Chronic Injury

Question 1

How do regeneration & fibrosis affect permanent repair?

Answer 1

The fibrosed area matures & contracts, the epitherlium thickens, resulting in a fully regenerated epithelium with an underlying area of scar tissue

Question 2

When does a permanent scar occur?

Answer 2

When damage is deeper than 33% skin thickness or takes more than 3 weeks to heal

Question 3

What is scar tissue comprised of?

Answer 3

Disorganised collagen matrix produced by myofibroblasts

Question 4

What are the characteristics of a normal scar?

Answer 4

• Confined to edges of original wound
• Gradual fading and atrophy
• No treatment
• Best in elderly

Question 5

What are the characteristics of a hypertrophic scar?

Answer 5

• Confined to edges of original wound
• Regresses after initial peak (often over several years)
• Treatment: Silicone patches or gels
• Worst in the young

Question 6

What are the characteristics of a keloid scar?

Answer 6

• Extends beyond edges of wound
• Progressive
• Treatment: Intralesional steroids
• More common in darker skin
• Failure of apoptosis

Question 7

What are the types of treatment for skin wound healing?

Answer 7

Silica gel patches, compression, hydrotherapy, steroid injections, laser, liquid nitrogen

Question 8

How are muscle tears classified?

Answer 8

Grade 1, 2, 3 tears - grade 3 is complete tear with complete loss of function

Question 9

What is the treatment for muscle tears?

Answer 9

Rest (less than 1 week)

Question 10

What occurs during the late phase of muscle repair?

Answer 10

• Atrophy from injury & disuse
• Reduced length
• Reduced flexibility/elasticity
• Reduced cardio training
• Reduced whole body stability, core strength & agility

Question 11

What are the symptoms of late stages of repair?

Answer 11

• Shortened tissue length
• Tenderness, sensitivity or pain when performing the movement
• Stiff to get moving, sore after exercise
• Weak, poorly controlled, fatigues early

Question 12

How can lung tissue be damaged?

Answer 12

By infections, chronic inflammation & chronic lung diseases

Question 13

What are the characteristics of pulmonary fibrosis (lung scarring)

Answer 13

• Shortness of breath
• Dry cough
• Fatigue, weakness
• Loss of appetite, weight loss

Question 14

What are the treatments for damaged lung tissue?

Answer 14

• Breathing exercises

- Physical training for inspiratory muscles & peripheral muscles

Question 15

What are the rough recovery times for:

• Muscle strain
• Ligament
• Bone
• Chondral cartilage
• Vessel
• Tendon
• Strength
• Control/skill

Answer 15

• Muscle strain: 3 days-6 weeks
• Ligament: 4-8 weeks
• Bone: 6-8 weeks
• Chondral cartilage: 6 weeks-never
• Vessel: Up to 3 weeks
• Tendon: 3-18 months
• Strength: 6-8 weeks
• Control/skill: 2-4 weeks

Question 16

What tendons commonly experience chronic overuse injuries?

Answer 16

• Supraspinatus
• Medial/lateral elbow
• Achilles
• Patella
• ITB
• Gluteus medius

Question 17

What bones commonly experience chronic overuse injuries?

Answer 17

• Stress fractures tibia, feet
• Cartilage/menisci
• Knees
• Hands
• Shoulders
• Wrists

Question 18

What are the interventions for chronic overuse injuries?

Answer 18

• Address the balance
• Unload
• Increase flexibility & resilience
• Address biomechanical issues
• Increase training more slowly
• Rest days
• Cross training

Question 19

What interventions facilitate slow tissue repair & restore function?

Answer 19

• Warm-up
• Graduated return to activity
• Stretching
• Strengthening
• Core stability/cardio

Question 20

Why is a warm-up important?

Answer 20

Increases elasticity, relaxes muscles