Adhesions

Adhesions are a normal part of the soft tissue healing process. Soft tissue heals in three main phases 1) inflammation, 2) fibroblastic (formative) and 3) remodeling (organizational). The first phase takes 48-72 hours. The second phase (fibroblastic) occurs where collagen fibers are formed in a random disorganized pattern. Finally in the third phase the collagen fibers are begin orientating themselves perpendicular to the structure they are forming (tendon, blood vessel, skin). During this healing process all of the soft tissue structures are healing together in the same location and can be thought of as connected together by a single viscous gel. This "sticky" substance and random fibers can cause temporary or permanent "adhesions". Adhesions are more common with surgical sutures internally and with immobilization for longer periods of time. Adhesions can be thought of as internal scar tissue.

Symptoms of adhesions can be varied depending on location. Following surgery it is common to have increased adhesions at the surgical site. Trauma surrounding a joint and the capsule can produce an adhesive capsulitis. Adhesions can become painful when entrapping a nearby nerve or may decrease motion around a joint.

Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce swelling in the joint. An injection may be used for both diagnosis and for treatment. Physical therapy can be very beneficial for proper range of motion and to reduce inflammation (swelling) in the area.