Healing’s Three Phases
The path between wound and scar is called healing and has three phases. If you were to look at a magnified view of a soft issue tear, you would see the fibers have been interrupted in much the same way paper fibers look when it is torn. Getting the fibers to repair themselves is a complicated process. When soft tissue is damaged, the first phase in repairing the wound is inflammation, often showing up as swelling. The body acts to immobilize the damaged area so the body can begin to delicately knit the sundered fibers together. Inflammation and swelling may last 72 hours or more.
The second of healing’s three phases is called regeneration. As the swelling subsides, the damaged area is flushed with collagen fibers, a protein, which fill in the wound, bridging the gap between the tissues. The collagen fibers lay down in an irregular felt-like pattern as compared to the more regular pattern of healthy tissue. The regeneration of the tissue lasts 6 to 8 weeks. This bridge of collagen fibers, or scar tissue, being much less organized is weaker, stiffer and more painful than healthy tissue. After 3 weeks, scar tissue has 15% of the tensile strength of healthy tissue; at 6 weeks, 60% and at 6 months, 80% of the tensile strength.
The good news is that scar tissue can mature. This final phase of healing’s three phases is called remodeling and lasts up to 12 months more. The controlling factor in the quality of the healing is motion/direction dependent action. You need to move the wounded area in all the directions you want the least restrictions. (That’s all the directions!) Remedial remodeling is working directly on the scar to help it mature in the healthiest manner possible. Physical therapy and manual therapy both have much to offer. The amount and easy range of motion normally increase with time and dedicated, wise healing activities.