Info for medical professionals, February 2018: Tissue damages - tissue regeneration - tissue remodeling - part 2

With neck trauma, there is often tissue damage. External load surpasses the strength of joint ligaments, meniscus attachments, muscles and sinew attachments. External trauma damages your important soft tissue structures, leading to your experience of pain, decreased neck / head function and thereby considerably diminishes quality of life and ability to work. Therefore, it is very important that we as soon as possible get a good overview of the damages, and thereby be able to initiate effective rehabilitation measures.

Firda Physical Medicine Center diagnostics consist of the Firda Model consisting of:

  1. We carry out a thorough clinical examination with experienced therapists with access to the best of diagnostic equipment. In this examination we employ functional ultrasound with high-end equipment; GE Logiq E9. For many this will be sufficient for precise diagnostics, and we can initiate effective rehabilitation measures quickly.
  2. We also consider whether we will recommend future use of positional CT and positional MRI neck - 3T (London). These two methods produce excellent images of bone structures and joint positions, as well as the tissue that surrounds the joints (joint capsules, ligaments, muscles). We are aware that many choose to use upright MRI. We are very familiar with this imaging method and have utilized it on several occasions at 2 different facilities in London. Our conclusion is unequivocal: We no longer use this method because the quality is very low, resulting in substantial risks of misinterpretation of findings.
  3. MRI: We use positional MRI 3T - with T2 weighted sequences - where we compare possible findings with the corresponding MRI intersection with STIR projections. STIR projections will be able to show edemas / active inflammation in the same structures. This is a complementary combination of MRI sequences. CT and the MRI 3T examinations work well in conjunction with our clinical and ultrasound examinations.

This is a very extensive combination of examinations - which require a lot from us at Firda Physical Medicine Centre, and which is costly for you as a patient. Therefore, we need to be certain that this is something that we want to recommend for you.

Our plan is to offer more of these extensive examinations after Easter 2018.

Let us go back to the issue of functional ultrasound:

This article is the follow-up for the same patient discussed in our article published January 2018, which documented her status from June and November in 2017. The patient is a female under 30 years of age. When reading the previous article, you will find that we are following this patients' joint and soft tissue injuries, subsequent tissue regeneration, and remodeling of the soft tissues between atlas - axis.

I have chosen to illustrate her further tissue regeneration (reparation of tissue - collagen fibers - in joint ligaments and capsules for the facet joints atlas - axis right and left side) and tissue remodeling (that the new fibers are laid down functionally in such a way that they support in the correct directions and planes, with improved guidance of the joint function). This is important news for everyone who suffers from neck injuries!

Status in November 2017: We were satisfied with the progress in tissue regeneration and tissue function on the right side of the atlas - axis facet joint.

We were not satisfied with the tissue regeneration on the left side of the atlas - axis facet joint (C1-2)

January 2018: New status for the left side of the atlas-axis facet joint - where the results now show clearly improved regeneration of the joint capsule and ligaments.

Image 1: Facet joint atlas-axis left side - November 2017

The left side of the facet joint atlas-axis (C1-2). The left side of the image is turned towards the nose, the right side is turned towards the back of the head. This intersection focuses on structures in the center of the joint and forwards - as this was the area we were least satisfied with in November 2017.

Center of the joint
We see that the front part of the joint capsule is ruptured (damaged) to a significant degree. The same goes for the capsular ligaments and overlying ligaments for the joint. As it appears in this image, the capsule and ligaments for the front parts of this joint have extensive tissue damages.
When following the structures towards the back, it is easy to see when they transition to more intact and well-formed capsule and ligament structures.

Image 2: Facet joint atlas-axis left side - January 2018

After thorough tissue stimulation for cell regeneration with laser, class 4, acoustic compression therapy (using Piezo Wave 2) - guided by thorough clinical testing and ultrasound, as well as training with MCU (Multi Cervical Unit) - the ultrasound images from January 2018 shows clearly improved tissue regeneration and tissue reorganization.

Considerable tissue regeneration and reorganization of capsular tissue compared with the status of November 2017.
Remnant flap of the joint capsule that we are working hard to better reorganize with the other part of the joint capsule.
Excellent regeneration and reorganization of ligaments / capsular ligaments. It must be pointed out that the patient in question is skilled at training with MCU and in the gym as important part of a successful rehabilitation.
Segmental musculature

Check-up materials

The way we interpret "checkups" at Firda Physical Medicine Center, we compare earlier injury/damage findings with their current state. Are there changes towards better or worse, or is the tissue state in a standstill? These are important questions to be answered. Can a path to further tissue regeneration be found? We know the appearance of the anatomical structures. Comparing you to other patients with neck injuries or to others who have no ailments is a waste of time and usually useless work. How others experience their own neck injuries is not helpful when we are working on your diagnostics and rehabilitation.

Please Note:b We chose to avoid manipulation of the injured area of the neck with tissue damages such as these. Manipulation could very well make your injuries worse! This also includes "atlas techniques. " It often takes very little to injure you further! Without precise diagnostics we have no overview or control over your tissue damage. You must also be careful with neck stretches where you amplify the stretching of the neck with your hands.

Medication: When it comes to medications, it is important to not take medicines that greatly reduce your tissue regeneration abilities. Please address this with your physician.

An important focus is to ascertain which measures should we take to make you better?

An equally important focus needs to be which measures should we avoid to not make you worse?

This article series will be continued - follow us on Facebook and at


Please note: From Jan 1st 2018 we no longer accept credit cards. Only debit cards can be used.

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