Tissue Healing: Give Your Body Some PEACE & LOVE
After an injury, we frequently hear questions in the clinic or gym that start with the phrase, “How long until I can _____?” Although this question is largely an “it depends” response scenario, there are certainly general timelines we can use to guide you in safely returning to your sport or other preferred activities!
There are numerous individualized components contributing to healing timelines for your own body, including but not limited to your overall health status, medical history, age, and the severity of your specific injury or injuries. Although research continues to show that there is variability and fluctuation with tissue healing timelines from person to person, there are general time frames for different structures within every body. The healing process has been categorized into three overall stages. As you will notice below, there is some overlap with these stages given variability in our individualized experiences with injury. Tissue that is highly vascularized (has a great blood supply) typically heals quicker than tissue that is poorly vascularized. Examples of highly vascularized tissues in the body include bone and muscle. Examples of poorly vascularized tissue in the body include ligaments (e.g., ACL) and tendons.
Here are the three stages of healing in the body:
Stage I: Acute/inflammatory (0-6 days)
Pain
Inflammation & swelling is natural with initiation of the healing process
Stage II: Sub-acute/proliferative (0-24 days)
Reduced pain
New and immature tissue is produced, this tissue is weak
Stage III: Remodeling/maturation (3 weeks- 2 years)
New tissue matures and strengthens
“Scar tissue” replaces injured tissue over time
Once upon a time we were told RICE after an injury: Rest, Ice, Compression, Elevation. This way of recovery was later modified to PRICE: Protection, Rest, Ice, Compression, Elevation. Thankfully we now have a relatively new model to follow that advocates for the importance of promoting the body’s own natural healing processes, empowering the individual to trust themselves, and reinforcing the importance of loading tissue to make it healthy and strong again! This model is PEACE & LOVE. In the initial stages after an injury (Stages I and II), it is recommended to consider PEACE: Protection, Elevation, Avoid anti-inflammatories, Compression, Education. Then as our body has had some time to heal naturally (Stages II and III), we can progress to LOVE: Load, Optimism, Vascularization, Exercise!
PEACE & LOVE:
Protection: Avoid aggravating activities to prevent further damage to tissue
Elevation: Keep the injured body part higher than heart whenever possible to promote fluid movement
Avoid anti-inflammatories: Allow the natural healing process in the body to occur
Although NSAID’s (Ibuprofen, Advil) might help with pain relief, early use of them can actually delay the initial healing process. Also avoid use of ice for the first few days for the same reason**
Compression: Helps reduce swelling
Education: Listen to your body; avoid unnecessary passive treatments
Load: Allow pain and subjective feelings in your body guide you to gradually return to normal activity; tissue development responds positively to safe progressions in load
Optimism: Our minds are powerful in aiding or deterring our recovery
Vascularization: Pain-free cardiovascular activity like biking or walking can help improve blood flow for repairing tissues
Exercise: Take an active approach to your recovery by maintaining or restoring your mobility, strength, and sensory systems
We hope you learned something new today about your body’s natural ability to heal itself, and how we should be doing our best to support our bodies through these stages! If you or someone you know has had an injury and would like professional support and guidance in optimizing your recovery, we would be happy to chat further about how Loon State Physical Therapy can be your teammate in getting you back to moving and feeling your best! Call us at (612) 405-8503 or book with us online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.
Andrew Eccles, Doctor of Physical Therapy
Loon State Physical Therapy