11/11/2022
Il riposo dopo un infortunio non è riabilitazione!
⚠️ 𝐑𝐄𝐒𝐓 𝐰𝐡𝐞𝐧 𝐢𝐧𝐣𝐮𝐫𝐞𝐝 𝐢𝐬 𝐧𝐨𝐭 𝐫𝐞𝐡𝐚𝐛𝐢𝐥𝐢𝐭𝐚𝐭𝐢𝐨𝐧 ⚠️
Although it can represent a part of our dog’s recovery process (and is in some cases even indicated in the inflammation phase), rest itself through the longer healing period will not return the tissues back to function sufficiently - especially not in our canine athletes. Rehabilitation stands for accelerating and optimizing the recovery through all stages of healing with a big goal ahead: 𝗮𝗰𝘁𝘂𝗮𝗹 𝗿𝗲𝘁𝘂𝗿𝗻 𝘁𝗼 𝗳𝘂𝗻𝗰𝘁𝗶𝗼𝗻.
To understand this, let’s first take a look at the three main stages of wound healing: 𝗶𝗻𝗳𝗹𝗮𝗺𝗺𝗮𝘁𝗶𝗼𝗻, 𝗿𝗲𝗽𝗮𝗿𝗮𝘁𝗶𝗼𝗻 𝗮𝗻𝗱 𝗿𝗲𝗺𝗼𝗱𝗲𝗹𝗶𝗻𝗴. Each phase is characterized by different mechanisms, and we can help at each stage by the use of appropriate modalities and techniques available.
🔸 𝐈𝐧𝐟𝐥𝐚𝐦𝐦𝐚𝐭𝐢𝐨𝐧 phase starts immediately after injury and lasts about 5 days, it’s main components are hemostasis (the formation of blood clot to prevent bleeding) and immigration of the immune cells to the affected spot. The characteristic signs of inflammation phase are: oedema, redness, local temperature rise, pain and impaired normal function. In this phase tissue has little load bearing capacity, so we are limited to cryotherapy, laser therapy (and other appropriate modalities), and possible medications, to reduce inflammation and aid pain management.
🔸 Next is the 𝐑𝐞𝐩𝐚𝐫𝐚𝐭𝐢𝐨𝐧 phase that lasts from day 5 to 21 after injury. Main characteristics are formation of new blood vessels and connective tissue. In open injuries we can see the epithelialization and wound contraction. There is also collagen deposition occurring. In this stage we normally add PROM (passive range of motion), basic therapeutic exercises, therapeutic ultrasound (which is great to help with proper collagen fiber alignment!), and continue with modalities that accelerate healing and manage pain (for example laser, PeMF, ESWT, etc). If there is still pain and swelling present we also continue using cold packs and medications.
🔸 Last is the 𝐑𝐞𝐦𝐨𝐝𝐞𝐥𝐢𝐧𝐠 phase (after day 21) where the deposited collagen fibers begin to align along the lines of force. Tissue is regaining its original strength, the percentage depends on the individual tissue type. Using modalities that promote proper collagen alignment is essential (for example therapeutic ultrasound), we continue with PROM, and add appropriate active therapeutic exercises that progressively load the tissues and enable them a gradual return back to function over the next period of time.
➡️ All phases of healing should therefore be properly addressed in order to return the damaged tissue back to function - and yes, that’s what we do with the help of rehabilitation! 🙂 And as said in the beginning, each tissue type has its own healing characteristics, but that’s a story for the next time!
