Let’s break down what happens during each stage and what you might feel along the way.

Stage 1: Acute Stage – Inflammatory Reaction (Days 1–5)

This is the body’s first response to injury — and it happens quickly. You’ll likely notice:

• Swelling

• Redness

• Warmth in the area

• Pain, even at rest

• Trouble moving the area normally

What’s going on inside?

• Blood vessels change to bring healing cells to the area.

• Chemicals are released to start the clean-up process.

• A blood clot forms to protect the area.

• White blood cells come in to clean out damaged tissue.

• Your body begins forming new tissue.

Why it hurts: The injury triggers chemical changes and swelling that irritate nerve endings. Your muscles may tighten around the area to protect it — this is called muscle guarding.

Stage 2: Subacute Stage – Repair and Healing (Day 5–3+ weeks)

In this phase, your body shifts from cleaning up to rebuilding. You may notice:

• Less swelling and pain

• Some stiffness or weakness

• You can move a bit more, but not fully

What’s happening now?

• The body builds new tiny blood vessels to feed the area.

• Soft tissue (like collagen) starts to form.

• New tissue is fragile and can be easily re-injured.

Important to know: Even though you’re feeling better, your tissues are still healing. Be careful not to push too hard too soon. This stage typically lasts 2–3 weeks, but can take longer (up to 6 weeks) for areas with poor blood flow like tendons.

Stage 3: Chronic Stage – Maturation and Remodeling (3+ weeks to 12 months)

This final phase is all about strengthening and reshaping the healing tissue so it can handle everyday life again. You may experience:

• No more inflammation

• Some lingering tightness or weakness

• Pain only when you push your limits

What’s happening?

• Scar tissue becomes stronger and more flexible

• Collagen fibers line up with the direction of movement

• Muscles, joints, and nerves relearn how to work properly

Keep in mind: Healing doesn’t always mean “back to normal” right away. You might need physical therapy or regular movement exercises to regain full strength, endurance, and control.

Quick Summary: Clinical Signs by Stage

Final Thoughts

Healing is a process, not an event. Each stage has a purpose and a timeline — and rushing it can cause setbacks. Whether you’re working with a physical therapist or managing an injury at home, understanding these stages helps you know what your body is doing and how to support it best.

Remember: Pain is information, not always a problem. Listen to your body — and give it the time and care it needs to heal right.

The post Understanding the Stages of Tissue Healing: What Really Happens When You Get Injured first appeared on HA Physical Therapy.

1. Formation and Composition

• Scar Tissue: Scar tissue forms as part of the body’s natural healing response to injury. It is composed primarily of collagen fibers laid down in a disorganized manner. This dense tissue fills in gaps left by injury, surgery, or inflammation, replacing normal skin, muscle, or other tissue.
• Adhesions: Adhesions, on the other hand, are bands of scar-like tissue that form between tissues and organs. They result from the body’s inflammatory response, causing tissues to stick together abnormally. Commonly seen in the abdomen after surgery, adhesions can form within or between muscles, organs, and other structures, often restricting movement.

2. Location and Impact

• Scar Tissue: Typically, scar tissue is localized to the injury site. While it may cause some stiffness and reduced flexibility, it is usually isolated and doesn’t attach separate structures to each other.
• Adhesions: Adhesions commonly bind adjacent structures that would otherwise move freely. For instance, post-surgical adhesions in the abdomen may tether organs together, while those in muscle tissue can restrict range of motion and cause pain, as they limit normal tissue gliding and mobility.

3. Functional Consequences

• Scar Tissue: Over time, the body remodels scar tissue, and with proper physical therapy, the tissue can regain some of its original elasticity. However, excessive scar tissue may still limit movement and flexibility at the injury site.
• Adhesions: Adhesions can lead to significant functional impairment, especially when they involve muscles, tendons, or organs. Restricted movement, pain, and decreased flexibility often require specific manual therapy or even surgical intervention to address.

4. Treatment Approaches

• Scar Tissue: Physical therapy can help with scar tissue remodeling through techniques like myofascial release, deep tissue massage, and stretching. These methods help realign collagen fibers to improve flexibility and strength at the injury site.
• Adhesions: Breaking down adhesions often requires more intensive manual therapy. Techniques like deep tissue mobilization, instrument-assisted soft tissue mobilization, and stretching are used to restore range of motion. In cases where adhesions are severe and restrict internal organ movement, surgical intervention may be necessary.

Conclusion

While both scar tissue and adhesions involve fibrous tissue formation in response to injury, their impact and location in the body can differ significantly. Scar tissue primarily repairs the site of injury, while adhesions involve abnormal connections between tissues, often causing more complex functional impairments. Early and consistent intervention in physical therapy can be crucial to minimizing both scar tissue and adhesions, restoring optimal movement, and reducing long-term complications.

The post Understanding the Difference Between Scar Tissue and Adhesions: Implications for Healing and Mobility first appeared on HA Physical Therapy.