The Process of Healing
The body is a marvellous machine, able to repair and heal itself. This process of healing happens in stages, and understanding these phases can help ease the frustration and fear of dealing with an injury. There are three main steps of tissue healing: Inflammation, Repair, and Remodeling.
Inflammation: The body immediately begins healing a traumatic injury with inflammation. The injured tissues release chemical signals that dilate blood vessels to bring extra blood flow, white blood cells, and nutrients to help clean up and wall off the injured area. This also serves to limit the function of the injured area, to prevent additional tissue damage. The swelling and pain, as uncomfortable as they are, are a protective process. Bodywork can support this phase by working on associated structures while avoiding the injured tissues. It also will help shift the nervous system out of fight or flight mode into relaxation and repair mode through stimulation of the parasympathetic nervous system, which allows more of the body’s resources to focus on the healing process.
Repair: Once the injured area is walled off and cleaned up, inflammation subsides and construction begins to replace or repair the injured tissue. Temporary blood vessels grow in order to supply the nutrients needed for healing, and special cells called fibroblasts begin producing a fragile form of scar tissue called granulation tissue to fill in the gaps left after the damaged structures were cleaned out by the body. This is when it is easiest to reinjure the tissues, as pain levels have gone down but the repairs are not yet strong enough for full use. Bodywork can begin to gently address the injured areas, being careful of the fragile granulation tissue, and can continue to work on associated structures to maintain function, minimize compensation, and increase circulation.
Remodeling: Once enough granulation tissue is produced, the construction of permanent tissue can begin, usually as strong scar tissue made from a dense network of collagen fibers. At first, the collagen fibers are arranged in all directions, and they adjust according to how the body moves as it heals. Some fibers are reinforced to provide more strength, as others are destroyed to provide more flexibility. This process is best done with a gradual return to functional activities, followed by time for the tissue to adapt. At this point, bodywork treatment can work much more directly on the affected area, focusing on breaking up scar tissue and increasing range of motion, even as it continues to address compensating movement patterns.
There is no specific time frame for each phase of healing, so it is important to be aware of the signs and symptoms of each part of the process in order to treat them effectively. Remodeling in particular can take months or even years, and supporting the body as it finds its best function as it heals can do a lot to help reduce chronic dysfunction and discomfort. Bodywork and self-care are effective ways to support this process, helping us stay in conversation with our bodies and respond to their needs.