Commonly, when we treat patients with injuries, we get asked this question: “How long will this take to heal?” In this article, we first discuss the healing phases that tissues go through after an injury. Next, we reveal ways for you to optimize healing. Finally, discover how long it takes injuries like yours to heal.
Injuries to the Musculoskeletal System Heal Slower
We’re used to watching a wound on our skin heal. Under normal circumstances, it’s all healed up within a week or two. The musculoskeletal system goes through the same phases of healing, however the time frames are much longer.
Phases of Injury Healing
There are four phases of healing that injured tissues go through. Keep in mind, the duration of each phase can vary depending on the severity of the injury and the tissues affected. Notice that each of these phases overlap. In other words, the body is undergoing more than one phase at any given time until around six months after your injury.
- Hemostasis: bleeding begins immediately, generally resolves in 6-8 hours, but highly vascular tissues can bleed 1-2 days
- Inflammatory: begins within hours of injury – lasts several days
- Proliferation: begins within 24-48 hours after injury, reaches peak at 2-3 weeks, continues for several months
- Remodeling: starts several days after injury, can last for 1 year or more
Regeneration vs. Repair
Healing through regeneration refers to substitution of the exact same tissue. A great example is a lizard who gets it’s tail traumatically cut off. Lizards have special stem cells that enable them to grow a whole new tail. By the end of this article, you might wish you were a lizard!
Healing through repair refers to fibrosis or scar tissue formation. In other words, tissues are replaced with different cells than the structure being repaired. Think about patching a small hole in drywall. The substance you’re using to repair the wall isn’t drywall. But it can be molded and sanded to look and function just like the rest of the wall. It’s an adequate repair, for sure. But, we know that patched hole isn’t as solid and stable as the rest of the wall.
As it turns out, most tissues of the musculoskeletal system are able to heal through a combination of regeneration and repair. And some, can only heal via repair. Remember, the more regeneration a tissue undergoes, the more closely it resembles it’s original makeup.
Optimizing Injury Healing: Using Forces
Fortunately, physical therapists have ways to trick the body into making a stronger repair, and even stimulate regeneration. In our world, it all comes down to mechanical forces. Forces like friction, tension, and compression work at the cellular level to prepare the healed tissue to handle the demands we put on our bodies.
Real world examples of these forces include:
- Friction: soft tissue mobilization
- Tension: stretching and strengthening
- Compression: weight-bearing or loading
Over time, repetition of these forces optimizes the flexibility and strength of the repaired area. Consequently, forces are needed to prepare the healed tissue to handle normal loads.
Should You Take NSAIDs After an Injury?
If you look for advice about what to do after an injury, you’re sure to hear someone suggest Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Interestingly, there’s poor evidence for using them after a musculoskeletal injury. In a nutshell, they alter the natural healing response and have long-term negative impacts on healing your injury.
Do You Need Rest After an Injury?
Some injuries require rest or immobilization if they’re considered unstable. You need to visit a licensed healthcare professional to determine that. But in general, your body will heal better and faster the sooner you get moving (remember those forces?).
Certainly, you can resume moving the parts of your body that aren’t injured. What else can you do early on? Focus on things like breathing exercises and managing your swelling. But ultimately, it’s best to get specific guidance about your injury from a physical therapist.
How Long Do Different Tissues Take to Heal?
|Tissue||Method of Healing||Time-Frame|
|Bone||Regeneration/Repair||6-8 weeks – on average for a healthy adult|
Complete remodeling depends on loading and how chronic the injury is
|Muscle||Regeneration/Repair||Tissue damage still detected up to a year on MRI|
|Ligament||Regeneration/Repair||Laxity noted 6-12 months following injury|
Severity dependent – up to 1 year
|Articular Cartilage||Repair||6-12 months|