The process of tissue repair (after an injury) typically occurs over three distinct phases:
Phase One: Reaction or Acute Inflammatory phase
This 72 hour phase is characterized by swelling and pain. During this phase, use ice to reduce inflammation, and if required, take an over-the-counter anti-inflammatory medication. Avoid using these medications after the first 72 hours since they can have a negative effect on tissue regeneration. Even during this initial stage, it is important to get some motion into the affected area in order to speed the healing process.
Phase Two: Regenerative or Repair phase
During this 48 hour to six-week phase, collagen is formed and laid down to repair the injured area. If the injured person is performing the correct exercises, the majority of the collagen will be laid down in the same direction as the tissue being repaired, making the repaired tissue stronger and more capable of performing its function. If the individual is not exercising, the tissue will be laid down in more random patterns, leading to the development of weaker tissue that is easily re-injured.
Phase Three: Remodeling phase
The remodeling phase can last up to 12 months. During this phase the collagen fibers increase in size, diameter and strength. The amount of remodeling that takes place is dependant upon the forces that are applied to the tissue - in other words - the collagen remodels to withstand the stresses that are placed up on it. Tissue remodeling is dependant on the forces that are applied the tissue. If the injured person is performing appropriate strengthening exercises, the collagen will remodel to withstand the stresses placed upon it. With exercise, this remodeling will lead to a complete recovery of the injured tissue, along with a decreased chance of re- injury. Without appropriate strength training, the possibility of re-injury is very high.
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