Podcast
Questions and Answers
During the Proliferative Phase, which tissue response is primarily occurring?
During the Proliferative Phase, which tissue response is primarily occurring?
Which clinical sign is associated with the Proliferative Phase?
Which clinical sign is associated with the Proliferative Phase?
What is a key management strategy during the Remodeling Phase of healing?
What is a key management strategy during the Remodeling Phase of healing?
What factor is NOT a lifestyle consideration affecting healing?
What factor is NOT a lifestyle consideration affecting healing?
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Which phase focuses on the remodeling of Type III collagen to Type I?
Which phase focuses on the remodeling of Type III collagen to Type I?
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What is a piece of advice for patients during the Proliferative Phase?
What is a piece of advice for patients during the Proliferative Phase?
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What is a common clinical sign during the Remodeling Phase?
What is a common clinical sign during the Remodeling Phase?
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Which is NOT an element of the 'LOVE' strategy for the Proliferative and Remodeling Phases?
Which is NOT an element of the 'LOVE' strategy for the Proliferative and Remodeling Phases?
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What characterizes a Grade 2 sprain or strain?
What characterizes a Grade 2 sprain or strain?
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Which phase of soft tissue repair involves the strength and completion of repairs?
Which phase of soft tissue repair involves the strength and completion of repairs?
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What is the primary response during the inflammatory phase of soft tissue repair?
What is the primary response during the inflammatory phase of soft tissue repair?
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What symptom is typically identified during the inflammatory phase based on the tissue response?
What symptom is typically identified during the inflammatory phase based on the tissue response?
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How long can the proliferative phase last especially for tissues with limited circulation?
How long can the proliferative phase last especially for tissues with limited circulation?
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Which condition describes the complete displacement of a joint?
Which condition describes the complete displacement of a joint?
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What is a common management consideration during the inflammatory phase?
What is a common management consideration during the inflammatory phase?
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Which tissue pathology refers to tendon pathology affected by mechanical load?
Which tissue pathology refers to tendon pathology affected by mechanical load?
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Study Notes
Soft Tissue Healing
- Soft tissue healing is a complex process involving various phases
- Key objectives include understanding soft tissue lesions, phases of healing, treatment recommendations, and the PEACE and LOVE acronym for management
- Examples of soft tissue lesions include strains (musculotendinous unit), sprains (joint capsule, ligaments), dislocations (complete displacement), subluxations (partial displacement), tendinopathy, synovitis, hemarthrosis, bursitis, and contusions
Grades of Sprain/Strain
- Grade 1: Stretching or microscopic tears in tissue. Minimal swelling, localized pain, and almost normal range of motion (ROM).
- Grade 2: Partial tear of tissue. Moderate swelling, bruising, and loss of ROM with significant pain.
- Grade 3: Complete tear. Severe pain, swelling, bruising, and loss of ROM.
Healing Times by Grade
- Times vary by tissue type and grade of injury, but general guidelines are provided in a table.
Soft Tissue Repair
- Inflammatory Phase: Assess damage, clear out damaged tissue, lasts 4-6 days to 2 weeks.
- Proliferative Phase: Begin repairs, lasts 4 to 24 days or up to 6 weeks in limited circulation.
- Remodeling Phase: Strengthen and complete repairs, lasts 3 weeks to 2 years depending on tissue type and injury grade.
Stages of Wound Healing
- Presents a visual graphic of the stages of wound healing, including inflammation, proliferation, and remodeling.
Inflammatory Phase (Details)
- Tissue response: Chemical signals (e.g., histamine, bradykinin) trigger vascular changes and edema. Chemotaxis draws immune cells to the area. Clot formation and phagocytosis occur.
- Clinical signs: Swelling, redness, heat, pain, and pain before tissue resistance during movement.
Inflammatory Phase (Management)
- Management considerations: Control stress on the injured tissue (protection). Reduce swelling. Control the inflammatory response, but don't interfere with it. Pain is a guide. The PEACE acronym is a helpful guide (Protection, Elevation, Avoid anti-inflammatories, Compression, Education).
Proliferative Phase (Details)
- Tissue response: Growth of capillary beds, collagen formation (Type III), and granulation tissue development.
- Clinical signs: Pain is synchronous with tissue resistance during movement; decreasing inflammation.
Proliferative Phase (Management)
- Management considerations: Continue controlled stressing of tissues (increase ROM, intensity, frequency). Increase activity as tolerated. Still fragile tissue. Avoid explosive stressing. Pain is the guide. The LOVE acronym is a helpful guide (Load, Optimism, Vascularization, Exercise).
Remodeling Phase (Details)
- Tissue response: Maturation of scar tissue; contracture healing; remodeling of Type III collagen to Type I collagen; collagen aligns with stress.
- Clinical signs: No inflammation; pain at end-range tissue resistance during movement.
Remodeling Phase (Management)
- Management considerations: Progressive stress to tissues (increase volume, load, and intensity); incorporate explosive movements; progressive return to prior level of function; avoid pain, but discomfort is normal when pushing limits. The LOVE acronym is a guide.
Factors Affecting Healing
- Lifestyle factors (diet, activity levels, smoking/alcohol use, stress)
- Comorbidities (age, obesity, diabetes, immunocompromised conditions)
Application (Overview)
- Apply knowledge of phases and healing times to patient cases.
- Identify the healing phase experienced by a patient.
- Predict when a patient transitions to the next phase.
- Provide appropriate patient education.
- Plan appropriate interventions for patients.
Case Studies (Examples)
- Case Studies are presented showing patient details such as age, injury type, injury duration, pain level, activity limitations, and goals to illustrate application of the knowledge to specific situations.
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Description
Explore the complex process of soft tissue healing, including the phases involved and key objectives for understanding soft tissue lesions. Delve into the grades of sprains and strains, their healing times, and management strategies using the PEACE and LOVE acronyms.
