How controlled stress affects healing tissues.

Restoration of a patient's full range of motion, strength, and function are the primary goals of occupational and physical therapy. Immobilization of normal connective tissue leads to biochemical, biomechanical, and physiologic changes within a week. These changes are magnified in the presence of trauma or edema, and they may create permanent damage if not addressed swiftly and properly. This is best accomplished by applying specific types of stress to the involved and associated structures at optimal intervals during the rehabilitation process. Load must be applied at adequate intensity and duration to successfully affect the viscous property of connective tissue. This is necessary to effect permanent elongation of the restricted tissues. Early controlled motion is vital to prevent the negative changes associated with immobilization and to maintain normal viscoelasticity and homeostasis of connective tissue. Hand therapists must have a thorough understanding of the changes associated with injured structures. Only then can they provide optimal stress delivery to facilitate restoration of function.