No matter how careful or physically prepared we are for the demands of sport, exercise and physical activity, injuries do happen. And when they do, it's important that we understand our body's healing process so that we can help optimise our recovery!
Acute or inflammatory phase
This is the first phase of recovery and lasts 48 hours. It is characterised by bleeding, swelling, inflammation, heat, redness of the skin, pain, and loss of function. No healing occurs at this stage as it is mainly the body reacting to the damage which has been inflicted. Histamine is released which helps mediate itching and increases the permeability of capillaries so that white blood cells can remove pathogens in the damaged tissues. Fibrinogen is also released which binds platelets and plasma proteins together which, along with vasoconstriction, prevents further bleeding. The main focus in this stage is to prevent further injury, reduce pain, and minimise inflammation. This is the stage where the RICE (rest, ice, compression, elevation) or PRICE (protect, rest, ice, compression, elevation) protocols can be utilised. Any form of massage or physical therapy would not be suitable during this stage.
Repair, regeneration or proliferation phase
The second stage of recovery begins 48 hours after the initial injury and usually lasts between 14-21 days. No further bleeding or swelling occurs at this stage and healing tissues begin forming. Collagen fibres are created to help support the healing tissue, however, at this stage the collagen is fairly ‘immature’ and too much stress may cause it to break down resulting in more swelling and pain. Some stress is required though in order to aid alignment of new collagen fibres with existing tissues. Otherwise collagen fibres may not be organised optimally and negatively impact the healing process resulting in tissue dysfunction. Consequently, any physical activity or rehab during this stage should be carefully prescribed and performed with caution. New lymphatic vessels are also created during this stage to aid drainage and reduce oedema. New blood vessels are also created to deliver oxygen and nutrients which further promotes healing. Massage and other forms of physical therapy can be key to supercharging recovery during this phase.
Remodeling
The final stage of recovery begins 21 days post initial injury and can extend up to 6-8 weeks for bone and muscular injuries. For ligamentous injuries this phase increases to roughly 12 weeks. Gradual and progressive increases in loading (weight training) promote strengthening of the collagen fibres, but it is important to note that the injured tissues are likely to remain more susceptible to further injury, even when fully healed. It is at this stage that it is imperative to have a well-designed and effective treatment plan in place. One which includes a combination of appropriate stretching, movement drills, rehabilitative exercise and massage.
So next time you're looking at another spell on the sidelines, try taking the above information into account. Act appropriately depending on the stage of recovery your body is observing. I guarantee that following the above tips and giving your body the time and space to recover, you'll be back to full speed quicker and fresher than ever!
And if you need a hand devising a post-injury recovery plan, or supercharging the above process with a massage, then please do get in touch!
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