Stage Race

Any insult or injury  to tissue will present in a characteristic manner with three distinct stages. These stages are known as the Inflammatory response , a repair stage, and finally a remodeling stage. (1)

In the initial stages of injury , within the first 4 to 6 days, a strong inflammatory response is produced. Anyone with an injury can tell you what they are experiencing and it is usually some of the following 5 signs: swelling, heat, pain at rest and loss of function.

As the inflammatory phase and hallmark signs decrease the tissue begins to enter a repair and regeneration stage. At this point repair of the injured site begins to take place, the fibroblastic cells begin to produce collagen, new blood capillaries are formed and the tissue injury site begins to shrink. This stage can last anywhere from 10-17 days, about 14-21 days post injury. The new tissue that is formed is weak and loose, it requires further development.

The final stage of healing is known as the Maturation and Remodeling stage. In this stage the inflammatory process is limited and nearly absent. What is left is weaker tissue characterized by poorly aligned collagen fibers and weaker musculature surrounding the injury site. The ability to perform tasks is generally reduced poorly performing muscles. The duration of stage will depend on the type damage, its extent, and the health of the tissue prior to the injury. It can last anywhere from six months to one year .

These stages are important to know, they provide the framework for what a rehabilitation specialist is trying to control and manage as the patient begins to heal. The management process is very similar to training for any athletic event, careful management of loading in a progressive manner, not too much and not too little will allow for the desired result in rehabilitation.

1- Kisner C, Colby LA: Therapeutic Exercise ed 5. F.A Davis Company, Philadelphia 2007 pg 295-306