The aim of this paper is to summarise the salient issues in the field of soft tissue repair without claiming to provide a full review. In a subsequent paper, the capacity for different elec- trotherapy modalities to influence these processes will be considered. Some examples of the potential influence of man- ual and exercise therapies are included in this text.
Tissue healing consists of a complex series of cellular and tissue reactions that enable the body to achieve a functional repair of tis- sues that have been damaged – in most cases. There are individu- als for whom this process goes astray, and those that seek help for a normally presenting repair process.
Research concerning tissue repair is published at a significant rate and there are several areas of rapid development, particularly (a) the identification of numerous growth factors that influence and control the processes and (b) the role of angiogenesis as an essen- tial component of repair. Reference will be made to recent work in both fields. More complete and in-depth reviews can be found in references 1-9.
BASIC TISSUE REPAIR PHASES The process of tissue repair is complex and for most individuals, fol- lowing some form of injury or tissue damage, is remarkably effi- cient. It would also be difficult to argue that there was any need to change the process of tissue repair. If there is an efficient system
8 bleeding inflammation proliferation
REPAIR: THE CURRENT STATE OF THE ART
Weeks Figure 1: The essential phases of tissue repair
through which tissue repair is initiated and controlled, why would there be any reason to change it? The more logical approach would be to facilitate or promote the normal tissue repair process, and thereby enhance the sequence of events that take the tissues from their injured to their ‘normal’ state. Understanding the basic responses that occur in the tissues during the sequence of events