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The Science of Healing: Understanding How Your Body Recovers From Injury

Updated: Mar 7


Woman with neck pain from a car injury

Tissue repair and healing following an injury is a complex process involving biological, psychological, and social components. This article focuses on the biological aspects of healing following an acute musculoskeletal injury, though it's important to remember that injury and pain involve much more than just cellular mechanisms.


The Four Phases of Healing: Your Body's Recovery Timeline


When injuries occur or surgery is performed, our bodies repair themselves in a systematic, organized way. Wound healing begins immediately after injury and progresses through four overlapping phases that represent a continuum on the healing spectrum.


Healing Phases

Coagulation

Inflammation

Granulation

Maturation

Onset and duration of each phase

Seconds - Minutes

Minutes - Days

Days - 6 Weeks

Weeks - 1 year

Primary role of each phase

Stop bleeding

Clean up cellular debris

Provide structural support

Maximize tissue strength


Phase 1: Coagulation (Minutes)

The coagulation phase starts immediately after injury and typically completes within minutes. During this phase:

  • Blood vessels constrict to reduce blood flow

  • Platelets aggregate around the injury site

  • Blood clots form to stop blood loss


This initial response prevents excessive bleeding and prepares the site for the inflammatory response.


Phase 2: Inflammation (Days 1-3)

The inflammatory phase begins almost immediately after injury and usually lasts 1-3 days. Key processes include:

  • Increased blood vessel permeability

  • Migration of leukocytes and phagocytes to clean debris

  • These cells act as "garbage collectors and incinerators"


While inflammation is crucial for healing, prolonged inflammation can delay recovery and increase pain.





Phase 3: Proliferation (Days 2-42)

The granulation or proliferative phase begins around day two as inflammation subsides. During this critical 6-week period:

  • New connective tissue forms

  • The body lays down a basic architectural framework

  • Tissues remain fragile and vulnerable to excessive loading

  • Proper nutrition becomes essential for collagen synthesis


During these weeks, the body works to decrease wound size and progressively increase structural support to the new tissue.





Phase 4: Maturation & Remodeling (Weeks to 1 Year)

The final phase involves:

  • Tissue maturation to withstand greater loads

  • Collagen fiber remodeling and realignment

  • Formation of functional scar tissue


Be patient during this phase—it can last from several weeks to a full year. Complete tissue maturation requires time, and there are no shortcuts to proper healing.





Factors That Influence Healing Quality and Speed


To achieve ideal healing, several conditions must be met:

  • Clean wound environment

  • Good blood circulation

  • Proper alignment of wound edges

  • Balanced cellular mechanisms


Internal Factors

  • Age

  • Presence of metabolic diseases (e.g., diabetes)

  • Circulatory disorders

  • Injury mechanism (surgery type, severity, chronicity)


External Factors



A Tale of Two Injuries: Why Some People Heal Faster Than Others




Let's examine how these factors influence healing in two different individuals who underwent shoulder surgery.


Bob's Challenging Recovery

  • 56 years old with Type 2 diabetes

  • Poor diet consisting mostly of fast food and frozen meals

  • Drinks several sugar-free sodas daily

  • Poor sleep due to sleep apnea

  • 10-year history of shoulder pain before surgery


Bob's Experience: Bob experienced greater swelling and pain due to his diabetes. The swelling restricted blood flow, limiting oxygen and nutrient delivery to healing tissues. His poor nutrition and hydration further compromised his body's ability to deliver essential nutrients to the injury site. Sleep deprivation exacerbated inflammation, creating a vicious cycle that kept him stuck in the inflammatory phase.


Jim's Smooth Recovery

  • 66 years old with no metabolic conditions

  • Eats fresh fruits, vegetables, and organic meats

  • Properly hydrated

  • Physically active (regular golf player)

  • Gets adequate sleep

  • Recent rotator cuff tear (acute injury)


Jim's Experience: Jim experienced only mild swelling and moderate pain initially. His body efficiently moved through the inflammatory phase, allowing him to begin the proliferative phase around day two. Good circulation enabled efficient delivery of nutrients and removal of cellular debris. As smaller tissues healed, his recovery gained momentum through improved blood flow and nutrient delivery.





Key Takeaways for Optimal Healing

  1. Prioritize overall health before injuries occur. Individuals with poor nutrition, hydration, and metabolic conditions tend to remain in the inflammatory phase longer, delaying healing and increasing pain.

  2. Rest appropriately for chronic inflammatory conditions. "Itis" injuries (tendonitis, bursitis, etc.) often remain inflamed due to constant irritation. Electric dry needling can help eliminate chronic inflammation in just a few sessions.

  3. Respect healing timelines even when feeling good. Premature loading of healing tissues can cause small tears or complete ruptures of surgically repaired structures, especially during weeks 6-8 of recovery.

  4. There are no shortcuts to healing. Optimal recovery requires both time and guidance from skilled clinicians who know how much stress to apply, when to apply it, and when to back off.


If you've had surgery, are preparing for surgery, or have suffered an injury, we're here to help with your rehabilitation needs!

SCHEDULE YOUR APPOINTMENT TODAY BY CLICKING BELOW!





Here's to your health and your recovery!


Dr. David Didlake, DPT

PT, Cert. SMT/DN, CSCS, Cert. TPI Medical Level 3, Dip. Osteopractic, FAAOMPT

Owner, Integrative Therapeutics "Home of the Saint Louis Golf Doc"

Follow me @theintegrativeclinic @thestlgolfdoc


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This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before beginning any new treatment.

 
 
 

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