The 3 Phases of Tendon Healing
The inflammatory phase
This phase occurs during the first 7 days. Even a small amount of bleeding occurs after the surgery. Platelets help form a clot and a fragile bond, which helps limit the bleeding. Messenger chemicals attract inflammatory cell such as white blood cells.
The proliferative (new cell formation) phase
The inflammatory phase gradually transforms into the proliferative phase, which occurs 2 to 3 weeks after surgery. New cells replace the inflammatory cells to produce scar tissue (collagen) and new blood vessels which replace the original clot. This scar tissue is the scaffold of the more permanent repair tissue. During the following week, this repair tissue grows stronger during the transition to the maturation phase
The maturation and remodeling phase
This begins around week 3 after surgery as tissue production slowly tapers and scar tissue (collagen) matures. Immature scar tissues are replaced by mature tissues. The collagen is continually remodeled until permanent repair tissue is formed.
Tendon healing takes at least 12 to 16 weeks, but may indeed take up to 26 weeks to reach its final strength.
Aggressive early movements following surgery, which overly stresses the repair and exceeds the mechanical strength of the repair construct, must be avoided