proliferation, remodelling and management Flashcards
when does proliferation occur?
- 1 to 10 days
what is attracted to injured area and when ?
- fibroblasts attracted to area 24 hours post exercise
what do fibroblasts do?
- fibroblasts degrade fibrin and replaces it with extracellular matrix
what two processes does extracellular matrix signal?
- angiogenesis
- granulation
what does proliferation produce?
- collagen
- glycoproteins
- hyaluronic acid
what are the nine influencing factors on proliferation?
- severity of trauma
- early management
- tissue vascularity
- age
- nutrition
- medication
- temperature
- biochemical factors
- appropriate loading
what capacity does muscles have? - describe
- regenerative capacity
- MuSC - myoblast- myocyte - myotube - myofiber
when does remodelling process occur?
- 10 days + post injury
what does remodelling involve?
- ongoing fibroblast activity and collagen production
when does remodelling peak?
- peaks at 2-3 weeks following injury
what does remodelling absorb and deposit?
- absorption of older fibrous tissue
- deposition of new fibrous tissue
what contracts in the remodelling phase?
- scar tissue contraction
what are type III collagen fibres replaced with?
- replaced with type I collagen fibres
how do physios manage healing tissues?
- make sure there are no contrary influences
- all possible favourable conditions are encouraged
do all injuries recover in the same amount of time?
- different injuries take different periods of time to recover
- muscles recover quicker than ligaments and tendons due to higher blood supply and content of cells that repair
what are the two management processes used in the inflammatory phase?
- PEACE
- LOVE
what does PEACE stand for?
Protection
Elevation
Avoid anti- inflammatory
Compression
Education
how do you protect?
- avoid activities and movements that increase pain during first few days
describe elevation
- elevate injured limb higher than heart as often as possible
why should you avoid anti- inflammatory medicine?
- as they reduce tissue healing
- no icing
what do you use for compression?
- use elastic bandage or taping
- reduces swelling
what is the importance of education ?
- avoid unnecessary passive treatments as body knows best
what does LOVE stand for?
Load
Optimism
Vascularisation
Exercise
describe load
- let pain guide your gradual return
what does optimism mean?
- condition your brain for optimal recovery by being confident and positive
what is vascularisation?
- choose pain- free cardiovascular activities
^ blood to repairing tissues
what does exercise restore?
- restores mobility, strength and proprioception by adapting an active approach
what does large amount of inflammatory exudate contain? what does this do?
- contains lots of fibrins
- coats structures and becomes organised into scar tissue in unwanted places
what does large amounts of inflammatory exudate in joints cause?
- thickened, contracted joint capsule or adhesion formation
what is not used in the inflammatory process?
- ice
what should you keep an eye on in inflammation stage?
- check joints, swelling, amount of pain and functional loss
- ensures inflammation hasn’t got worse
what treatment do you use in the proliferation phase?
- protection and optimal loading
what treatment do you use in the remodelling phase?
- optimal load
what does chronic inflammation cause? what could occur?
- causes continuous pain, swelling and lack of function
- could occur with no preceding acute inflammation
what does chronic inflammation involve?
- adhesions and fibrosis
- pathological remodelling
what is gradually causes chronic inflammation?
- gradual avascularisation of fibrous tissue
- becomes scar tissue
- shrinkages as ages
- leads to contractures
