Tissue Response to Injury & RICE

Inflammatoy phase

Clot formation

Defense mechanism that isolates the damaged area(s) and allows

for tissue repair and restoration.

•Occurs on a continuum.

• Both internal and external injury

Phase 1

redness

caused by Blood vessel dilation

swelling

caused by Bleeding from torn vessels

• Increased blood vessel permeability

• Allows plasma proteins to leak out of vessels

• Increases osmotic pressure to fluid accumulation

pain

caused by Nerve irritation from injury

• Pressure on nerve endings from swelling

• Pain initiates negative feedback loop

• If it hurts, don’t do it

warmth

caused by Blood vessel dilation- movement of nutrients and waste

• Increase in metabolism

loss of function

Restriction from swelling

• Often, this is what forces patient to

seek care

• Pain does not….

Reflex muscle guarding- Pain/Spasm Cycle

• PT and OT can help break

this cycle

Fibroplastic repair phase

Temporary Scaffolding of granulation tissue

• Stronger collagen to reinforce. Random

collagen fiber alignment

Fibroplasia

Formation of delicate connective tissue (granulation

tissue)

• Think of it as a

temporary scaffold

scar formation

Gradual replacement of weak fibrin plug with stronger

collagen

– Formation of disorganized scar tissue (adhesions) when

not stressed properly

Maturation & Remodeling

Long-term process

• Realignment of collagen along stress lines

• Continued breakdown and synthesis of collagen =

increased strength

• Tissue will gradually assume normal appearance

• Lasts approximately 3 weeks = strong scar

• May require several years to complete