The healing process is divided into four broad stages which are not mutually exclusive and overlap considerably.

1. Initial vascular reaction – Active Swelling

2. Inflammatory response – Passive Congestion

3. Proliferative phase – Repair

4. Remodeling 

Wound healing refers to the body’s replacement of destroyed tissue by living tissue (Walter & Israel 1987). It comprises of two essential components whose differentiation is based on resultant tissue: Regeneration and Repair.

TISSUE INJURY CAUSES RESTRICTION OF MOTION DUE TO:

1. Inflammation & Swelling
2. Pain
3. Muscle Spasm 

THE MAJOR GOALS OF CHIROPRACTIC CARE:

1. Relieve Pain
2. Promote Full Healing
3. Restore & Maintain Full Function
4. Reduce the Likelihood of Re-Injury
5. Prevent Accelerated Degeneration 

Chiropractic Care Should Continue Throughout the Repair Stage. It Take Longer For Tissues to Heal & Normal Function to be Restored Than it Takes for Pain Relief. Pain Relief is not the Only Goal.  Chiropractic Helps:

1. Restore Normal Motion, Function & Biomechanics
2. Improve Alignment of New Connective Tissue
3. Prevent Shortening of Scar Tissue & Chronic Stiffness
4. Restore & Maintain Flexibility of Ligaments & Muscles
5.  Restore Normal Muscle Tone
6. Promote Quicker, More Effective Healing
7. Restore & Maintain Normal Sensation
8. Reduce the Risk of Re-Injury and Degeneration 

STAGES OF SOFT TISSUE HEALING

 

STAGE I: ACTIVE SWELLING

1. Swelling Occurs for 12 to 72 hours
2. Motion is lost and pain increases 

Goals of Care: Minimize pain and swelling

Care:

1. Rest & Support of Injured Area
2. Ice to Block Swelling, Pain, and Spasm 

STAGE II: PASSIVE CONGESTION   

Fluid trapped in tissues restricts motion, causes pain, & delays healing. Begins by second to fourth day

Goals of Care for Passive Congestion:

1. Remove fluid
2. Pain Relief
3. Begin to restore range of motion 

Care:

1. Chiropractic Adjustments Help

• restore motion
• block pain
• restore normal sensation
• relax tight muscles
• remove swelling
• accelerate healing

1. Heat and Cold to Remove Fluid
2. Controlled Motion Exercises
3. Physical Therapy helps in Some Cases
4. Acupuncture Can Help With Pain Control 

STAGE III: REPAIR

Beginning 5 days after injury, scar tissue is made for up to 6 weeks. 

Lack of motion causes excess scar tissue in dense patterns disrupting normal function causing:

1. Excess Scarring
2. Chronic Stiffness
3. Limited Range of Motion
4. Poor Biomechanics
5. Chronic Pain
6. Weak Muscles & Ligaments
7. Loss of Normal Sensation
8. Poor Nutrition
9. Increased risk of Re-Injury
10. Accelerated Degeneration 

If Motion is Restored & Maintained, Tissues Heal in a Much More Functional Way.

Coals of Repair Stage:

1. Restore Normal Range of Motion
2. Restore Sensation
3. Promote Full Healing
4. Relieve Pain 

STAGE IV: REMODELING 

Connective tissue remodels for better strength & flexibility. This often takes 3 to 14 week but may take up to 1 year with severe injury. 

Chiropractic Helps Achieve these Goals:

1. Improve & Maintain Motion & Flexibility
2. Restore & Maintain Function
3. Reduce Chronic Pain
4. Reduce Risk of Re-Injury & Degeneration

This Post was based on Dr. Malik Slosberg’s Research.