Achilles Tendonitis Tissue Healing Phases
The tissue healing response is comprised of two essential aspects incorporating regeneration and repair. The difference between the two is in the resultant tissue. During regeneration, the replacement of destroyed tissues occurs, whilst during the repair phase the lost tissues are replaced by granulation tissue which in turn becomes scar tissue.
Although there is officially only two phases of the tissue healing process, these can be further broken down to establish four smaller components. These include the bleeding, inflammation, proliferation and remodeling phases, and although these phases do occur in succession, it is possible for them to overlap.
The bleeding phase is a short lived part of the overall tissue healing process and occurs only in soft tissue injuries. There is no specific time frame for when the bleeding phase should cease, but the greater the amount of muscle in the affected area, the greater the length of time this phase will last. It is estimated that the average time between the occurrence of the injury and the end of the bleeding phase averages between 6-8 hours.
The second essential component of the tissue healing repaid process is termed the inflammatory phase. The inflammatory phase occurs in 3 different time frames – hours (rapid onset), days (phase is at its maximum magnitude) and weeks (inflammation is slowly resolved).
The third stage of the tissue healing response is called the proliferation phase and involves mainly the generation of repair tissue including the production of scar tissue. This phase has a very fast onset, but can take several weeks to reach its maximum reactivity.
While the phase may reach its peak 2-3 weeks after the initial injury, this does not indicate that the production of the scar tissue is complete, but more that the majority of production has occurred during this time. The maximum point in this phase occurs rapidly, but the descent of this phase occurs much slower, and can take up to several months.
The final phase of tissue repair isn't usually considered important, but it is an essential part of the tissue healing. The remodeling phase does not occur quickly but does result in ‘an organized and functional scar which is capable of behaving a similar way to the parent tissue (that which it is repairing)’. The remodeling phase is thought to overlap with the proliferation phase, around 1-2 weeks after the initial injury.
The final product of tissue healing response will not be a replacement of what was originally injured, but will be a fully functional ‘scar’ which can be used to enable a full recovery from injury.