PT & Tissue Healing

Physical Therapy & Tissue Healing
by Dr. Daniel Ramirez DPT, PT, CSCS

“Proper Dosage of Exercise After an Injury”

The goal of physical therapy is to restore normal function in the body and to help patients return to their desired lifestyle and everyday activities. Achieving this goal is accomplished through a treatment process that includes educating, strengthening, stretching, and functionally retraining the neuromuscular system for each patient. The proper selection of the correct treatment phase is done with consideration of the tissue affected and the stage of tissue healing.

5 Phases of Rehab Treatment:

  1. Max Protection
  • Goal: Tissue protection, decrease inflammation, and maintain basic function
  • Treatment: educate, modalities, body mechanics, taping, ice
  1. Mod Protection
  • Goal: Tissue maturation, muscle activation, and protect development
  • Treatment: NMES, AAROM, support involved (tape, bracing, etc)
  1. Min Protection
  • Goal: Tissue reorientation, light functional activities
  • Treatment: AROM, light tissue stress/tension, light functional movements/ activities
  1. No Protection
  • Goal: Functional progression and return to skilled activities
  • Treatment: Properly dosed exercises to increase function without regression
  1. Return to Sport/Play
  • Goal/Treatment: Gradual progression to 100% with the assistance of parents, coaches, strength coaches, athletic trainers, and doctors involved. [1]

3 Stages of Tissue Healing:

  1. Inflammatory – max protection treatment
  2. Reparative – mod/min protection treatment
  3. Remodeling – no protection or return to sport/play

*Although someone is returning to sport, their tissues are still remodeling and a gradual return is essential to decrease the risk of reinjury. [2]






0 – 3 days

5 – 28 days

28 – 112 days (4 months) for proper mechanical loading

Muscle/Tendon Junction

0 – 4 days

4 – 7 days

Varies between tendon and muscles

Skeletal muscle

0 – 10 days

10 – 21 days

21 days – 12 weeks for return of strength


0 – 3 days

3 – 14 days

3 – 12 months for 50-70% tensile strength

[1] Gould. Davies, G. Wallaces Phases of Rehab. Orthopedic and Sports Physical Therapy. 1985
[2] Woo SL, Buckwalter J. Injury and Repair of Muskuloskeletal Soft Tissues. American Academy of Orthopedic Surgeions. 1988. 103-117.


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