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1) Bleeding - - this stage lasts about 10 minutes. Blood vessels are damaged whenever tissue is damaged. Bleeding soon stops as the blood clots. The blood can spread out under the skin (i.e. forms a bruise).

2) Inflammation and Swelling - this stage lasts up to 10 days. Within 10 mins of injury inflammation begins. The blood supply to the area is increased and chemicals are released, causing the area to go red and feel hot. At the same time a fluid called serum (which comes from the blood) builds up. Serum is a thick, sticky, yellow fluid which contains protein. This protein will eventually form scar tissue.

The body tends to produce so much serum that it causes swelling e.g. sprained ankle. As serum is sticky, it binds the tissues in the injured area so that they cannot move easily and feel stiff.

Consequently, during this stage of healing it is important to gently move the area to minimise stiffness and swelling, and to help the serum to be absorbed once it has done its job. Movement can be started very gently, with frequent rest periods, and gradually built up.

3) Repair - begins 2-3 days after injury and continues for 3 months. The protein in the serum joins together to form scar tissue, which repairs the gaps left by the injury. From 3 weeks after the injury the scar tissue begins to contract and tighten. It is therefore important to stretch the healing tissue to increase its elasticity and strength.

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