1. Tissue Healing
Sports Medicine 1/2

2. Inflammatory Response Phase
Begins immediately following injury – critically important
Without the inflammatory phase the other phases will not occur
Phagocytosis occurs to clean the injured area
Phagocytosis is when cells come in and ingest/ digest all bacteria in the injured area
Chemical mediators are released to facilitate healing
Histamines, serotonin and Bradykinin
Symptomatically presents with the following
Redness, swelling, warmth, tenderness and loss of function
If bleeding occurs( slow due to vasoconstriction then increased blood flow due to mediators release vasodilation).
Stage lasts about 72 hours

3. Fibroblastic Repair Phase
Proliferative and regenerative activity occurs resulting in scar formation (fibroplasia)
Occurs within initial hours of injury and continues up to 4-6 weeks
Inflammatory phase and repair phase overlap
S&S of inflammatory phase subside
Athlete will still experience some tenderness and pain with motion
With increasing development of the scar, complaints of pain and tenderness will decrease

4. Maturation-Remodeling Phase
Long-term process
Phase overlaps with the repair phase
May last up to over a year
Re-alignment of scar tissue according to tensile forces acting on tissue
Re-align to position of maximum efficiency (parallel to lines of tension)
Tissue gradually resumes normal appearance and function
After 3 weeks
Firm, strong, contracted, nonvascular scar exists
Adhesions

5. Acute Traumatic Injuries

6. Chronic Overuse Injuries
Importance of Inflammation in Healing
Essential part of healing process
Must occur following tissue damage to initiate healing
Signs and Symptoms
Pain, redness, swelling, loss of function, and warmth
If source of irritation is not removed then inflammatory process becomes chronic

7. Tendinitis Most common overuse problem in sports
Gradual onset, with diffuse tenderness due to repeated microtrauma and degenerative changes
Obvious signs of swelling and pain
May also experience crepitus (due to chemical products of inflammation)
Key for treatment is rest and removal of causal factors
Work to maintain fitness but avoid activities that aggravate condition

8. Tenosynovitis Inflammation of synovial sheath
In acute case - rapid onset, crepitus, and diffuse swelling
Chronic cases result in thickening of tendon with pain and crepitus
Often develops in long flexor tendons of fingers
Treatment is similar to that of tendinitis
NSAID’s may also be of some assistance

9. Bursitis
Bursa
Fluid filled sac that develops in area of friction
Sudden irritation can cause acute bursitis, while overuse and constant external compression can cause chronic bursitis
Results in increased fluid production, causing increases in pressure due to limited space around anatomical structures
Signs and symptoms include swelling, pain, and some loss of function
Three most commonly irritated bursae
Subacromial, olecranon, and prepatellar bursa

10. Osteoarthritis
Wearing away of hyaline cartilage as a result of normal use
Changes in joint mechanics lead joint degeneration (the result of repeated trauma to tissue involved)
May be the result of direct blow, pressure of carrying and lifting heavy loads, or repeated trauma from an activity such as running or cycling
Commonly affects weight-bearing joints but can also impact shoulders and cervical spine

11. Symptoms include pain (as the result of friction), stiffness, prominent upon rising in the morning, localized tenderness, creaking, grating, and often localized to one side of the joint or generalized joint pain