Pert 5 - Soft Tissue Damage and Healing
Pert 5 - Soft Tissue Damage and Healing
Pert 5 - Soft Tissue Damage and Healing
DAMAGE AND
HEALING
HELLO!
Riza Pahlawi
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MECHANISMS OF
INJURY
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“ Many factors produce
mechanical injuries in sport.
Soft tissue damage occur
through direct or indirect
trauma to muscle, ligament,
and joint capsules.
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SOFT TISSUE DAMAGE
▰Direct trauma
Injury occurring from blunt trauma or
sudden overload (MACROTRAUMA)
▰Indirect trauma
Result from repeated submaximal loading,
leading to clinical sign and symptoms
(MICROTRAUMA)
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THREE STAGES OF INJURY
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Tissue elongation curves 7
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EXAMINING SOFT
TISSUE INJURIES
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1. History
• Onset
• Pain location
• Mechanism of injury
• Prior treatment and 3. Assessment
rehabilitation 4. Treatment Goal
• Goals of athlete
5. Treatment Plan
2. Physical Exam
6. Treatment Procedures
• Inspection
• AROM/PROM
• Palpation
• Neurological
• Strength and motor control
• Special test
• Functional exam
• Gait analysis
Acute Phase
Subacute Phase
Soft tissue
healing
Chronic Phase
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ACUTE/INFLAMATORY RESPONSE PHASE
Involves a
Accumulatio
Up to 72 number of
n of exudate
hours inflammatio
and edema
n response
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ACUTE/INFLAMATORY RESPONSE PHASE
Sign of inflamation
▰Redness (rubor)
▰Swelling (tumor)
▰Tenderness and pain (dolor)
▰Increased temperature (calor)
▰Loss of function (functio
leasa)
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“ This initial inflammatory response is
critical to the entire healing process.
If this response does not approach
what is supposed to, or if it does not
subside, normal healing cannot take
place
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SUBACUTE/FIBROBLASTIC REPAIR PHASE
Fibroblast begin to
48 hours – 6 Structures rebuilt
synthesise scar
weeks and regeneration
tissue
Increase
3 weeks-12
Strong scar functional
months
capabilities
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Incorporate
How to therapeutic Evaluate the
assess modalities outcomes
and exercise
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STAGE 1: ACUTE INFLAMMATORY PHASE
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REHABILITATION GOAL
Control pain
Limit swelling
given?
C - Compression E - Elevation
1-2 hari 22
EFFECT OF PROLONGED IMMOBILIZATION
Actual loss of
collagen fibers Muscle atrophy
Contractures, Disorganization
of collagen
fibers
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STAGE 1 - THERAPEUTIC EXERCISE
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STAGE 2 – REGENERATION AND REPAIR
The structure
REPAIR OR 48 HOURS
are rebuilt and This is a risky
FIBROBLAS UP TO 6
regeneration period
TIC PHASE. WEEKS
occurs
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REHABILITATION GOAL
▰ HEAT THERAPY
▻ Increase temperature, blood flow, extensibilty
of soft tissue
▻ Useful at the start of rehabilitation session
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STAGE 2 – THERAPEUTIC EXERCISE
▰ Flexibilities exercise
▰ Strength conditioning
▰ Muscular endurance
▰ Aerobic conditioning
▰ Neuromuscular
▻ Proprioception, coordination, and balance
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STAGE 3 – REMODELLING PHASE
3 weeks to 12 months
Remodelling of collagen
• Increase the functional capabilities of the muscle, tendon, etc.
Critical issues
• Residual strength deficit in individual muscles
• Imbalance between agonist & antagonist groups of muscle
• Side to side asymmetry
• Loss of sports specific skills
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STAGE 3 – MANAGEMENT & REHABILITATION
Continued
conditioning
Development of
sports-specific Return of
skills the
Rehabilitatio
training &
competitio n Goals
n
Prevention of further
injury
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THANKS!
Any questions?
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INTERMEZZO
CEDERA YANG TIMBUL AKIBAT BENTURAN ATAU
PEMBEBANAN BERLEBIH, DISEBUT ?
a. Microtrauma
b. Macrotrauma
c. Indirect trauma
d. Blunt trauma
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CEDERA YANG TIMBUL AKIBAT PEMBEBANAN YANG
DILAKUKAN BERULANG ULANG DALAM WAKTU YANG LAMA
1. Direct trauma
2. Indirect trauma
3. Macrotrauma
4. Microtrauma
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CEDERA YANG TIMBUL AKIBAT PENAMBAHAN BEBAN SECARA
BERTAHAP SELAMA LATIHAN DISERTAI ADANYA INFLAMASI
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TAHAPAN YANG PALING MENENTUKAN KESELURUHAN PROSES
PENYEMBUHAN CEDERA JARINGAN LUNAK ADALAH..
a. Remodeling phase
b. Proliferasi phase
c. Inflamatory phase
d. Fibroblastic repair phase
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DAMPAK NEGATIF YANG DITIMBULKAN OLEH IMOBILISASI
DAPAT TERLIHAT DALAM WAKTU..
a. 6 jam
b. 72 jam
c. 7 hari
d. 4 minggu
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PEMBENTUKAN JARINGAN IKAT SUDAH SEMAKIN KUAT DISERTAI
DENGAN PENINGKATAN KEMAMPUAN FUNGSIONAL
a. Inflamatori phase
b. Subacute phase
c. Fibroblastic repair phase
d. Remodeling phase
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PENANGANA AWAL UNTUK MENCEGAH DECONDITIONING
1. PRICER
2. Isometric exercise
3. Active ROM exercise
4. Pasive ROM exercise
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GOAL REHABILITASI PADA FASE KE 2 ADALAH
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KAPAN TERAPI PANAS DAPAT DIGUNAKAN DALAM FASE
REHABILITASI CEDERA JARINGAN LUNAK ?
1. Acute phase
2. Inflamatory phase
3. Remodeling-maturation phase
4. Regeneration-repair phase
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