If you are physically active, it is very likely that you will get injured. Most of the times the injuries are not big, but at other times an injury will put you out for weeks and months. In today's article we are going to learn about how your body heals injuries.
Not all injuries are the same in their effect, and in their recovery. Minor injuries cause some disruption of tissues accompanied by minor swelling that gets better in a couple of days, if given proper rest, though immobilization is rarely needed. Usually, these kind of injuries do not require extensive medical care, if anything, the GP may prescribe an NSAID. Also, no rehabilitation is required either. Working the muscle at a slightly less intensity for a week or so is sufficient to get the muscle to function correctly.
Major injuries are a different beasts altogether. Major injuries cause significant disruption to bones, and soft-tissues, with or without bleeding. Sometimes the bleeding is internal and is very dangerous. There's also significant swelling of the said part.
This brings us to the topic of our discussion. All injuries big or small has primarily 3 phases. The length of each phase may vary depending on the extent of the injury. These 3 phases are - inflammatory response phase, repair phase, and maturation and remodeling phase.
Inflammatory Response Phase
Immediately following the injury there is some disruption of tissue. This causes localized inflammation. Inflammation is the body's way to alert the immune system to the injury. The immune system then responds by sending chemical mediators to the injury site that increases blood flow and capillary permeability in the affected region.
Increased blood flow, and capillary permeability also leads to swelling of the said part. There is also substantial pain in the acute phase. Both, swelling and pain are important in the acute phase to immobilize the body part to prevent further damage to the tissue.
The inflammatory phase lasts anywhere from 2 days to a week. This phase may be longer depending upon the extent of injury.
Once the inflammation has subsided the body enters the repair phase. In the repair phase the body is highly catabolic, meaning, that it breaks down the older injured tissue. This is done to remove the tissue that is no longer suitable for repair. This is why see that the limb with injury are significantly smaller compared to the limb that are not.
Along with this cleaning, the body lays down new collagen fiber randomly across the injury site. In healthy tissues the orientation of the fibers is along the direction of the force along that tissue. Therefore we can see that the newly laid tissue is not very good at bearing stress, or produce force.
In this phase we need to avoid stressing the new tissue very aggressively, however, assisted or manual mobilization of the affected must begin in this phase. Isometric exercises at various joint angles can also be included.
The repair phase can last from 2 weeks to upto 2 months maybe even more.
Maturation and remodeling phase
In this phase the collagen laid down in the repair phase is replaced by a much stronger type 1 collagen. The tissue can now start bearing stress and is now capable of producing force. As a result of this the fibers begin to align along the direction of the pull, in turn strengthening the new tissue.
Where the goal of exercise in phase 2 was to restore joint's range of motion, and achieving pain free motion across all range of motion. In the present phase of healing the goal of exercise is to gradually expose the tissue to more and more stress until it reaches stresses of day to day living.
This phase may last for years. But for the most part the deficit won't be noticeable except for the very early part of phase 3. The pain during this phase may be very less or not there at all, but we have to keep in mind that we need to protect the muscle from loading it very aggressively. The chance of re-injury is very real.
A decision to return to your activity must be made while keeping the requirement of your job in mind and comparing it to your current level of preparedness.
If your sport or mode of training extremely intensive on the tissue that is trying to heal, it may cause further aggravation of the tissue. You may have to switch a mode of training that is not as taxing on the new tissue, while gradually strengthening the tissue with appropriate exercises and loads.
I hope that this short article on injuries gave you a little perspective on how we heal from injuries. Most injuries do not need us to get concerned, and with patience bigger injuries can be overcome too.