1. Tissue’s Response to Injury
Unit 4 Evaluation and Assessment of Athletic Injuries

2. Introduction
The starting running back has sprained his ankle 2 days before the 1st playoff game.
The coach, parents, and athlete want to know what can be done to make him well more quickly.
Question: What does the athletic trainer need to know to answer their question?

3. Bell Work What are the names of these two muscles?
What view are you in?
How do you work them out?

4. Biceps Brachii Origin Insertion Short Head-coracoid process
Long Head-supraglenoid tubercle of scapula
Insertion
Radial tuberosity

5. Triceps Brachii Long Head Lateral Head Medial Head
Origin
Long Head
Infraglenoid tubercle of scapula
Lateral Head
Posterior humerus
Medial Head
Insertion
Olecranon process of ulna

6. Objective By the end of the lesson: Define the 3 Phases of Healing
Identify factors that impede healing

7. Three Phases of healing
There are 3 phases that an injury will go through in order to heal.
Inflammatory Response Phase
Fibroblastic Repair Phase
Maturation-Remodeling Phase

8. Time Span Interpret this graph. What does it mean? 3 2
1: Inflammatory Phase
2: Fibroblastic Phase
3: Maturation-Remodeling Phase 1
Injury
6 Wks
Day 4
2-3 Yrs

9. Inflammatory Response Phase
Once tissue is injured, the healing process begins immediately
This phase is characterized by:
Redness
Swelling
Tenderness/Pain
Increased Temperature of tissue
Loss of function

10. Inflammatory Response Phase
Inflammation Process
White blood cells are delivered to the site of injured tissue – begin the clean up!
Vasoconstriction lasts for 5-10 minutes
Chemical mediators then produce dilation – causing swelling
Formation of a clot begins – scab/scar
This phase lasts 2-4 days after initial injury

11. Inflammatory Response Phase
This phase of healing is CRITICAL to the entire process of healing. If this response does not accomplish what it is supposed to do, normal healing cannot take place.

12. Inflammatory Response Phase
On the 6th -7th day collagen fibers are deposited in a random formation which creates a scar
As more fibers are laid down, the stronger the scar is – which begins the maturation phase

13. Fibroblastic Repair Phase
Characteristics:
1. Fibers are created, causing a scab/scar in the tissue
2. Signs and symptoms of inflammation decrease
Inflammatory Process:
1. Increased blood flow during this phase brings nutrients to the injury site – essential for growth
2. This stage can begin 2hrs after injury and last up to 4 wks

14. Fibroblastic Repair Phase
Increased BF is essential to tissue growth

16. Fibroblastic Repair Phase
What would happen if the inflammatory response and fibroblast phases are prolonged?
What do you think would happen to the scar?

17. Maturation-Remodeling Phase
Remodeling of the fibers creates scar tissue – according to the force it was subjected to
What does this mean?
If fibers were laid down properly during Phase 1 and 2, the scar tissue will be strong and return close to normal.
If fibroblast stage was too long or too short, the tissue may not return to normal.

18. Maturation-Remodeling Phase
With increased stress & strain (Rehab); fibers realign in maximum position = parallel to the lines of tension
Tissue assumes normal appearance, but not as strong as normal tissue.
By the end of 3 weeks a firm scar is formed
This phase can last up to 3 years

19. Maturation-Remodeling Phase

20. Question What could make the healing process slow down?
What factors could impede healing?

21. Answer Extent of injury Prolonged swelling Infection
If severe, each phase could be prolonged
Prolonged swelling
Prevented by good first aid management
Infection
Not caring for an open wound can cause a delay in healing
Age, health, nutrition
The older we get, the greater the change in wound healing

22. Closure
A wrestler receives a sudden twist to his right shoulder, causing a grade II muscle tear. What happens in the first hour of this injury?
What is the timeline for an injury? How long is each phase?