The healing process plays a very important role during your time in physical therapy and often determines the trajectory of your care.  In order to ensure the best healing, we coincide our treatment with these phases to make your tissue stronger and healthier.  Here’s a brief overview of the phases of healing:


ACUTE PHASE:  This is immediately after your muscle injury and occurs in the first week.  Our job during the acute phase is to PROTECT.  We want to make sure the tissue has plenty of time to respond to the initial pain, bleeding, and swelling that is associated with inflammation, which starts a chain of cell reactions.  Typically, this is when we put the RICE method into action – rest, ice, compress, and elevate.  In physical therapy we use modalities like ice or electrical stimulation to speed up the inflammatory process and promote faster healing.


SUBACUTE PHASE:  Once the inflammation begins to subside, the subacute phase begins and can last up to 6 weeks.  Often associated with being the REPAIR phase, the subacute phase lays down new soft tissue and marks the beginning of scar tissue.  To prevent atrophy and promote mobility, in physical therapy we start range of motion exercises and pain free concentric movement.  We want to start moving the joints and muscles as soon as possible so the tissue is laid down at the most optimal functional level.  There is a lot of research to support early mobilization of an injured tissue.

REMODELING PHASE:  Even after the subacute phase, healing continues with the remodeling phase up to 3 months.  During the remodeling phase, the body is constantly being stimulated to increasing physical demand – this causes MATURATION of the soft tissue.  Because the original tissue that you injured was compromised, the new, young tissue that was laid down must be strengthened and stretched so it can meet the demands of your normal function.  In physical therapy we start challenging you to promote proper alignment of the new tissue with eccentric and heavier concentric strengthening as well as increased flexibility and stretching.

FUNCTIONAL PHASE: Just as it sounds, we use this phase to return to NORMAL ACTIVITY – whether this means walking to work, or playing sports, we individualize your treatment plan to appropriately target function that is important to you.  This phase can last up to 6 months and beyond, depending on the extent of your injury and the goals you want to return to.  In physical therapy, we aim to increase speed, endurance, agility, and strength as well as correct any faulty compensatory mechanics or muscle imbalances you may have developed along the way.  This is a very important phase of healing to prevent re-injury and should not be overlooked!


As you can see, healing can take a very long time – but how amazing is it that our bodies can regenerate at such an intricate level?!  To learn more about the healing phases on a more cellular level, click here.


At Wallace & Nilan PT, we work with you to maximize your healing and promote stronger, better, healthier tissue so you can get back to what moves you, pain free!