Thought you guys would be interested....Tendons and expecially Ligaments have a very limited blood supply.....This is why Ligaments and tendons have a hard time healing 100% correctly on there own.....Muscles have a large blood supply...the reason why muscle pulls, strains and tears will heal much quicker and correctly
When you read the part where they mention prostaglandins, this is where there finding taking Anti InFlams for 10 days right after an injury blocks this chemical process that is needed during the inflammation process.........so for many years the gold standard was take anti inflams after an injury...which I did many many times...come to find out that could be a big part of incomplete healing of a injuried tendon or ligament.....I now tend ot wiat till 3 days go by...and then if still inflamed or in pain from a normal pull or strain I will start the anti inflam then....Interesting stuff
THE INFLAMMATION PROCESS
Understanding inflammation is key to gaining an insight into how prolotherapy works. The first phase is called acute inflammation and is about one hundred hours long. This step begins at the time of the injury, when the ligament and the adjacent cells are broken open and their contents spill at the wound site. The ligamentous and cellular debris and a number of chemicals in the fluid or plasma around the broken-open cells attract an influx of white blood cells called leukocytes. Their job is to clean out the bacteria and prevent infection at the injury site. Many of the chemicals released during this phase will be broken down into messengers or chemical signals that tell cells to become active or inactive during this phase of inflammation. Some of these chemicals are called prostaglandins, which can cause pain at the injury site.
The leukocytes also secrete hormones which attract an important cell called the "macrophage". The arrival of the macrophages at the injury site signals the beginning of the next phase in the healing process, the granulation phase. As the macrophages arrive at the injury site, they begin to "clean up" the area through a combination of digesting the broken-down cell parts and secreting enzymes, which break down many of the damaged ligament molecules. The macrophages also release a number of hormones which will bring more cells to the injury site.
The macrophages also release chemicals (growth factors) which stimulate the growth of new blood vessels, intercellular matrix, and the cells that will make new ligaments. These specialized cells which make ligaments are called fibroblasts. The fibroblasts will be responsible for the actual repairing of the sprained ligament. The combination of all of these cells and the new blood vessels being formed causes the thickness and fullness that can be felt at the injury site. The granulation phase will be present for ten days to two weeks.
Fibroblasts will find the site where the ligamentous structures attach to the bone: the fibro-osseous junction. The fibroblasts will be stimulated, or "turned on", to make new ligaments by chemicals and hormones that have been released by the incoming macrophage. When the fibroblasts are "turned on", they rapidly make massive amounts of the basic building blocks of ligaments: collagen.
The third phase of healing is called "wound contraction". During this phase, the new collagen deposited at the injury site will be organized into a new ligament. The fibroblasts make single long molecules which, when outside of the cell, will begin to entwine around each other, forming what we call a collagen fiber, which is a "triple helix" of these molecules. The individual molecules are held together by strong chemical bonds, As the collagen fibers wind around each other, they begin to contract and the molecules become shorter and tighter. Water is squeezed out (like squeezing a sponge), which also causes shrinkage. As the millions of collagen fibers lose water and shrink, the ends of the ligament will be slowly pulled together and the laxity will decrease. We can see this in the healing of a skin wound as the edges of the wound pull tightly together near the end of the healing process.
During the third phase of the healing process, all of the cells originally present to "clean up" the wound are recalled by the body. All that is left at the injury site are the fibroblasts which have been "turned on"and are secreting the collagen and other substances which will be used to increase the integrity of the injury site. The third phase of inflammation lasts for a number of weeks, and the "new ligament" tissue will not reach its maximum strength for several months.