Stages Of Tissue Healing

One of the most common questions we hear as physical therapists is “How long will it take for me to recover”? Soft tissue injuries such as ligament sprains and muscle strains follow a characteristic pattern of healing with three general phases, the inflammatory phase, the proliferative or fibroblastic phase and the maturation or remodelling phase. These stages may overlap and are not always linear, injuries may progress or regress through the phases depending on certain patient specific factors that may be either intrinsic (such as severity of the injury and age) or extrinsic (such as anti-inflammatory use or repeated re-injury).

The inflammatory phase is characterized by a complex cascade of events at the biomechanical and cellular levels. The net result is clotting of any ruptured blood vessels with a return to homeostasis, followed by vasodilation and the introduction of antibodies, white blood cells, enzymes, nutrients and growth factors to the wounded area. Pain, swelling and redness are typically noted during this initial phase, which lasts five to ten days.

Once the damaged tissue has been cleared with the inflammatory phase, the body can begin laying down new tissue during the proliferative phase. This tends to be a relatively inelastic type of scar tissue that is different in make – up than the original tissue of the ligament, tendon or muscle. This stage of healing can last from four to six weeks.

The final phase of healing is characterized by remodeling of the collagen fibers, which will become more parallel with the lines of stress applied to the injured tissue. Tensile strength will continue to increase, providing greater mechanical integrity and reducing the susceptibility to injury in the future. This process can continue for up to a year, the clinical implications being that a client may still feel some mild residual symptoms and may be prone to injury with lesser insult.

Given the stages of healing typical of a soft tissue injury, clients can expect a six to eight week recovery process, with the understanding that that the final phase of healing can continue for up to a year following the injury. Also of note, the stages of healing are affected by client specific factors including age, the severity of the injury, previous injuries, co-morbidities, job demands and compliance with activity modifications recommended by the therapist. For further information or to speak with one of our physical therapists, please contact us at 780-424-4804 or message us here.