The attending chiropractor must be able to quantify the severity of a condition and its progress in order to personalize the treatment plan, evaluate progress and customize care to the unique needs of each patient. It is very important for patients to understand these goals and the time required to achieve each of them, so that they appreciate the process and endpoints of care. He presents a simple and concise paradigm that examines the relationship between tissue repair, function and symptoms. Both responses contribute to immobilization and disuse. Muscle patterns of coordination, recruitment and co-contraction may become disturbed.
Soft tissues become progressively stiffer and inflexible as fibrotic infiltration ensues.
Finally, cardiopulmonary function declines because of reduced activity and minimization of aerobic requirements due to activity avoidance. All of these factors contribute to progressive chronic musculoskeletal dysfunction, which may persist long after the healing processes is completed and may ultimately result in chronic pain and disability. One of the common criticisms of the diagnosis of soft tissue sprain or strain is that such an injury is normally followed by healing. Symptoms should settle over the expected tissue healing time. However, if the problem is dysfunction, then symptoms can persist for as long as dysfunction continues.