The soft tissues of the spine need constant and consistent movement to properly heal. Using the right tools of treatment for the correct stage of healing is critical for the resolution of injury and the restoration of normal function. There is a consensus in the research community that soft tissue repair takes 4 to 6 weeks and tissue remodeling takes up to one year.

There are four stages of soft tissue healing. These are the stages you go through when you have a whiplash injury from a car accident or any other type of accident that sprains and strains your neck muscles.

• Stage one: Active Bleeding. 0-72 hours. Blood vessels are broken. Muscles are bleeding internally. Cells are dying because they are starved of proper blood circulation. Blood coagulation begins to stop the hemorrhage of blood from the capillary beds.

• Stage two: Inflammatory stage. Day 1 to day 7. Histamines released locally in the cells cause fluid to build up. This is designed to contain potential infection, which is not a threat in most whiplash injuries. This is the reason why inflammation from auto accidents is overkill, and must be contained as well as possible. Collagen synthesis begins so connecting fibers can regrow.

• Stage three: The Healing Stage. Day 5 to day 60, but most intense for the first 15 days then tapers off. Fibroblast cells grow collagen fibers to reconnect torn areas, laying down a haphazard array of fibers that provide weak, temporary support. These fibroblast cells work poorly in tissues that are poor in oxygen and nutrients.

• Stage four: The Remodeling Stage. Up to one year after the injury. Collagen fibers that are laid down haphazardly are broken down and replaced by fibers that are more linear and resemble the original tissue more accurately. These fiber align themselves along the linear lines of stress, which is why proper movement is so important.

An experienced clinician is required to determine the site of injury and the severity of the injury. Proper information and advice must be given for nutrition and exercise protocol.

Todd Lloyd, DC