Healing Timeframes

Question 1

What are the 4 general phases of tissue healing?

Answer 1

1. bleeding (4-6 hrs)
2. inflammation (days - weeks)
3. proliferation / granulation (up to 1 month)
4. remodelling (months to years)

Question 2

What happens in the hemostasis / bleeding phase of tissue healing?

Answer 2

1. vascular spasm
2. platelet plug formation
3. blood coagulation

(lasts 4-6 hours)

Question 3

What happens in the inflammatory phase of tissue healing?

Answer 3

• antibodies, nutrients and WBCs travel to site
• PMNs (polymorphonucleuar leukocytes) migrate to wound to clear debris for 72 hours
• macrophages continue to clear debris and manufacture growth factors days 3-4

(maximum inflammation days 1-3, gradual resolution within weeks)

Question 4

What is happening in the granulation / proliferation phase of tissue healing?

Answer 4

• rebuilding phase
• new tissue and new network of blood vessels created
• days 5-7: fibroblasts have migrated to wound and lay down new collagen
• re-epithelization occurs (thin epithelial layer bridges wound initially, then collagen formation continues to increase bonds)

(up to 1 month)

Question 5

What happens in the remodelling phase of tissue healing?

Answer 5

• injury closed
• dermal tissue matures and strengthens

(months to years)

Question 6

What is the typical healing timeframe for a bone fracture?

Answer 6

6-8 weeks typical healing

• 4 weeks smaller bones ie: phalanges
• up to 12 weeks larger bones ie: femur

Question 7

What is the typical healing timeframe for a Grade 2 ligament sprain?

Answer 7

typically 4-6 weeks, can take up to 12 weeks for more complex sprains

Question 8

What is the typical healing timeframe for a Grade 2 muscle strain

Answer 8

3-6 weeks

Question 9

What is the typical healing timeframe for a partial tendon tear?

Answer 9

6 weeks - 3 months

Question 10

What is the typical healing timeframe for a disc herniation?

Answer 10

Self-limiting 3-6 months

expect SSX reduction 4-6 weeks

Question 11

What is the typical healing timeframe for a radiculopathy or peripheral nerve compression?

Answer 11

SSX reduction 1-3 weeks

Resolution between 3 months and 3 years

Question 12

What are the 3 types of nerve injury?

Answer 12

Grade 1 - neurapraxia (partial demylination), healing 1-3 days

Grade 2 - axonotmesis (damage to axon, Wallerian degeneration), slow regrowth months - years depending on site of injury

Grade 3 - neurotmesis (damage to axon and myelin sheath), surgical repair, full recovery not possible

Question 13

What is the typical healing timeframe for a facet or CV/CT sprain?

Answer 13

2-3 weeks pain free

4-6 weeks recovery

Question 14

What is the typical healing timeframe for an ankle sprain?

Answer 14

4-6 weeks recovery