Tissue Repair Update

I was fortunate enough to listen to and chat with Professor Tim Watson, the guru on tissue repair, for the latest nuggets of information. Here's what I learnt......

The way in which tissue repairs after injury is the same, irrespective of the tissue or the species. However, the efficiency of the process and the length of time it takes to fully repair is influenced by a number of factors including age which may increase the time by up to 20%! In order to achieve tissue repair it is necessary for the tissue to go through the stages of bleeding, inflammation, proliferation and remodelling. As a physiotherapist I have the knowledge and skills to be able to accelerate this process.

Bleeding typically lasts up to 6 hours during which time the acronym PRICE is critical to cause vasoconstriction and limit blood loss. Ice for maximum of 10 minutes at a time.

After approximately 1 hour the inflammatory process commences and takes between 10 days (muscle) and 3 weeks (ligaments and tendons) depending on the tissue. In this phase the faster the blood flow the quicker the process completes. This is where exercise, electrotherapy, cryotherapy, manual therapy, soft tissue therapy are gems. Icing now needs to be prolonged at more than 10 minutes to bring about vasodilation. Correct implementation of these techniques actually help to stimulate the repair process. Yes, speed up the natural healing ability of the body.

Once the proliferation part of the process starts the ability of the body to make collagen from fibroblasts is dependent on oxygen. Therefore, stimulating circulation will help to circulate oxygen to the tissues. Physically stimulating the tissue, whether it be through manual therapy or soft tissue therapy, increases cellular activity and angiogenesis therefore accelerating tissue repair improving outcomes.

So, the take home for me was that there is no doubt that physiotherapy can stimulate the repair process. The implementation will vary with skill, knowledge and experience. With 13 years as a physiotherapist I am forever fine tuning treatment modalities to bring about the best outcomes. I am always learning and I am extremely grateful to all of my patients, of all species, for sharing this journey with me.