The problem is when soft tissues are stressed they produce a group of chemicals called inflammatories. These include histamine, bradykinin, and prostaglandin. These chemicals are designed to provoke specific physiological responses, which are supposed to be part of the healing process. Ideally, these chemicals are broken down as soon as they are produced by enzyme action as they come in contact with the blood. If the blood supply is inadequate and these chemicals are allowed to build up sufficiently, they produce adverse reactions that may not only slow healing but also increase soft tissue stress. In such circumstances, histamine increases swelling, bradykinin increases tissue sensitivity, and prostaglandin increases pain.
Histamine affects circulation in the soft tissues affected by inflammation by opening the arterioles, leading to the capillaries, while simultaneously closing the venules leading away from the capillaries. This has the effect of promoting swelling while at the same time, if deep tissues are affected (tendons, ligaments, joint capsules, or fascial layers), increasing skin resistance right over the inflamed deeper tissues. When the capillaries are engorged and open up around and in inflamed tissues the capillaries in the skin just over those deep tissues reciprocally constrict, increasing surface skin resistance to the passage of electrical current.
Bradykinin does not hurt overtly, but it does have the effect of making the involved tissues sensitive. This sensitivity increases and can affect adjacent tissues as the bradykinin builds up and spreads out. By rule of thumb, the tissues will remain sensitive (easily irritated) for two weeks after all of the pain is gone. In that period, the tissues remain tender and easy to irritate and re-inflame.
Prostaglandin is an organic acid that burns the tissues it comes in contact with. If allowed to remain in the area long enough its burning action causes the body to respond as if it had been burned. It tries to heal the burn. It floods the area with collagen in the form of collagen fibrils, which would ordinarily collect to form a scar matrix. There is no scar matrix to form, so these fibrils start sticking tissue layers together, becoming what are called adhesions. These adhesions cause these tissue layers to “catch” as they try to slide over one another. This increases tissue stress and provokes more inflammation, thereby becoming a self-perpetuating process. Adhesions are the source of most of the chronic problems seen in orthopedics, physical medicine and the chiropractic field.
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