The human body is constructed from a variety of tissue types, each of which heals at a different rate and responds differently to various exercises or activities. It is important to know what type of tissue is compromised when injury occurs, in lodge to appropriately approximate a fourth dimension frame for healing and to set up appropriate expectations for rehabilitation. Listed below are the well-nigh commonly injured tissues that we deal with in physical therapy, along with a typical healing time frame for each. Considerations for rehabilitation for different tissue types are outlined thereafter. Please keep in heed that these are full general guidelines. The body's healing processes can be affected past a multifariousness of factors related to each patient'south individual wellness history and life circumstances. Physical therapists will help each patient to make more personalized estimates for their own specific timeline for healing and rehabilitation, and will design each patient'southward therapy treatment program to optimize this process.

Typical Tissue Healing Time Frames

Tissue types: Range of fourth dimension for healing:
Musculus 2-iv weeks
Tendon 4-six weeks
Bone 6-eight weeks
Ligaments 10-12 weeks
Cartilage ~12 weeks
Nerve 3-4 mm/twenty-four hour period

Muscle Healing Considerations:

  • Muscle has a rich blood supply, which is why it is the fastest healing tissue listed to a higher place. The circulatory system provides all tissues with nutrients and oxygen – both of which enable the tissue to heal. Because muscle gets lots of blood menstruation, it has a good environment for healing.
  • Contracting and/or stretching muscles via a variety of specific targeted exercises stimulates blood to menstruation through the muscle tissue, encouraging wellness and healing.
  • Injures tin can occur when musculus imbalances, are present. In these instances, some muscles are stiff and tend to attain a asymmetric amount of work, at the same fourth dimension as other muscles are weak and/or operate with poor motor command or efficiency. Oft the strongest muscles are the 'moving' muscles, while the weak muscles are our stabilizing postural muscles. Postural muscles should be firing constantly to maintain appropriate posture and body position. If they finish firing correctly, the 'moving muscles' try to practice their job. This will eventually lead to pain and injury – sometimes because the 'moving muscles' are overworked and begin to fail, and other times because the postural muscles' failure to work creates a dysfunctional mechanical situation that stresses the skeletal structure. Correcting muscular imbalances via activities that promote proper movement and muscle recruitment patterns can allow muscle healing to occur.

Tendon Healing Considerations

  • Tendons attach muscles to bones. Tendons generally accept a more limited claret supply than muscles. This makes them somewhat slower healing structures in comparison to musculus.
  • Blood supply to injured tendons can be stimulated by activities that cause tension on the tendon tissue. This could mean either tension that occurs when a musculus is contracted, or when it is stretched.
  • Tendons tend to reply well to a particular type of tension. Eccentric activity, which means that a tendon is stressed while it is being diffuse, is especially helpful for tendon remodeling later on injury.
  • Ane example of an eccentric do is performing a standing heel enhance (pressing up onto your toes) and so slowly lowering your heels back to the ground. The deliberate, tiresome lowering towards the footing is eccentric exercise for the Achilles tendon
  • Excessive tension on tendons while they are healing can cause increased pain, slowed healing, or sometimes even further injury. Physical therapists design tendon treatment programs with activities that provide gradual increases in tendon stress, so that the body tin progressively adjust to high-intensity tendon activities such as those required in sports or heavy work.

Bone Healing Considerations

  • Bones heal best when loads are applied to them. Weight bearing activities through injured bones stimulates an increase in bone growth at injury sites and a subsequent increase in bone strength. This concept is why immobilizer boots are often used in talocrural joint and pes fractures rather than plaster casts. Allowing patients to walk while protecting their healing os allows the bony repair procedure to occur faster and more thoroughly than keeping weight entirely off of a fracture site.
  • Afterward a fracture, even if a patient is immune to bear weight, the injured bone should exist immobilized and then that the healing process tin occur. Allowing besides much movement at a fracture site too early on in the healing process can atomic number 82 to delays in fracture repair.
  • Initial rehabilitation subsequently a os fracture often focuses on normalizing body motility in regions around the fracture site. Promoting general circulation through aerobic activity and strength training in other body parts tin assist with the bone healing process. As a fracture knits and becomes sufficiently stable, rehabilitation activity is focused more on the trunk part that has been fractured.

Ligament Healing Considerations

  • Ligaments adhere bones to other basic. They by and large have a more limited blood supply than either musculus or tendon – lengthening their healing fourth dimension.
  • Ankle sprains and ligamentous tears in the knee (such every bit an Inductive Cruciate Ligament injury) are 2 common ligament injuries.
  • At that place are 3 grades of ligament sprain. Grades are based on the amount of disruption involved to the ligament in an injury, and are defined as follows:
Grade 1 Grade 2 Grade 3
· Balmy sprain

· No swelling, and small hemorrhage (bruising)

 · Moderate sprain

· Small tear

· Meaning amount of swelling

 · Complete tear

· Low stability (unstable)

· Requires surgery to repair
  • For whatever blazon of ligament injury, protecting the injury site is important while the tissue is healing. At the aforementioned fourth dimension, motion at the injured joint is desired, to promote circulation so that healing occurs. In lodge to permit motion while protecting ligament, some sort of bracing is oftentimes utilized. Concrete therapists likewise design ligament handling programs so that the movements made during therapy activities protect the healing tissue.
  • The rehabilitation process after a ligament sprain may exist accelerated or slowed depending on the grade of the ligament injury. Handling program design after ligament injury is individualized and also modified depending on each patient's response to every phase of post-injury intendance.

Cartilage Healing Considerations

  • Cartilage is avascular, meaning that it has no blood supply. The lack of blood circulation in cartilage means that it is a very slow-healing type of tissue. Nutrition to cartilage is maintained past fluid in the joints, which lubricates the tissue. The lubrication process occurs by a sort of flushing mechanism, when load is applied and then removed from the tissue repeatedly. Activities such as stationary cycling and walking that involve repeated shine joint motility can promote this lubrication process without creating too much stress on injured cartilage tissue.
  • Cartilage is also aneural – pregnant that it has no nerve supply. Because of the lack of nerve endings, hurting is mostly not felt when cartilage is damaged until it has been worn down significantly. Pain is felt when faulty motion at the injury site has started to impact another tissue in the area, such every bit underlying os or associated ligamentous tissue.
  • Inactivity has negative effects on joint cartilage. Lack of motility or of weight bearing tin can cause thinning of cartilage, making it susceptible to injury. Therefore – fifty-fifty adequately immediately after injury – exercises that encourage joints to move throughout their range of motion and that involve some degree of load bearing through the joint surfaces assist cartilage to heal. Increased stresses to healing cartilage tissue then need to proceed in a very gradual pattern to protect the slowly healing tissue.

Nerve Healing Considerations

  • Fretfulness conduct signals from your encephalon to your muscles, assuasive movement. Fretfulness also bear letters towards the brain, relaying information from muscles, peel, and joints most temperature, pressure level, hurting, body position, and body motility. Some fretfulness are quite long – extending for instance from the base of the spinal string all the manner down to your toes.
  • There are multiple areas in the torso where nerves tin become entrapped or pinched when an injury occurs. Over-stretching a nervus can also cause it to be injured. An injured nerve can cause pain too as other symptoms such equally numbness, tingling, or musculus weakness. Sometimes nerve tissue is injured merely in a modest region. Other times, the effects of an injury tin cause problems forth the unabridged length of the nerve.
  • After a nervus is injured, it is of import to improve the mobility of the nerve and of the other soft tissues around the nervus, to save pain and also restore a nervus's normal power to glide in relation to the tissues surrounding it. Normalizing nervus mobility can also improve the conduction of letters sent both towards and away from the brain.
  • Too much stress on a healing nerve can cause increased pain and nerve reactivity. Rehabilitation activities targeted towards nerve tissue need to exist prescribed carefully – often in short intervals initially.
  • Nerve healing gain at a very tedious rate, and can exist interrupted by repeated overstress. Stimulating nerve repair is a process that requires patience and persistence. However, information technology is possible to design treatment and practise programs that allow patients to participate progressively in normal activities while besides continuing to promote the health of the healing nerve tissue.

Information technology is worthwhile to note that typically, more than one blazon of body tissue is involved when the body is affected past injury and/or illness. The most effective physical therapy treatment and rehabilitation progression will include activities designed to impact each type of involved tissue. The design of an appropriate handling program needs to take into account the relative priorities of a body that is healing, and needs to be continuously modified as the healing process occurs so that each tissue that is healing is provided with its optimal healing stimulus at whatever given fourth dimension. The same activities that are appropriate initially later on an injury are seldom the most appropriate activities to go on with equally the healing process evolves.

It is not uncommon for physical therapists to hear that their patients were sent dwelling subsequently initial medical consult post-injury with a written sheet of activities that they were told to work on at home. This was probably (hopefully) a expert starting bespeak. However, it was also a very generic, one-size-fits-most place to begin rehabilitation. Regardless of how simple or circuitous recovery is anticipated to be in any given situation, a physical therapist working as a team with each patient will be able to provide additional effective intendance during the entire grade of a rehabilitation procedure. Sometimes this might involve but several visits over the course of time. Other times more intensive or frequent care might be indicated. The therapists at Symmetry recommend consulting with your concrete therapist any time that mobility and daily function are negatively impacted by pain or injury. Getting started on an appropriate program of rehabilitation tin considerably speed the process of recovery and minimize activity limitations – allowing maintenance of optimal musculoskeletal health.