The Remodelling Process

​The remodelling process + The importance of Scar tissue

Sports Injuries

​Today

​Learning outcomes

To recap the physiological responses to injury

To explore the remodelling phase of injuries

To look at ​the importance of scar tissue

Week 6​

​create a mind map on a3 paper as you go to help with understanding

I will be adding random words to the slides that have NO relevance to the topic... See how many you can pick up on and remember. The more attention you pay to the slides, the better you will do at this!​

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​Quiz at the end

​Just for fun

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Open Ended

Name 2 causes of inflammation?

Multiple Choice

Which of the following is NOT a sign/symptom of inflammation?

• Redness

• Accumulation of Fluid

• Tender to Touch

• Increased ROM

Match

Match the following - The Healing Process Stages

• Stage 1

• Stage 2

• Stage 3

Initial Inflammation

Rebuild and Repair

The Remodelling Phase

• Initial Inflammation

• Rebuild and Repair

• The Remodelling Phase

Multiple Choice

An Intermuscular Haematoma is when?

• Bleeding occurs within the compartment of the muscle, and seeps into the surrounding compartments

• Bleeding occurs within the compartment of the muscle, but does not seep into the surrounding compartments

• Blood escapes to the surrounding tissue (for example, different muscle compartments)

• No Bleeding occurs

​What are the main purposes of injury healing?

Pineapple​

​soft tissue healing from injury

• Repairing damaged tissue

• Replaced by granulation tissue, which matures to form scar type tissue

• Phases overlap

• Bleeding / inflammatory / proliferation / remodelling phases

Chair​

​Inflammatory phase

•Essential component of tissue repair

•Rapid onset - first few hours

•Quickly increases to maximum 2 – 3 days

•Gradually resolves over next few weeks

•Largely beneficial

•Is accompanied by debris removal and repair of damaged tissue

•Over response can cause problems​

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Towel​

Multiple Choice

When does the inflammation stage occur?

• Few weeks

• 2 -3 days

• Rapid onset - first few hours

• A year later

​Proliferation phase

• Generation of the repair material

• Production of scar tissue (collagen material), needs to be laid down in an orientated way

• Rapid onset 24 – 48 hours

• Peaks 2 – 3 weeks / bulk scar tissue

• Final products several months

• Repair tissue is different. Fibres shorter, inelastic and different elasticity, increases risk of recurrence of rupture

Rabbit​

Multiple Choice

When does the proliferation phase peak?

• 2-3 days

• 2-3 weeks

• 2-3 months

• 2-3 years

​Remodelling phase

• Greatly overlooked phase

• Results in organised / functional scar tissue

• Starts as early as 2 weeks

• Continues for months to a year

• With maturity, the collagen becomes more orientated in line with local stress

Jigsaw

Multiple Choice

How long does the remodelling phase last?

• up to 2 weeks

• up to months

• up to years

• 2-3 days

​TV

​There are 3 main stages to the healing process

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​Need to be able to replicate for assignment!

Match

Match the following

• Inflammatory stage

• Remodelling stage

• Repair stage

Immediate

After six weeks

Few hours after up to six weeks after

• Immediate

• After six weeks

• Few hours after up to six weeks after

Open Ended

Why do you think scar tissue is important?

​The importance of scar tissue in the remodelling process

The remodeling process (the development of scar tissue) restores the tissue at the site of an injury as close as possible to its original state.

Money​

​Proliferation/remodelling phase

​important in successful healing!

Collagen fibres need to be orientated to provide tensile strength in the right direction

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Using normal stresses via movement, collagen can be laid down this way

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If not, collagen fibres are laid in haphazard and thus weakened pattern is caused

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With maturity, the collagen becomes even more orientated in line with stress

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Watch​

Draw

Draw how collagen usually looks within the body

Multiple Choice

Which phase of the healing process includes debris removal and repair of damaged tissue

• Inflammatory phase

• Proliferation phase

• Remodelling phase

Multiple Choice

How long does it take for the proliferation phase to begin?

• 1-2 hours

• 1-2 days

• 1-2 weeks

• 1-2 months

Multiple Choice

What stage results in organised / functional scar tissue

• Inflammatory

• Proliferation/Repair

• Remodelling

Multiple Select

What are some signs and symptoms of the REPAIR (proliferation) phase?

• Pain/tenderness

• Increased ROM

• Decreased ROM

• Bleeding

Open Ended

List as many of the different random words that you saw!

​​pineapple

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​chair

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​towel

​​rabbit

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​flower

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​jigsaw

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​Money

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​TV

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​Watch

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