After an Injury - Stages of Healing

There are 3 main stages of injury healing, regardless of where the trauma occurs. In each, different things are happening at the injury site, and there are different activities that are appropriate for treatment and resuming of ADL. This article will explain each of these 3 stages.

The Acute Stage
Also called the inflammatory stage, the acute stage occurs at the time of the injury, and continues for up to 4 days. During the acute stage, inflammation occurs. The purpose of the inflammation is to neutralize toxins so that the repair process (which occurs in later stages) can begin. Scar tissue begins to form during the inflammatory stage.

During the acute stage, rest and gentle movement, along with physical therapy and anti-inflammatory drugs are generally recommended.

The Sub-Acute Stage
The sub-acute stage of healing takes place between the 4th to the 21st day after the injury occurs. This stage is marked by new growth of connective tissue and capillaries, to help repair damaged structures. Scar tissue continues to grow during this time. Tissues in this stage are very fragile, so placing stress on the injured area is best limited to a therapist's or doctor's skilled hands. During the sub-acute stage, inflammation decreases and pain that is related to damaged tissue may occur. Most physical therapists recommend that the patient begin with gentle movement during this phase, and gradually build up the intensity. Mild isometric exercise might be appropriate. Because activity is restricted during the sub-acute phase, there may be muscle weakness. This can be address with specific, low-intensity exercises.


Bibliography 1. Kisner and Colby Therapeutic Exercise, Foundations and Techniques, 1st ed.
2. Bryand, Michael, MD. Wound Healing Clinical Symposia, Vol. 29 No. 3 1977, CIBA Pharaceutical Company.