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Soft Tissue Injury and Fibroblast Regeneration

Mechanical friction during deep tissue massage, fascial manipulation or using techniques like Graston will activate the stimulation the fibroblast reproduction after soft tissue injury. These fibroblasts cells are the most common cells of connective tissue, and they synthesize the extracellular matrix (ECM) and collagen, which is the main framework of our soft tissues. The properties of the connective tissues depends on the composition of ECM – tendons, ligaments and other connective tissues. Elastic and reticular fibers, glycoproteins, glycosaminoglycans, and collagen are all found in ECM and made by fibroblasts. Collagen is the most important part of ECM and plays very important role in tensile loading. The stimulation of production of the above mentioned components can be achieved by frictioning tissues (in other words by providing cross-fiber massage).

Fibroblast production and degeneration is a normal process in every day mechanical loading such as walking, running, bicycling or any other form of movement. There are four basic types of loads: tension (tensile force-fibroblasts), compression (chondrocytes), fluid shear (vascular endothelial cells) and torsional shear. Collagen synthesis in patellar tendon ( which is used the most by bicyclist and runners) increases by nearly 100% as a result of just single bout of acute exercise, and the effect is till evident three days later. I guess I am doing a good job with my knees by keeping them busy with prolonged Mountain Bike Riding and avoiding soft tissue injury.

In the beginning of a training period the balance between synthesis and degradation is increased and there is a net loss of collagen. This enables a tendon to restructure and adapt to an increased loading pattern. It is not till training progress that there is a net gain in collagen synthesis. Deep friction massage can also help to repair a mild soft tissue injury to a knee tendon. Fibroblasts play an important role in wound healing. When connective tissue and blood vessels get injured, growth factors cause fibroblasts to enter the wound area, increase its numbers and begin synthesizing new collagen fibers, creating new granulation tissue and assisting in remodeling. The ECM of granulation tissue is created and modified by fibroblasts.

Recently I was exploring a new trail with another rider. During a steep rocky climb my rear wheel lost a traction and my right knee got over extended. I felt sharp pain but continued on riding. Next day I felt sharp pain around and under my right knee cap (patella tendon). Three to four sessions of deep tissue massage, cross friction massage and modalities such as electric stimulation and Erchonia Cold Laser L5000 model made my knee completely pain free. This is a real example of how Fabroblast is working.

There has also been research done that eccentric exercises may provide more benefit than concentric exercises regarding rehabilitation of muscles and tendons. Eccentric exercises provide greater stimulation of fibroblasts, increasing collagen synthesis and therefore stimulating the healing of soft tissue.

A Soft Tissue Injury (STI)happens when your muscles, tendons and ligaments get damaged because of a sprain or strain. It happens when one overuses or put too much stress on a particular joint. As a result the pain accompanied by bruising or swelling. STI is a very common problem and it can easily be remedied as long as the pain that accompanies it is not severe.

When STI occurrs, an immediate response applying the principle of “PRICE” would make a big difference. PRICE means Protection, Rest, Ice, Compression and Elevation. After an injury, the patient should be prevented from making any movements as it allows to prevent further damage. If the patient feels the pain, when he/she bends or walks then he/she should avoid these movements. If absolutely necessary, crutches may be used. Icing minimizes the pain and the swelling especially during the first 3 days after the injury has occurred. Ice is placed on the affected area for 15-20 minutes at a time every waking hour. Take a note that if you have diabetes or poor blood circulation, you must consult your doctor first before applying a cold pack. Pressure is applied to compress the injured area to control bleeding and swelling. Elevation of the affected area also minimizes the bleeding and swelling. Raise the affected area above the heart level for the first 72 hours or until the swelling would subside.

The “PRICE” management is effective but other treatments may be necessary if the patient experiences extreme pain that lasts for more than 24 hours. A health care professional would be able to make a diagnosis and recommend treatments. Treatments include chiropractic, physical therapy and massage therapy. If a patient suffers from severe pain, prescription medications might be necessary along with a rehabilitation program.

Chiropractic rehabilitation helps to rapidly solve the problem of injuried muscles, tendons and ligaments. One of the chiropractic specialties for such treatments is called ART or Active Release Techniques. Patient would be amazed at how fast your recovery would be if you go for a chiropractic adjustment, ART and Physical Therapy Modalities. It is a hands-on approach that locates then eliminates the scar tissues. The Graston Technique is a treatment using different stainless steel tools and it can be even more effective than ART. The Graston Technique uses instruments to treat the affected areas suffering from chronic inflammation or fibrosis of the soft tissues. SASTM is another chiropractic tool used that is made of acrylic instead of stainless steel as used on the Graston Technique. But, in some cases, in order to get the best result in treatment, both set of tools may be used on the patient as well as different modalities.

Question: What Kind of Therapy Have You Had For Your Soft Tissiue Injury? What was an outcome like?

Soft Tissue Injury and Fibroblast Regeneration

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