L4a, Tissue Injury, Healing and Adaptation

Question 1

What are the 4 stages of wound healing and how long do they take?

Answer 1

1. Bleeding (6-8 hours)
2. Inflammatory (0-6 days)
3. Proliferative (3 days- 6 weeks)
4. Remodeling (6 weeks- 1+ years)

Question 2

What are the 5 stages of inflammatory response?

Answer 2

1. Increased blood flow
2. Migration of white blood cells
3. Release of chemicals
4. Formation of blood clots
5. Pain

Question 3

What are 3 benefits of swelling during inflammatory responses?

Answer 3

1. Helps dilute harmful substances
2. Brings necessary nutrients for increased metabolism required during healing
3. Allows entry of clotting proteins

Question 4

How to treat the inflammatory phase: What is phase 1, how long does it take, and what is the goal?

Answer 4

• Acute phase
• 1-7 days
• Minimize inflammation and pain.

Question 5

How to treat the proliferation phase: What is phase 2, how long does it take, and what is the goal?

Answer 5

• Subacute phase
• 3 days- 3 weeks
• Prevent muscle atrophy, restore ROM, develop neuromuscular control

Question 6

How to treat the proliferation phase: What is phase 3, how long does it take, and what is the goal?

Answer 6

• Strength accumulation
• 3+ weeks
• Improve neuromuscular control, strength, and muscle endurance. Cardiovascular endurance, progress to functional activity

Question 7

What occurs during the maturation (remodelling) phase, how long does it take, and what is the goal?

Answer 7

• Decreased fibroblast activity, increased organisation of ECM, type III convert to type I collagen, realignment of collagen fibres
• 6 weeks- 1+ years
• Realignment of scar tissue/promote tissue strengthening

Question 8

What do fibroblasts do?

Answer 8

Maintain the structural integrity of connective tissues

Question 9

What do fibroblasts do?

Answer 9

Maintain the structural integrity of connective tissues

Question 10

What length of time was found necessary to reverse the detrimental effects of a six-week immobilization?

Answer 10

18 weeks

Question 11

Following the remobilization of ligaments, structural properties were nearly normal but mechanical properties of the healed ligaments were almost always inferior when compared to normal tissue, why?

Answer 11

May be due to the tissue accumulating mass to compensate for inferior tissue quality. Some areas of healed MCL were up to 2.5 times larger than the control

Question 12

The recovery process: What is phase 4, how long does it take, and what is the goal?

Answer 12

• Functional phase
• 2 weeks- 6 months
• Return to sport without re-injury at the end of the phase

Question 13

The recovery process: What is phase 5, how long does it take, and what is the goal?

Answer 13

• Return to competition
• 3 weeks- 6 months
• Return to competitive levels by the end of the phase but avoid a re-injury