Week 2 (Healing, Inflammation, Pain) Flashcards
Rudolf Virchow
Theorized that cell injury is the basis for all disease. Clinical pathology involves some type of dysfunction or failure at the cellular level.
Metabolism
Cellular activity. Interruptions to cellular metabolism have a cascading effect to surrounding cells and tissues….
Four types of tissue injury
- Neural
- Connective
- Epithelial
- Muscular
Types of tissue damage:
- Mechanical (fracture, bruise)
- Chemical (bleach, poison oak)
- Temperature (burn, frost bite)
Massage therapy is supportive to healing, but does not cure most conditions.
Massage can increase….
-local circulation
-flow of lymphatic fluids
-tissue temperature
-range of motion
-flexibility
-oxygen uptake in tissues
-cell permeability
-pain relief
Massage can decrease…
-nerve compression
-blood pressure
-anxiety + depression
Massage can improve…
-sleep
-digestion
-neuromuscular response
-muscle adhesions
-disc healing
Postoperative considerations
Depending on scope of injury, good to wait 6-8 weeks post surgery.
Many patients are on immunosuppressant drugs, which makes them more susceptible to illness.
Blood clots
Massage may improve scar tissue repair
Inflammation
Tissue response to threat of bodily injury or invasion
How does vasculature respond to injury/inflammation?
- Vasodilation + ^increased capillary permeability (^ blood flow + ^ leukocytes)
- It feels “SHARP”
SHARP
Swelling
Heat
A loss of function
Red
Pain
How de cells respond to injury/inflammation?
- Platelets form clots
- Platelets release chemicals…draw phagocytes to the area
- Clotting begins w fibrin to mesh –> repair
- Fibroblasts create collagen to repair damaged tissue
- Clots dissolve
- Scar tissue is strengthened and realigned
Stages of inflammation
Acute
Subacute
Chronic
Acute
0-48 Hours
Do not massage near site of injury.
Ice
PRICE
PRICE
Protect
Rest
Ice
Compression
Elevate
Subacute
3 days - a few weeks
Do not massage locally
Use gentle PROM
Contrast hot/cold/hot/cold
Chronic
3 months +
Tissues are less red. Colder. Because of reduced blood flow.
Can massage on site
Things that affect healing (locally…)
-Type, size, location of wound
-Vascular supply to area
-Infection
-Movement in the area
-Exposure to UV light
Things that affect healing (systemically…)
-Systemic infections
-Circulatory status
-Metabolic status
-Hormones (cortisol)
-Disease
Arndt’s Law
Minimal stimulation creates maximum results
Wolff’s Law
Every change in function of a bone is followed by changes in its architecture and external conformation (form is shaped by functions we do).
Ex: If you break a bone in your arm–>cast–>the muscle AND the bone atrophy. Bone needs tension to remodel.
Law of Reciprocal Inhibition
When a muscle group is contracted, the opposite muscle group is relaxed:
Ex: bicep contracts, so triceps HAS to relax.
Nocioceptors
-Nerve endings which sense pain
-Not in the brain, but are in the connective tissue that separate the sides of the brain (the falx)
-Produce reflex to pull away
-They dont adapt like other receptors. Prolonged stimulus ^ sensitivity to pain
