"How Long Will This Last?"

The 4 Stages of Healing

When you injure yourself, whether it be a muscle strain, ligament sprain, or even a cut on your skin, your body doesn't just sit and wait. It runs through a carefully orchestrated healing process in stages. Understanding these stages can help you set some realistic expectations, avoid setbacks, and support recovery more effectively.

1. Protection/Hemostasis (Day 0-2)

Right after the injury, no matter the cause, your body's top priority is to "stop & stabilise". Blood vessels constrict, platelets clot, and a fibrin network forms to seal up the wound, internally or externally. This is often included as a separate "hemostasis" stage or seen as the very start of inflammation. Basically, this is when it hurts like hell.

Why it matters? If this step fails (for example, ongoing bleeding internally or externally), healing cannot really proceed. This lays the foundation.

2. Inflammatory/Protection/Clean-Up (Day 0-7)

Inflammation begins almost immediately and continues for days. White blood cells flood the area, removes debris of the damage, fights off pathogens/infections, and releases signaling molecules (cytokines and growth factors). What you experience is warmth in the area, maybe swelling, pain, and limited range of movement.

Key point: This stage is absolutely necessary, regardless of how much it sucks. Too much suppression, like overusing anti-inflammatories, can actually delay later phases.

3. Proliferation/Repair (Day 2-Weeks 2-6)

Now your body is building new tissue. Fibroblasts generate collagen, tiny blood vessels called capillaries grow (angiogenesis), and granulation tissue forms. The injured area is gradually filled and "patched" like a pothole (unless you live in Colchester). This phase tends to peak around 2-3 weeks after the injury. This is commonly the most frustrating stage of healing, because people are happy that the intense pain is gone, but can't seem to shift the annoying ache that remains. It is also the most common time that people relapse in symptoms, because they feel better, but the area isn't fully healed.

My advice at this stage would be to continue with gentle, prescribed movement along with controlled loading, nutrition, and increasing circulation to the area to help this phase. Don't force it, but don't immobilise it for too long either. Patience is a virtue at this stage of healing.

4. Remodeling/Maturation (From Week 3-Months/Years)

The new tissue is refined. Immature collagen is replaced with stronger, more organised collagen (type III turns into type I), fibres realign along lines of stress, and the tissue gradually becomes stronger and more flexible. This is where the brain really starts to wire in that new tissue exists, along with new movement. Remember that because this phase is very long, many people "think they are healed" too early. However, a return to normal living is usually felt around this time depending on the injury.

So what influences the healing speed and success?

Healing timelines are really just guidelines. There are a TON of factors that modulate how fast, or slow, you might recover. But here are a few:

1. Type of tissue damaged (skin, muscle, tendon, ligament, bone, etc) - some heal faster than others due to differences in physiology

2. Blood supply/vascularity. Better circulation = better healing. For example, ligaments take quite a bit longer because they have significantly less circulation.

3. Age, existing health, nutrition. Poor diet, chronic disease, smoking or other lifestyle factors can inhibit how quickly you recover.

4. Load & movement strategy. The correct amount helps. Too much or too little can hinder progress.

5. Infection, existing inflammation, or re-injury. These of course will stall progress.

6. Certain medications. Excessive anti-inflammatory use in later phases of healing can reduce collagen formation.

How to APPLY this information

• Don't rush - healing stages overlap, so pushing too hard too early can easily backfire

• Respect pain & swelling signals, especially in early stages.

• Introduce gentle movement in a prescriptive manner in the repair stage (this is where a chiropractor or other sensory therapist can really help).

• Progress is loading slowly during remodeling. Small stress teaches the tissue and nervous system to adapt.

• Monitor progress over weeks, not days.

• If healing stalls (especially in inflammation or remodeling), reassess the approach.

The Takeaway:

Healing isn't linear or tidy. You might feel "better" yet still be remodeling internally. But knowing how the process works gives you patience, direction, and leverage to make smart recovery choices.