Phase II: Repair and Regeneration

2. Phase II: Repair and Regeneration • Once necrotic debris have been removed from the injury site a dense formation of capillaries form. • Fibroblasts – connective tissue. • Fibroplasia – wound healing or scar formation.

3. Firbroblasts manufacture collagen. • Main supportive protein in skin, tendon, bone, cartilage, and connective tissue. • Vascular and fragile. • 2 to 4 weeks. • During this time fibers become increasingly stronger. • Fibroblasts disappear marking the end of the phase.

4. Phase III: Remodeling and Maturation • The scar that is formed becomes enlarged and dense. • Strength of scar tissue continues to increase. • Shrink and becomes avascular and acellular. • May take a year or longer.

5. It is the responsibility of the athletic trainer to: • Localize the inflammatory response • Promote the healing process • Ensure that athletes are not imposing undue stress on healing tissue.

6. Another result of the injury cycle is atrophy. Atrophy – wasting away or deterioration of tissue, organ, or part. Immobilization and inactivity.

7. Changes in vascularity and innervation. Area is more susceptible to injury. Should not return to activity until the area has been rehabilitated to an optimum level.

8. The Immediate Care of Athletic Injuries Standard procedures for the immediate care of athletic injuries are based on how the body responds to trauma and the acute inflammatory process.

9. Initial treatment is designed to control: • Swelling • Minimize the magnitude of the hematoma. • Allows the process of healing to begin earlier and proceed at a more rapid rate.

10. R.I.C.E.S. or I.C.E.R.S or P.R.I.C.E Ice Compression Elevation Rest Support or Protection

11. Ice: First step is to apply cold to the injured area. Cold can slow down some of the inflammatory response. Diminishes local blood flow and constricts capillaries in the area of injury.

12. Decreases clotting time because it increases the viscosity of the fluids. • Reduces hemorrhaging in the area. • Lower tissue temperature. • Decreases metabolic demands and slows the chemical actions in cells.

13. Reduces the build up of waste products and allows cells to survive the period of temporary hypoxia. • Reduces the number of muscle spasms. • Decreases pain.

14. Compression: • Help control or reduce the amount of edema and provide mild support. • Elastic wrap or taping. • Also increases the issue pressure outside the blood vessels. • This also controls edema.

15. Make the injured area feel more comfortable. • Pain relief.

16. Elevation: • Limits fluid pooling and encourages venous return. • If possible elevate injured area above the heart. • Also decreases hydrostatic pressure within the blood vessels. • Decreases the amount of edema.

17. Rest: • Allows the body time to get the effects of the trauma under control. • Avoid additional stress and damage to injured tissue. • Time will vary.

18. Support (Protection): • Injury often requires stabilization or immobilization to prevent further injury. • Braces, splints, casts, tape, pads, slings, or crutches.