1) A-Specific Arousal, Sensory Dominant (aware of everything)(inflammation phase)
The actual injury happens unexpectedly. Whenever there is a warning, like a screech sound before getting rear-ended, the brain becomes very alert, and the innate immune system is activated. Both if these things help to encourage a good inflammation reaction should injury occur. The actual tissue that is injured releases chemicals that attract the immune system so that the inflammation occurs in the right places. Maybe the most important chemical is called substance P, which in part is released by the nocisensoric fibers via a reflex with the spinal cord. Normally this reflex is inhibited, but is actively un-inhibited whenever the brain is in a state if vigilance.
2) Specific Arousal (Focus)(proliferation phase)(dopamine phase)
After a few days, the inflammation has cleaned up the debris, and instead of being afraid of everything, the fear is more of a specific movement that corresponds with the actual tissue that is injured. The body is laying down proteins like collagen that will replace the injured tissue. Gradually then can move normally but they are still being careful not to put too much stress on that one part. This corresponds with the tissue which, on the one hand is no longer breathing, and on the other hand is not a full strength. This also corresponds to a sensitivity on the segment at the beginning of this stage, and by the end of the stage it would be harder to detect a segmental hypersensitivity. By the end of this phase the person can move normally but wouldn’t dare to move at full force. Most people don’t progress past this phase and their issue is never completely resolved which is why it lingers and comes back periodically.
3) A-Specific Arousal, Motor Dominant (Remodeling Phase)
At some point the person should add resistance and use the previously injured tissue at full force. This helps organize the repaired tissue and helps is remodel. Also, the conscious awareness of the injury is lessened dramatically when you are able, for the first time, to jump on the previously injured leg or do a pull-up on the previously injured shoulder. This would be like someone having glued a broken pull-up bar. Before you do a pull-up you would test the bar. Think of how much more confident you are in the bar after having put all your weight through it. That’s exactly how your brain knows that you no longer have to be too cautious. Most people never complete this step after an injury, but even so, this is not the last stage.
4)Endurance Phase (serotonin phase)
Once the person knows they can use their leg/arm at full strength, they can now try something repetitive like running or swimming or even hiking or cycling. Anything pretty intense and repetitive, if in fact those activities don’t hurt, promotes serotonin in the brain and endorphins to be dripped into the spinal cord. This permanently wipes out the emotional part of the memory of the injury. In other words, if you were in a car accident, you might break out into a sweat when you drive by the place you got hit, but after this phase you will still remember to look out for yourself as you go around the same corner, but you won’t be scared, etc. This endurance phase is necessary to wipe out the fear, and the brain goes on autopilot while being wide awake. This has the advantage of letting the person process things going on in their head without fear or caution, meaning more idealistic.
5) Posture Phase
At some point you have so much repetition that you can return to normal movement at be totally relaxed at the same time. Walking would be the most simple example. It is critical that a person develops a schedule/physiology in which much of their activities are at low intensity. One way to test if all the other phases went right is to know if a person has pain when they are relaxed on not distracted.