What to Expect With Injury Healing

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’

Unfortunately, the answer to this can be complicated and requires some understanding of how the different tissues of the body heal. Body tissues include muscles, tendons, ligaments and bone, and each of these tissues heal at different speeds. It’s also important to note that each individual will also have some variation on those times as a result of their individual health history and circumstances. 

The type of tissue injured and their different healing times is a crucial part of how your physiotherapist approaches treatment and rehabilitation goals. On an individual level, a patient’s age, the location and severity of the injury and the way the injury was managed in the first 48 hours all affect the healing times of an injury. Unfortunately, as we age, injuries do tend to heal more slowly than when we are young. Any medical condition that reduces blood flow to an area, such as peripheral vascular disease, can also reduce the body’s ability to heal at its usual rate. 

There are some guidelines that can be followed when predicting how long an injury will take to heal based on the tissue type affected. Muscles are full of small capillaries, which provide a rich blood supply, and as such, they have a comparatively fast healing time with 2-4 weeks for minor tears. This time will be extended for larger tears and more complicated presentations. 

Ligaments and tendons have less access to blood supply and injury to these tissues generally take longer to heal. Larger or complete tears of all soft tissues, may not be able to heal themselves and in rare cases, surgery may be required for complete healing to occur. Similarly, cartilage, the flexible connective tissue that lines the surface of joints is avascular, which means it has little or no blood supply. To heal, nutrients are supplied to the cartilage from the joint fluid that surrounds and lubricates the joint.  

While the different tissues of the body all have different healing times, they all follow a similar process of healing with three main stages, the acute inflammatory phase, the proliferative stage and finally the remodelling stage. 

The inflammatory stage occurs immediately after an injury and is the body’s primary defence against injury, typically lasting 3-5 days. This stage is identifiable by heat, redness, swelling and pain around the injured area. During this phase, the body sends white blood cells to remove damaged tissue and reduce any further damage.

The proliferation stage is the phase where the body starts to produce new cells. Swelling and pain subside and scar tissue is formed that eventually becomes new tissue. This stage usually occurs around days 7-14 following an injury. 

The final stage, known as the remodelling stage is when the body completes healing with the reorganization of scar tissue and the laying down of mature tissue. This stage usually occurs roughly two weeks after the initial injury is sustained. 

At each stage of the healing process, a different treatment approach is required and your physiotherapist can help to guide you through your recovery. Ask your physiotherapist to explain how your injury can be managed best and what to expect in your recovery process. 

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