Doctor Patient Intro Mopal Lab

Hello I am student clincian_____________.  I will be examing your back today and it will require me to open your gown and place my hands on your back and under your waistband.  If anything I do hurts you please let me know.  Anything that you tell me will be held in strict confidence.  May I Begin?????  (what for their answer, then you will begin your task on the patient)

Tissue Response to Injury

There are 3 phases of Healing

1. The Inflammatory Response phase which lasts 0-4 days
2. The Fibroblastic Repair Phase which lasts 4-6 weeks
3. The Maturation-remodeling phase which lasts 6 weeks to 2-3 years. 

The Inflammatory Stage

• Starts immediately
• The tissues in the area are warm, as a result of the large amount of blood supply reaching the site.
• The tissues in the area are swollen, again due to the increased amount of blood and protein present. 
• The area is painful, due to the expansion of tissues, causing mechanical pressure on nerve cells, and also due to the presence of pain mediators
• All this results in loss of function
• Vaso-constriction - 1st 10 minutes
• Followed by dilation which creates more swelling
• The blood stagnate tissue death
• Fibrin Clot forms - 12 hour post injury
• If inflammatory phase turns chronic, healing never occurs i.e. (tendinitis)

 Side Note - Acute inflammation is characterized by 5 cardinal signs: rubor (redness), calor (increased heat), tumor(swelling), dolor (pain), and functio laesa (loss of function)

Fibroblastic Repair Stage 

• Formation of scare tissue continues
• Point tenderness starts to subside
• Capillaries form in the wound to aid healing
• Fibrin Clot breaks down
• Collagen replaces the fibroblast
• increasing tensile strength develops

Maturation-Remodeling Phase

• Involves the realignment or remolding of the collagen fibers that make up the scar tissue
• The realignment will depend on the tensile forces which the scar tissue is subjected
• As stress and strain are applied to the collagen fibers the fibers realign in a position of maximum efficiency parallel to the lines of tension
• The tissue will then gradually become normal in appearance and function
• Usually within three weeks, a firm scar will exist, but can take up to a year

Lack of Motion

• Causes of excess scarring
• chronic stiffness
• limited range of motion
• poor biomechanics
• weakened muscles and ligaments
• poor nutrition due to the edema
• accelerated degeneration 

Chiropractic Intervention

• Production of tensile forces along the fibers
• restores motion which reduces swelling
• Blocks pain
• relaxes tight muscles
• promotes healing