CCMH PROFESSIONAL PRACTICE 2; LECTURE 1
and 2 QUIZZES & ANS!!
Inflammatory Process
Consists of several stages
• Is necessary for healing injured tissue
• Causes of damage can be internal or external:
trauma (dislocation, fracture, sprain/strain),
infection, surgery, immune responses,
extremes of heat and cold, ischemic damage,
chemical or radiation damage
Types of Healing
Primary/First Intension
Secondary/Second Intension
First intention healing
Wound edges are closely approximated (with the use of tape, sutures or staples)
-Quick seal across the wound within 24 hours
-Little granulation tissue begins at 3 days, fibroblasts make collagen in approx. 7 days
closing the edges firmly, and there is a small scar that remains
-Infection can lead to cellulitis
-
Late complications of first intention healing
Cicatrisation (excessive fibrous tissue leading to tissue distortion), keloid scar
(excessive scar tissue formation), cysts
Secondary/Second Intention Healing
-Extensive tissue loss
-Wound is larger
-Wound edges cannot be brought together easily
-Healing takes longer, depends on the type of wound, the amount of damage
-More granulation tissue occurs leading to a larger scar
-Infections/Complications same as 1st Intentio
Grade 1 (First Degree) tissue injury
Mild pain at the time of the injury or within the first 24 hours
•Mild swelling
•Local tenderness
•Pain mainly with over-stressing the tissue
Grade 2 (Second Degree) tissue injury
Moderate pain that requires stoppage of movement
•Painful when palpated or stressed
•Some fibres are torn causing increased joint
Grade 3 (Third Degree) tissue injury
75% or more fibres torn
•Severe pain with a partial or near-complete or complete tear
•Possibly no pain in stressed tissue if there is a complete tear
•Instability of the affected joint is obvious to both
, Acute - Inflammatory Reaction
At the moment of the injury
•Lasts from 3 to 4 days post-injury
•Healing begins
•Symptoms: Redness (Rubor), Swelling (Tumor), Heat (Calor), Pain (Dolor), Loss of
function (Functio Laesae (injured))
•Can have muscle spasm and guarding
•Bruising: black, blue, red or purple
rubur=
redness
tumor=
swelling
calor=
heat
dolor=
pain
functio laesae=
loss of funciton
Massage during Acute
Appropriate testing performed, X-rays
•
What are the treatment goals during the acute injury phase
limit the inflammatory process, reduce pain, swelling, protective spasms, sympathetic
nervous system firing, prevent re-injury
•Address compensatory structures
what therapies can be applied during the acute injury phase
Cold hydrotherapy is applied
•R.I.C.E. - rest, ice, compress, elevate
•Techniques during Acute Stage:
-Manual Lymphatic Drainage
-PROM (only when possible) in pain free ranges
-GTO
-Grade 1 Joint Mobilization
-NO circulatory or lymphatic work distal to site of injury (can create painful congestion)
Sub-Acute - Repair and Healing
Within 2 days of injury and up to 3 weeks, sometimes up to 6 weeks
•Signs of inflammation start to diminish
•Gradual restoration of the damaged structure
•Early or Late Sub-acute
Early Sub-Acute
Within 2 days of injury up to 3 weeks
•Pink, warm, slightly swollen, ROM painful and limited with tissue resistance
•Re-epithelialization: if skin is damaged, begins to regenerate.
Massage during Early Sub-Acute
General treatment remains the same as acute
and 2 QUIZZES & ANS!!
Inflammatory Process
Consists of several stages
• Is necessary for healing injured tissue
• Causes of damage can be internal or external:
trauma (dislocation, fracture, sprain/strain),
infection, surgery, immune responses,
extremes of heat and cold, ischemic damage,
chemical or radiation damage
Types of Healing
Primary/First Intension
Secondary/Second Intension
First intention healing
Wound edges are closely approximated (with the use of tape, sutures or staples)
-Quick seal across the wound within 24 hours
-Little granulation tissue begins at 3 days, fibroblasts make collagen in approx. 7 days
closing the edges firmly, and there is a small scar that remains
-Infection can lead to cellulitis
-
Late complications of first intention healing
Cicatrisation (excessive fibrous tissue leading to tissue distortion), keloid scar
(excessive scar tissue formation), cysts
Secondary/Second Intention Healing
-Extensive tissue loss
-Wound is larger
-Wound edges cannot be brought together easily
-Healing takes longer, depends on the type of wound, the amount of damage
-More granulation tissue occurs leading to a larger scar
-Infections/Complications same as 1st Intentio
Grade 1 (First Degree) tissue injury
Mild pain at the time of the injury or within the first 24 hours
•Mild swelling
•Local tenderness
•Pain mainly with over-stressing the tissue
Grade 2 (Second Degree) tissue injury
Moderate pain that requires stoppage of movement
•Painful when palpated or stressed
•Some fibres are torn causing increased joint
Grade 3 (Third Degree) tissue injury
75% or more fibres torn
•Severe pain with a partial or near-complete or complete tear
•Possibly no pain in stressed tissue if there is a complete tear
•Instability of the affected joint is obvious to both
, Acute - Inflammatory Reaction
At the moment of the injury
•Lasts from 3 to 4 days post-injury
•Healing begins
•Symptoms: Redness (Rubor), Swelling (Tumor), Heat (Calor), Pain (Dolor), Loss of
function (Functio Laesae (injured))
•Can have muscle spasm and guarding
•Bruising: black, blue, red or purple
rubur=
redness
tumor=
swelling
calor=
heat
dolor=
pain
functio laesae=
loss of funciton
Massage during Acute
Appropriate testing performed, X-rays
•
What are the treatment goals during the acute injury phase
limit the inflammatory process, reduce pain, swelling, protective spasms, sympathetic
nervous system firing, prevent re-injury
•Address compensatory structures
what therapies can be applied during the acute injury phase
Cold hydrotherapy is applied
•R.I.C.E. - rest, ice, compress, elevate
•Techniques during Acute Stage:
-Manual Lymphatic Drainage
-PROM (only when possible) in pain free ranges
-GTO
-Grade 1 Joint Mobilization
-NO circulatory or lymphatic work distal to site of injury (can create painful congestion)
Sub-Acute - Repair and Healing
Within 2 days of injury and up to 3 weeks, sometimes up to 6 weeks
•Signs of inflammation start to diminish
•Gradual restoration of the damaged structure
•Early or Late Sub-acute
Early Sub-Acute
Within 2 days of injury up to 3 weeks
•Pink, warm, slightly swollen, ROM painful and limited with tissue resistance
•Re-epithelialization: if skin is damaged, begins to regenerate.
Massage during Early Sub-Acute
General treatment remains the same as acute
