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When an injury occurs, a common concern is, “How long until I’m back to normal?”
Such events disrupt our lives, and naturally, we want to regain full function as soon as possible. A frequent challenge in injury recovery is understanding the healing timeliness. While we all wish for immediate recovery, the reality is that healing takes time, cannot be rushed and different tissues will heal at different rates. Many aspects of recovery are out of our hands, like age, the type of tissue injured, blood supply, and the extent of the damage.
Despite these uncontrollable factors, we can improve our recovery by enhancing our knowledge of tissue healing and avoiding actions that could impede it. We can optimise the healing journey by focusing on appropriate rehabilitation, consuming nutritious foods, ensuring adequate rest, and maintaining patience and positivity.
What Are The Phases Of Tissue Healing?
After an injury, the body's soft tissues naturally progress through specific healing phases, regardless of physiotherapy interventions.
The 3 Stages of Healing:
Acute Inflammatory Phase without disturbance normally takes 5-7 days.
Inflammation has a bad reputation, but is the inflammation a bad thing?
Inflammation is a biological response of the immune system that can be triggered by a variety of factors, including pathogens, damaged cells, toxic compounds or irritation. Inflammation is a defence mechanism vital to health and is essential for healing and tissue repair.
Effect of physiological inflammation process:
- Removing injurious stimuli and damaged cells/tissues.
- Initiating the healing process.
- Minimizing area affected by injury or infection.
- Restoration of tissue homeostasis and creation of new cells/tissue
There are five cardinal signs of inflammation: redness, heat, swelling, pain and loss of tissue function.
In this phase, the “R.I.C.E.” or “M.E.A.T.“ protocol is advised.
Physiotherapy treatment in this stage is focused on decreasing pain and swelling, protecting injured tissue and preparing the body for the next stage of the healing process.
Proliferation Phase: 1 week up to 6 weeks
This phase begins as inflammation subsides and the body starts repairing damaged tissue. Initially, new collagen fibres form as disorganized scar tissue, which is weaker and less flexible than the original tissue.
During this phase, you will likely experience less pain. However, there is a high risk of re-injury since the new collagen fibres cannot withstand as much stress as normal tissue. Often, people feel better during this phase and prematurely return to regular activities, leading to setbacks.
Physiotherapy treatment at this stage focuses on regaining range of motion, joint mobilization, and exercises with optimal loading to promote the proper alignment of collagen fibres.
Remodelling Phase: From 3 weeks up to a few years
During the remodelling phase, the body begins to remodel and strengthen the collagen fibres. A gradual increase in tissue loading during this phase is essential to help align the fibres correctly, allowing the tissues to get as close as possible to the function of the original tissue
During this phase, physiotherapy focuses on the gradual implementation of elements of pre-injury / target activities.
Timelines For Tissue Healing Based On Tissue Type
This chart shows the average range of healing times for various tissues in the body, including different grades of tissue injury for muscles, tendons, and ligaments. It can serve as a reminder that we can’t force our bodies to heal faster than physiologically possible.
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