By: James Breese, SPT

Information on physical therapy and soft tissue healing

Using Physical Therapy To Treat Soft Tissue Injuries

Soft tissue injuries are quite common and can happen to anyone. When the body sustains a soft tissue injury, such as a muscle strain or ligament sprain, normal cellular function is impaired. This results in the body initiating a complex physiological process to repair the injured tissue. The repair response begins immediately following the injury and can be broken down into three phases. The length of these three phases can vary based on type, severity, treatment and location of the injury.

1. Destruction/Inflammatory Phase (The Acute Phase)

The acute phase is when the initial injury, such as a contusion or a sprain, occurs. With a contusion or sprain, the muscle fibers and small blood vessels in the area tear, filling the injured area with blood. The injured soft tissue becomes inflamed as a result of inflammatory cells sending chemical messages to initiate the healing process. As a result of this, the local tissue site can have increased redness, pain, warmth and swelling. The pain and swelling can limit the function of the soft tissue as a protective mechanism to prevent further damage. This phase is brief, only lasting between 3-6 days.

The goals of this phase are to decrease pain and swelling. This is done through “P.R.I.C.E.” – Protection, rest, ice, compression and elevation.

  • Protection- The use of protective equipment such as braces, splints, crutches and even tape can be used for a brief period of time to assist with minimizing pain and decreasing any further damage to the tissue.
  • Rest- Resting the injured area prevents further injury and allows the healing process to occur.
  • Ice- Ice is beneficial to decrease pain and inflammation.
  • Compression- compression to the tissue can limit the amount of swelling.
  • Elevation- Elevation of the injured area also limits the amount of swelling.

2. The Repair Phase (The Sub-acute Phase)

In this phase, inflammation begins to diminish and the body works to repair the damaged tissue. Cells called macrophages come to the injured area and begin to clear away the dead tissue and blood. Once complete, satellite cells become myoblasts that work with another cell, called fibroblasts, to produce collagen. Collagen is important in the formation of new tissue, often called scar tissue. This new tissue is weak and unorganized. As the new tissue begins to form, new blood vessels are also being created. This phase begins around day 3 and can last 2-3 weeks. The focus during this phase is to regain range of motion, scar tissue mobilization, and gentle exercises.

3. The Remodeling Phase

The remodeling phase can overlap with the repair phase. This phase typically begins during the first week and lasts until the soft tissue is healed at approximately 6 weeks. Again, this is all dependent on the severity of the injury and how the injury is treated. The muscle fibers and connective tissue continue to regenerate and mature to become stronger. The new muscle fibers and connective tissue form along the lines of stress in order to accommodate the load placed on them during functioning.

If you have sustained a soft tissue injury, physical therapy can help. Physical therapy takes into account the phase of soft tissue healing in order to help:

  • Accelerate the healing process
  • Protect the injury
  • Decrease pain
  • Improve scar tissue mobility
  • Regain strength

Soft tissue injuries are extremely common. At Capital Area Physical Therapy, we can create a plan to implement physical therapy to treat soft tissue injuries. Call us today at our Saratoga Clinic at 518-289-5242, or in Queensbury at 518-502-1154.