Phase 1: Acute Recovery

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Phase I - Acute Recovery

Phase I is also known as the acute phase.  This is the period that begins immediately following the injury.  It can also be the period immediately following surgery.  A patient who sustains an injury that later requires surgery may have two separate acute phases in their rehabilitation process. During the acute phase the inflammatory process is in full gear.

This is the time when vascular reaction and exudate work to protect the traumatized tissues and begin the repair.  The patient will exhibit redness, swelling, pain, and increased local temperature.  As the inflammatory process progresses to the proliferative phase of the healing process, fibroblasts begin laying down the matrix of collagen (scar tissue).  Although pain may still be present, the redness and heat of the inflammatory process should be reduced and the swelling less evident.

The treatment goals of Phase I are to protect the area from further injury or infection, reduce pain, and control swelling in order to allow the healing processes to occur.  Strategies for accomplishing these goals include immobilization, if indicated, and RICE (rest, ice, compression, elevation).  This allows clotting to occur and the proliferative phase of healing to begin while reducing adjacent tissue damage that is caused by excessive swelling and tissue temperature.

Unfortunately, this is the phase where patients tend to receive little or no care.  There are many reasons for this.  Often patients won’t go to the doctor right away when they sustain an injury.  They will wait until it is “not getting any better” before seeking medical care.  Those who do decide to call the doctor have to navigate the process of scheduling an appointment which may not be available for weeks or months.  If it happens at all, they then might have to wait for approval from an insurance company in order to continue trying to schedule an appointment with the physical therapist or, in some cases, the orthopedic surgeon so that they can refer the patient for physical therapy.  Even post-surgery, outpatient surgery centers dress the area and send the patient home with equipment and instructions to which they may or may not adhere properly or diligently.  Whatever the reason, a poorly managed acute phase creates longer, more complicated subsequent phases.