Factors that can Inhibit Healing
1. Poor blood supply – especially tendon lesions where intrinsic blood supply may be poor.
2. Lack of initial protection and reduction of swelling (first few days).
3. Lack or not enough early mobilization – gentle natural mobilization encourages good quality repair (starting within the first week post-injury).
4. Prolonged inflammation: anything that prolongs or re-triggers this phase will cause poor healing – for instance infection, a hematoma, or excessive premature mobilization.
5. Inadequate use of steroid medication – decreases tensile strength of healing lesions, slows the rate of wound closure and vascularisation.
6. Nutrition – lack of nourishment inhibits the body’s response to injury and healing.
7. Diabetes – mechanical problems and metabolic defect impairs wound healing.
8. Increased or too much deposit of collagen or scar tissue.
9. The grade of mobilization or physical activity must be appropriated for the stage of healing. If too aggressive too early, or not enough stresses are applied to repair tissue, the end result can be the same – poor wound healing and function.
10. Inappropriate behavior in dealing with pain and its consequence--letting fear of pain paralyze your lifestyle, leading to fear-avoidance beliefs and behaviors such as: lack of movement, becoming inactive, low self-efficacy, low self-reliance, anxiety and depression.
11. Inappropriate behaviors on the part of the health care practitioner – encouraging patient to adopt sick-roles, obtain sick leave, and offering passive, clinician-led treatment strategies, which help to maintain low self-efficacy and clinician dependency.
I know I got a bit technical with this one, but for some of you it can be very useful.
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