Remodel Phase of Healing

Dr. Wallace Wade

Chiropractor in Citrus Park FL 33625

What Happens to the Tissue

Usually begins @ week 3

Overlaps repair and regeneration

  1. Purpose is to increase strength of repaired/replaced tissues
    1. First 3-6 weeks involves laying down of collagen and strengthening of fibers
    2. 3 months to 2 years allowed for enhanced scar tissue strength
  2. Balance must be maintained between synthesis & lysis
    1. # of fibroblasts, myofibroblasts, & macrophages reduced to pre-injury state
    2. # of capillaries decrease, H2O content decreases
  3. Take into consideration forces applied, immobilization time frames relative to tissue and healing time
  4. Scars
    1. Type I collagen continues to replace Type III collagen

Chronic Inflammation

  1. Result of failed acute inflammation resolution within one month termed sub-acute inflammation
  2. Inflammation lasting months/years termed chronic
    1. Results from repeated microtrauma and overuse
  3. Proliferation of connective tissue and tissue degeneration
  4. Presence of lymphocytes, plasma cell, macrophages(monocytes) in contrast to neutrophils (during acute conditions)
  5. Major chemicals include
    1. Kinins (bradykinin) – responsible for vasodilatation, permeability and pain
    2. Prostaglandin – responsible for vasodilatation but can be inhibited with aspirin and NSAID’s


  1. Increase Strength
  2. Align Collagen Scar Tissue
  3. Decrease Nerve Sensitivity


Phase III: Remodeling Phase (Longest Phase):

  1. Goal of returning to normal functional capacity
    1. Continued collagen realignment
    2. Pain continues to decrease
  2. Regain activity-specific skills
    1. Dynamic functional activities
    2. Activity-directed strengthening activities
    3. Plyometric strengthening
  3. Functional testing
  4. Determine specific skill weakness

Injury Response/ Pain-Spasm-Pain Cycle

If you have any further questions about how the body heals in the remodel phase give me a call at 813-265-4135

Dr. Wallace Wade Chiropractor in Citrus Park FL 33625