
acronym SHARP: swelling, heat, a loss of function,
redness, and pain.
Initially, surrounding blood vessels dilate,
increasing blood flow to the injured area. This
delivers the white blood cells and nutrients
necessary to clean up and wall off the injured
area. Affected tissue becomes hot and red as blood
flow increases. Over time, capillaries become more
permeable or "leaky," allowing nutrients, white
blood cells, and clotting proteins to move out of
the circulatory system and into the damaged area.
Affected and surrounding tissues become
The pain sensation produced during the
inflammatory response is global (felt in a large
area) because it is chemically induced and affects
both damaged and surrounding tissues. Clients
typically describe constant pain over a broad
region that significantly limits function. They
may have difficulty isolating the injury location
during this initial phase and difficulty resting
or sleeping is common. These symptoms continue as
long as the inflammatory chemicals remain active
within the tissue.
A secondary purpose of the inflammatory
response is to limit function in the injured area.
Forces or activities that injured the tissue must
be stopped in order to prevent additional tissue
damage. Swelling, muscle spasm, and pain inhibit
function and clients typically experience a loss
of mobility, strength, and endurance as a result.
Alternate movement strategies or compensation
(like limping on an injured ankle) may occur
immediately following injury. Compensation is
normal and necessary to minimize further injury
while maximizing function. Educate clients about
the purpose of inflammation to help decrease the
stress and frustration associated with acute pain
and loss of function.
Repair Phase:
The inflammatory response gives way to the
repair phase once the injured area is walled off
and debris from injured structures is removed.
Signs and symptoms of inflammation subside and
construction begins to replace or repair the
injured tissue. Clients often report more specific
areas of pain as the chemicals of inflammation
dissipate and healing- processes centralize in
areas of damage.