Athletic Training: A Case Study

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Athletic trainers are bound to see a variety injuries effecting different tissues within the body thus calling for different healing times and needs to promote the healing response. Understand how different tissues heal is critical to providing the most effective treatment to the athlete in order to return them to play in the most efficient way possible. Examining how ligaments, tendons, and muscles heal could be the best tissues to analyze given their frequency of injury with athletes of all sports. Ligaments in the acute phase of healing experience a flood of fluid becoming fragile and easily degradable which flows between the ends of the broken ligament. This fluid is composed of polymorphonuclear leukocyte (PMN), lymphocytes, and erythrocytes. …show more content…

Tendons are supported by the periosteum, synovial sheath, epitenon, and endotenon by providing a vascular supply and additional fibroblasts. The epitenon and endotenon provide cells similar to macrophages and fibroblasts which is important to begin debridement. Phagocytes fill in the wound gap and collagen begins synthesis begins just after one week of initial injury. After two weeks, collagen begins organization in accordance as to where stress is applied thus having proper alignment which may take up to 35 days to complete. Fibroblasts begin surrounding the connective tissue to form the granulation tissue which is aligned with the collagen along the tendon’s long axis. Revascularization sets in very quickly over the first three-week period allowing mobilization for a tendon undergoing surgical repair but immobilization before three weeks is crucial for allowing revascularization to happen. Following revascularization, the synovial sheath is reconstituted which gives the tendon the ability to glide against a surface without irritation. After two months, the remodeling stage has begun with collagen maturing and realigning along the tendon’s axis. type III collagen has been replaced by type I and tensile strength has returned to 85-95% after 3 months (Houglum, 2016, p. 47-48). Ligaments typically take longer to heal when compared to muscles and tendons because typically ligaments are avascular or have a very small blood supply directly to them. Also when ligaments do finally heal, generally there is a lack of elasticity and it should be no surprised if there is an noticeable amount of laxity if a stress test is applied to that

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