Tissue Healing and Therapeutic Exercise

3 phases of tissue healing

• inflammatory

• proliferative

• maturation

Inflammatory phase

• controls blood loss and clean wounded area

• blood loss is stopped by vasoconstriction, after 30 minutes, histamine released by Mast cells causes vasodilation

• the result is fluid pushing into tissue space causing pain, swelling, and discoloration around the wound

• lasts 2 day to 2 weeks

Proliferative phase

• begins once the area is cleaned of damaged tissue, foreign matter and bacteria

• the body has to fill in the space: this process includes granulation, angiogenesis, wound contraction and eptheliazation

• process happens best when wound bed is moist and protected, so “airing the wound out” is not correct

Maturation phase

• new epithelized cells go through remodeling

• water and amino acids are squeezed out of the granulation tissue (scar is turning light or white color from dark pink)

• the new skin is dense with collagen and considered “scar tissue” - not as elastic or nice looking as original skin, at completion. - 80% tensile strength of skin

Passive ROM

• client does not exert an effort to move independently

Active Assistance ROM 

• client can move their own extremity but needs assistance of an outside force to complete the range

• outside force can be a person or mechanical (pulleys)

Active ROM

• client can generate enough muscle force to complete full active ROM