Acute Injuries
Below we will detail what occurs during an acute injury and the steps we encourage you to take to aid you on your journey of recovery in the quickest time possible.
The 3 phases to healing
In order for healing to effectively and rapidly occur, an injury MUST proceed through ALL 3 phases of healing. By delaying the first phase, you ultimately delay the time in which the third phase will be completed.
1. Inflammatory phase (≤3 days)
a. Blood vessels dilate to allow essential cells; antibodies, WBCs (macrophages), growth factors, enzymes and nutrients to reach the wounded area
b. Associated with swelling, heat, redness and pain
2. Repair phase (3 days – 6 weeks)
a. Body begins to repair injured tissue
b. Wound is re-built with collagen fibres
3. Remodelling (3 weeks – 12 months)
a. Remodelling of collagen fibres, from type I to type III, to increase strength
There can be inflammation without healing but there cannot be healing without inflammation!
What’s happening?
Injury Timeline:
12-24 hours
o Active bleeding from injury site is occurring
o Chemical mediators in the body signal the delivery of the healing cells; begin flushing the wound site
24-48 hours
o Healing cells (i.e. macrophages) actively clean up injury site and activate the production of growth hormones in the body which regulate cell growth & repair.
o If not exacerbated (re-injured), active bleeding should have stopped by 48 hours.
o Once bleeding stopped, the body begins to lay down scar tissue
10 days
o Scar tissue formation peaks – very weak scar tissue
20 days
o Collagen (glue that holds body together) formation complete
4 months
o Scar tissue is at its maximal strength (only 70% of normal tissue!)
What you can do – Self Help!
Contrary to popular belief, the inflammatory response is not the concern following an acute injury, but rather the swelling. Swelling is produced by the end product of the inflammatory response once the healing cells have fulfilled their function (clean up & repair), and if left to accumulate, pool in the area of injury. A certain degree of swelling is needed, to limit movement and to stabilise the injury site, to avoid further damage, however if left to accumulate excessively will take up precious room & restrict the delivery of more healing cells being delivered to the area.
Movement: Your lymphatic system has the job of cleaning up the cells after they have done their job at the injury site. The lymphatic system, unlike your cardiovascular system, does not have a pump to move things around the body. It instead is strategically placed within the muscles of your body and its contents are pumped back into circulation via a skeletal pump. Simply put; stuff moves when YOU move!
o Healing works by getting the ‘good stuff’ in and the ‘garbage’ out
o Pain is your indicator; get as many muscles in the vicinity of the injury site working as much as possible WITHOUT causing pain. Pain indicates further damage and will prolong your healing time
“Use your brain, NEVER cause pain”
Fluids: Drink plenty of water. The body requires adequate hydration to complete the healing process effectively. Avoid stimulants such as coffee, energy drinks, and especially alcohol
Sleep: Ultimately the body’s healing process is kicked into overdrive when you sleep, so get adequate sleep during times of injury recovery.
Pain Relief: Ultimately this is up to you, however it is better to completely ‘feel’ an injury, as it will give you a clear indication of what is good or bad for your body. If you take pain relief you will not have an accurate measure of how much, or type, of movement is too much for your injury and thus risk increasing your overall time of recovery!
Ice: Although ice is a very effective proven form of natural pain relief, icing an acute injury delays the arrival of the all important inflammatory cells and mediators to the site of injury. It also decreases the signalling between muscles and nerves → decreased muscle activation → decreased skeletal muscle pump. Both these actions prolong the inflammatory phase and ultimately prolong your healing time!
Heat: After 48 hours you may use heat, in the form of a wheat bag or hot water bottle etc. Do not use heat on an injury site within first 24 hours as this will slow the clotting process.
Epsom Salts: If not an open wound, soaking in a bath of Epsom salts is effective by not only helping relieve muscle splinting, but also by targeting the nervous system and aiding it in activating the healing side of your autonomic nervous system.
Ask yourself why? Assess what’s been going on in your lifestyle which has brought you to this point. Look at your chemical, mental/emotional and physical stressors. Have they been constructive or destructive on your current path?
Diet / Supplements: Both turmeric and ginger are brilliant during times of inflammation, as is arnica, & vitamin C (needed for all healing processes in the body).
Avoid Coffee, Refined sugars, Alcohol, Processed foods as much as possible for quick healing times
Notes:
Very commonly pain is related to how much congestion (swelling) is in the area. Decrease congestion →decrease pain → easier therapy → increased range of motion.
Following injury, care must be taken to warm up properly before exercising if there is scar tissue formation as scar tissue is far less contractile when compared to normal healthy tissue. This will leave you prone to further injury!