I. Tissue injury causes restriction of motion due to:
A. Inflammation and swelling
B. Pain
C. Muscle spasm
II. Major goals of Chiropractic care:
A. Relieve pain
B. Promote full healing
C. Restore and maintain full function
D. Reduce the likelihood of re-injury
E. Prevent accelerated degeneration
III. Stages of tissue healing
A. Stage 1: Active Swelling
1. Swelling occurs for 12 to 72
hours, motion is lost and pain increases.
2. Goals of care: To minimize pain
and swelling by rest and support of injured area and ice to block
swelling, pain and spasm.
3. Home Care: RICE:
Immediately after an injury (or if there is a re-injury) we
recommend our patients use the RICE principle: R = Rest, I = Ice,
C = Compress, E = Elevation. For the first 24 hours post-injury
ice should be applied 20 to 30 minutes every two hours with rest
and continuous compression and elevation of the body part.
Compression is achieved with an elastic wrap applied over the ice
pack or directly to the body part when the ice pack is not in
place.
B. Stage 2: Passive Congestion
1. Fluid trapped in tissues
restricts motion, causes pain and delays healing. It begins by
the second to the forth day.
2. Goals of care for passive
congestion:
Remove fluid; relieve pain; begin to restore motion.
3. Care
a. Chiropractic adjustments
-
restore motion
- block
pain
- restore
normal sensation
· relax tight muscles - remove swelling
- accelerate healing
b. Home Care:
Following the injury, contrasting heat and cold should be applied
to remove excess swelling. After the first 24 hours we recommend
the patient apply alternating cold and heat compresses 3 times a
day for the next 48 hours. Always start with cold and end with
cold. Apply this helps squeeze edema (excess fluids) and debris
from the area while pumping fresh blood and nutrients to the
injuried area.
c.Home Care:
Mild controlled motion exercises, never to the point of pain.
d. Application of
physiological therapeutics (see Physiological Therapeutics
information sheet)
C. Stage 3: Repair
1. Beginning five days after
injury, scar tissue is made for up to six weeks.
2. Lack of motion causes excess scar
tissue in dense patterns disrupting normal function causing:
a. excess scarring
b. chronic stiffness
c. limited range of
motion
d. poor biomechanics
e. chronic pain
f. weak muscles and
ligaments
g. loss of normal
sensation
h. poor nutrition
i. increased risk of
re-injury
j. accelerated
degeneration
3. Goals of Repair stage:
a. Restore normal
motion, sensation, promote full healing and relieve pain.
b. If motion is
restored and maintained, tissues heal in a much more functional
way.
c. Care should continue
throughout. Chiropractic the repair stage. IT TAKES LONGER FOR
TISSUE TO HEAL AND NORMAL FUNCTION TO BE RESTORED THAN IT TAKES
FOR PAIN RELIEF. Pain relief is not the only goal.
Chiropractic care helps:
- Restore normal motion, function and biomechanics.
- Improve alignment of new connective tissue.
- Prevent shortening of scar tissue and chronic stiffness.
- Restore and maintain flexibility of ligaments and
muscles.
- Promote quicker, more effective healing.
- Reduce the risk of re-injury and degeneration.
d. Home Care: Therapeutic exercise rehabilitation program
D. Stage 4: Remodeling
1. Connective tissue remodels for
better strength and flexibility. This often takes 3 to 14 weeks
but may take up to one year with severe injury.
2. Chiropractic helps achieve these
goals:
a. Improve and
maintain motion and flexibility
b. Restore and maintain
function
c. Reduce chronic pain
d. Reduce the risk of
re-injury and degeneration
Dr. Mark Slosberg
Dr. Kenneth Knight
Dr. Max Atnip