Muscle

Tendon

Ligament

Information for patients after an injury or surgery

Learn what you can do to improve soft tissue healing

Learn about:

• The soft tissue healing process

• Three stages of soft tissue healing

• Your role at each stage

What is soft tissue damage?

Your body is made up of different types of tissues. Muscles, tendons, and ligaments are examples of soft tissue.

Your body’s soft tissue is able to handle a normal amount of pressure during everyday use. The natural movements of your body (such as walking, running, standing) stretch and apply pressure to your soft tissue.

However, soft tissue can be damaged when it is stretched or compressed too much. This can cause injuries that you can see and feel such as a bruise, cut, sprain, or strain.

Soft tissue can be injured by:

• Trauma - one large force all at once (for example, a sprained ankle)

• Overuse - many smaller forces (microtraumas) over a long period of time (for example, tennis elbow)

How does my body heal?

It takes time for your body to heal itself. The amount of time it takes depends on the type of soft tissue, and how much it was injured.

A larger injury takes longer to heal.

Your general health affects how fast your body can heal. Things that can slow the healing process include:

• Smoking

• Diabetes

• Poor circulation

• Infection

• Poor diet

• Some medicines

• Age

3

When soft tissue is injured, your body tries to fix the damage. This is called the healing process.

3 Stages of healing

The healing process has 3 stages:

Stage 1 – Inflammation

Stage 2 - Repair and regeneration

Stage 3 - Maturation and remodeling

Everyone heals differently and these stages of healing overlap. Speak to your healthcare team about things that could slow down your healing process.

Stage 1

The first stage of healing is called inflammation. Inflammation is your body’s first response to damage. Your blood flow to the injured area increases to bring nutrients and special cells to the injured area. These cells get ready for repair by removing damaged tissue.

Signs and symptoms

Inflammation starts right away, and it lasts about 4 to 6 days after the injury. Common signs include swelling, redness, and warmth when touched. Pain is common in the injured area when you rest, when you move it and when you touch it.

4

What you can do:

Your role is to decrease swelling and pain.

• Protect the injured part to prevent it from getting injured again.

• Rest and apply ice wrapped in a cloth to the area for 15 minutes. Talk to your therapist about using ice and heat safely.

• Talk to your therapist about whether you should start gentle movement.

• Wrap a tensor bandage, or anything that gives gentle compression, over the area.

• Raise and support your injured arm or leg as high as possible on a pillow or stool.

• Your doctor may suggest medicine to help with pain and inflammation.

Raise and support your leg on a pillow and apply ice pack to knee

5

Stage 2

The second stage of healing is called repair and regeneration. During repair and regeneration, special cells in your body produce material that is needed to repair the damage. The damage is repaired with scar tissue, but this new tissue is not strong.

Signs and symptoms

• Very little or no swelling

• Very little or no redness

• Pain when you move

• Muscles feel weak

The regeneration and repair stage lasts about 2 to 3 weeks after the inflammation stage.

What you can do:

Doing gentle movement of the injured area helps the new tissue to be flexible. Your therapist will give you special exercises to help the new tissue become stronger.

Gently moving the injured arm

6

Stage 3

The third stage of healing is called maturation and remodeling. During maturation and remodeling, your new scar tissue slowly changes to its final form. The repair becomes stronger. This tissue becomes more like the original tissue, but it will never be exactly the same as normal tissue.

Signs and symptoms

• No inflammation

• Pain when the injured area is stretched

• Injured area feels tight when you move it

• Muscles feel weak

This stage lasts about 6 to 8 weeks after the repair and regeneration stage. Sometimes it can last as long as 1 year, depending on the type of injury.

What you can do

Your role is to return to normal activities by performing stretching and strengthening exercises. These exercises increase the strength of the new tissue. Your therapist will provide you with specific exercises you can do.

Do strengthening exercises

7

Soft tissue at different stages of healing

Soft tissue in inflammation stage

Soft tissue in repair and regeneration stage

Soft tissue in maturation and remodelling stage

Chronic Inflammation

Normal Soft Tissue

8

What is chronic inflammation?

If tissues are injured again before they heal properly, it may slow down the healing process. If this happens over and over again it may lead to what is called chronic inflammation.

Chronic inflammation can be caused by:

• injuring the scar tissue over and over again

• doing activities that cause small amounts of damage over and over again.

If the re-injury is greater than your body’s ability to fix itself, the damaged tissue will not work properly. You must stop reinjuring the tissue for it to heal properly.

You are more likely to develop chronic inflammation if you have:

• Weak or tight muscles

• Poor posture

• Return to activity too soon after injury

• Poor set-up of work station

Signs and Symptoms

• Swelling and pain after activity

• Pain after standing or sitting for a long time

• Stiff joints or tight muscles

Soft tissue in the chronic inflammation stage

9

What can I do to stop chronic inflammation?

Your role is to stop what is causing the repeated damage.

• Do the stretching and strengthening exercises your therapist gives you

• Change the way you do your activities (i.e. use a bundle buggy instead of carrying grocery bags or sit with proper posture)

• Use ice or heat after activity to reduce pain.

X

Changing poor sitting posture

10

Review - the stages of healing

Today _____________________ , you are in Stage ______ of healing.

What you learned about the stages of healing:

• Your body needs time to heal soft tissue that is injured.

• The soft tissue healing process has 3 stages and you have a role to play in recovery at each stage.

Stage of Healing Your role at each stage

Stage 1 Inflammation

Your role is to protect the injured area and begin gentle movement, with your therapists’ advice.

Stage 2 Repair and Regeneration

Your role is to continue with gentle movement and early strengthening, with your therapists’ advice.

Stage 3 Maturation and Remodeling

Your role is to gradually return to normal activities and continue to strengthen the injured area.

• Chronic inflammation can be caused by repeated re-injury of scar tissue. Your role is to stop the activities that are causing the repeated damage and allow the soft tissue to heal properly.

11

For more information

Talk to your physiotherapist, occupational therapist or doctor about your specific injury and stage of healing.

72204 Rev. Jul24 2019 V2

30 Bond Street, Toronto, ON M5B 1W8 Canada416.864.6060 stmichaelshospital.com

St. Michael’s cares about your health.  For reliable health information visit our Patient and Family Learning Centre or find us online at www.stmichaelshospital.com/learn

This information is not intended as a substitute for professional medical care.  Ask your healthcare provider about this information if you have questions.