Ahmed Bawa Kuyini (Chairman)Bawa has worked as a teacher and social worker in Ghana, Norway and Australia. He is currently engaged as a Senior lecturer in Education and Social Work at the University of New England, Armidale, Australia. A The cells will be involved in the clearance of dead and dying cells and any foreign matter prior to the re-growth of new vascular channels and nerves into the damaged area. PainA results from the presence of noxious inflammatory chemicals and heightened mechanical sensitivity.Just as tissue damage always causes inflammation, so inflammation always causes the tissues to become hypersensitive (Levine and Taiwo 1994).
This stage commonly lasts three toeight weeks depending on the histologic makeup and relative vascularity of the damaged tissue.
He has extensive experience in schools and working with children at risk of leaving school early. Generally speaking, the entire process and scar tissue formation is lengthened ifthe damaged tissue is less vascular (poor blood supply) in its non-traumatized state.A  For example, tendons and ligaments require more time for scar tissue formation than muscle or skin.
GranulationA In the repair phase cellular proliferation begins with rapid increase in collagen (protein) deposition. Although the scar tissue can be easily damaged in this phase, controlled movement is helpful. By the fourth or fifth day after injury the amount of collagen is significant and there is a continued but slower increase, up to six weeks, after injury. Gentle tension from controlled movement, applied early in the healing process promotes greater tensile strength in the long run.


Progressive increased movement should continue with the goal of full range by the third or fourth week.Inactivity During Repair (not good)Cellular activity is stimulated by physical stresses to the tissue. With inactivity, collagen turnover still occurs and new collagen is made, but is poorly organized and not oriented along lines of stress. After three weeks it iscommon for the individual to experience recurrent bouts of pain when the repair is stressed.Treatment ObjectivesAt this stage the tissue is more amenable to therapeutic movement because collagen is being laid down at the injury site at an accelerated rate (tissue repair), forming weak hydrostatic bonds. This intermediate stage of care and healing presents an excellent opportunity for reshaping and molding of the scar that will form, without great risk of re-injury.A Therapeutic movement is achieved with various forms of passive (manual) and active movement therapy.
If this phase of healing is left unattended, a greater amount of unorganized scar tissue may form leaving the soft tissues less elastic, less flexible and the joint less mobile. Therapeutic movement helps promote more organized and more functional scar tissue, and more functional, stable joints.A From this stage we will transition you to more independent, active forms of therapy called rehabilitation.
Nonetheless, collagen synthesis is still occurring and additional therapeutic benefit can be attained with appropriate intervention as the tissues continue to mature (7).
Once the tissues mature, management becomes a more difficult proposition as the tissue reverts to a more inactive and non-pliable status. Most of your benefit at this stage will come from therapeutic exercise, typically performed at home. However, continued passive manual may still be beneficial during remodel because of the contractive nature of the healing dense connective tissue (ligaments).A  At this stage the treatment plan is to wean you off passive care as much as possible but at the same time carefully monitor and manage against intersegemental stiffening of the injured area. This theoretically is more applicable with spinal joints because of the multiple segments involved.


This is determined by how you feel and by clinical findings by palpation on each subsequent visit as we extend the period of time between visits.Remodeling can last for 12 months, sometimes more after injury. Because of the protracted nature of remodeling, it's important in many cases, to continue active therapeutic movement for some time after you feelA  better! The maturation (remodeling) time is different in every individual based on a multitude of independent variables unique to each individual. Abdulai is a Lecturer in Public Policy in the department of Political Science at the University of Ghana, Legon, Accra Masoud K. Without proper movement there is no balance between formation and lysis of the regenerating elements of the involved tissue.
Proper alignment of collagen does not result and the scar tissue tends to remain poorly organized. With that, any small stress applied to an inappropriate tissue is sufficient to disrupt newly formed fibers in the healing breach.A  This in turn starts another inflammatory response and a vicious cycle of chronic repetitive disruptions of inferior quality connective tissue will result. Because of the protracted nature of remodeling, it's important in many cases, to continue active therapeutic movement for some time after you feelA  better!



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