Soft Tissue Healing
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The Healing Process[edit | edit source]
The healing process after a muscle injury:[edit | edit source]
This classification is based on a treatment protocol of “Clanton et al.” [1] (Level of evidence: 3B) But is not indifferent from other classifications. It is possible that some phases overlap, dependable on the individual response to healing and the type of injury. Not every patient undergoes all phases to achieve a full rehabilitation.
1. PHASE 1: Acute phase: ( 1 to 7 days)
In this phase treatment exists out of the RICE-method. This method exists of Rest, Ice, Compression and Elevation. The main goal of this method is to minimize inflammation and pain. During the treatment with ice, a flexion and extension exercises are important but must be pain free (to prevent further injury).
2. PHASE 2: Subacute phase: (Day 3 to < 3 weeks)
This phase starts when signs of inflammation begin to reduce. Inflammation signs are heat, swelling, redness and pain. Muscle action is important to prevent muscle atrophy. When the patient has a full range of motion without any pain during this movement, concentric strength exercises can be done. When there is pain, the intensity must be immediately decreased.
3. PHASE 3: Remodeling phase: ( 1 to 6 weeks )
In this phase, the patient can begin with stretching exercises to avoid a decrease in flexibility of the hamstrings. Eccentric strengthening exercises can also be done in this stage. These exercises are heavier than concentric exercises. Therefore it is important that the muscle is already regenerated because otherwise, reinjury is possible.
4. PHASE 4: Functional phase: ( 2 weeks to 6 months)
The main goal in this stage is to return to sport without a reinjury. To accomplish this goal, the patients need to increase their strength, endurance, speed, agility, flexibility and proprioception until the normal values of patient. Sport specific activities are the best indicators for a patient who returns to his sport.
5. PHASE 5: Return to competition phase: ( 3 weeks to 6 months)
When a patient returns to the competition, it is important that he can avoid a reinjury. Only when the patient has a full range of motion, strength, coordination and psychological readiness, he is allowed to return to competition. A study reveals that a program consisting of progressive agility a trunk stabilization is effective in promoting return to sports and in preventing for reinjury. This program turned out to be less risky for acute reinjury than isolated stretching and strengthening exercises. [2]
