When you see a doctor or clinician about an injury, they all want to know details that help them develop the most thorough treatment plan for you. Chronicity, or how long you’ve had your injury, is one crucial detail.
In physical therapy, knowing if your injury is short or long-term (acute or chronic) helps us understand its characteristics and create a rehab program that best fits your needs. Here’s what we mean.
Chronicity describes how long your body has been trying to repair your injury. There are three categories of chronicity (1):
- Acute: Less than six weeks
- Subacute: Between six weeks and three months
- Chronic: More than three months
The typical healing time depends on the body’s tissue, its blood supply, and how involved your injury is. Some injuries can heal within the acute phase, while others may enter the subacute or chronic phases before fully healing.
Acute vs Chronic: Explained
There are some general characteristics between acute, subacute, and chronic injuries that help physical therapists understand what’s going on.
- Acute injuries tend to happen suddenly and have an obvious cause, like stepping in a hole and twisting your ankle. Most tissue healing is happening during the acute phase (first six weeks), so the main priority is to protect the injury. This phase has more intense pain associated with it, so your physical therapist may suggest ways to offload the area while introducing some movement to prevent stiffness and atrophy (muscle weakening) as much as possible.
- Subacute injuries have similar characteristics to acute injuries, but the tissue needs longer than six weeks to heal. At this point, pain intensity may be less, but tissues are still vulnerable. You may be able to start loading the area with more movement or load depending on your doctor’s clearance. This could mean starting a strengthening program or getting back to a walking routine.
- Chronic injuries are more complex. They could involve more tissue damage, which requires longer healing times. They could also have difficulty healing due to internal or external factors, like reinjury or poor blood supply to the area. Some chronic injuries develop slowly over time, like low back or neck pain. Depending on your injury, you should be able to move and load the area under medical guidance while considering new lifestyle habits that support pain relief and further healing.
What Chronicity Means for You
Your physical therapist will use chronicity, along with other important details in your initial evaluation, to help you:
- Understand your injury and healing milestones
- Develop a plan to reach your goals
- Create realistic expectations regarding your healing journey
It will also help your physical therapist determine which types of exercises are most appropriate for your condition in its current healing phase, so your tissues undergo a healthy amount of stress required for growth and development.
It doesn’t matter if you have an acute or chronic condition—reach out to JACO Rehab to start your healing journey now. Start physical therapy at one of our four Oahu locations: Honolulu, Waikele, Mililani, and Kapolei. Contact us to schedule our initial evaluation.
Written by Nicole Hernandez, DPT
1. King, W. (2013). Acute Pain, Subacute Pain, and Chronic Pain. In: Gebhart, G.F., Schmidt, R.F. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28753-4_75