The document discusses the four phases of tissue healing and repair: bleeding (phase 1), inflammation (phase 2), proliferation (phase 3), and remodeling (phase 4). It focuses on phase 2 (inflammation), describing it as the immune system's response to tissue damage aimed at repairing the tissue. The types of inflammation (acute vs chronic), signs of inflammation, and physiotherapy management for each healing phase are also summarized.

1. Namita Kaushik

2. Tissue healing and repair
 Phase-1 – Bleeding
 Phase -2 – Inflammation
 Phase -3 – Proliferation
 Phase -4 – Remodeling

4. INFLAMMATION
 A set of complex changing responses to tissue injury
primarily caused by toxic chemicals, some
environmental agents, trauma, overuse, or infection.
 The immune system's response to tissue damage.
 The processes involved will occur whether the damage
is due to an exogenous source such as a cut or burn or
to endogenous failures such as a bone fracture.
 The principal aim behind inflammation is to repair the
tissue and bring it back to its original state.

5. Common Causes of Inflammation
 Soft tissue trauma (sprains, strains, and contusions)
 Fractures
 Foreign bodies (sutures)
 Autoimmune diseases (rheumatoid arthritis)
 Microbial agents (bacteria)
 Chemical agents (acid, alkali)
 Thermal agents (burns or frostbite)
 Irradiation (IV or radiation)

6. DOLOR= PAIN CALOR=INCREASED TEMPERATURE TUMOR=
SWELLING RUBOR= REDNESS FUNCTIOLAESA=
LOSS OF FUNCTION

7. TYPES
 ACUTE
INFLAMMATION
Lasts for only a few hours
to a few days.
Acute inflammation may
be seen, for example,
following a surgical
incision.
 CHRONIC
INFLAMMATION
persistence of the
inflammation usually
beyond 10-14 days.
Rheumatoid arthritis is an
example of a chronic
inflammatory condition.

8. Different forms of acute
inflammation
 Serous inflammation
 Catarrhal inflammation
 Fibrinous inflammation
 Haemorrhagic inflammation
 Suppurative inflammation
 Pseudo membranous inflammation
 Gangrenous / necrotising inflammation

9. Different forms of chronic inflammation
 Diffuse interstitial inflammation
 Granulomatous inflammation
Causes of chronic inflammation
 Persistence of infection with micro-organisms
 Autoimmunity
 Prolonged exposure to either exogenous or
endogenous toxins
 Persistence of acute inflammation

10. Phase 1 & 2
Phase 3
Phase 4

11. Physiotherapy management
Aims in phase 1 & 2 :
 To reduce pain
 To limit and reduce inflammatory exudates
 To reduce metabolic demands of tissues
 To protect newly damaged tissue from further injury
 To protect newly forming tissues from disruption
 To promote new tissue growth and fibre alignment
 To maintain general levels of cardiovascular and
musculoskeletal fitness/activity.

12. Phase 1 & 2
PRICE principle
Protection- strapping, slings, walking aids
Rest
Ice- crushed ice, ice/gel packs, cold compressive devices
and ice submersion.
Compression
Elevation

13. Phase 3
Aims:
 To decrease pain
 To decrease swelling
 To decrease local temperature
 To prevent further trauma
 To protect new tissue
 To increase ROM
 To maintain/increase muscle strength/timing and
control

14. Phase 3
 Cryotherapy- if the area has elevated temperature.
 Graded exercises to increase ROM, maintain/improve
muscle functions.
Gentle active pain free controlled movements
Functional activity in pain free range
Isometric exercises for muscles not directly affecting
the injury site
 Electrotherapy- UST, pulsed SWD, LASER

15. Phase 4
Aims:
 To promote collagen growth and fibre/tissue
 To increase ROM
 To increase muscle strength/control/timing
 Preventing soft tissue adaptation in injured and non
injured tissues
 Maximizing function

16. Phase 4
 To prevent tissue contraction and adhesion formation-
End range stretching activities
 Soft tissue mobilization
 Functional activity