![\"mechano](\"https:\/\/stg-blogs.bmj.com\/bjsm\/files\/2013\/10\/mechano-pic-300x206.jpg\")
Many BJSM followers know about mechanotherapy – so skip this blog.<\/p>\nMany BJSM followers know about mechanotherapy – so skip this blog.<\/p>\n
If you aren’t aware that you know about it, there is a BJSM podcast – here’s the link<\/a>.<\/p>\n Relevant background —\u00a0 I have a \u2018competing interest\u2019 \u2013 I\u2019m blogging about a paper I coauthored. It’s my 2nd such post since we started blogging seriously at BJSM (2009). The objective measure is that the paper has been downloaded almost 90,000 times in full text<\/a> and PDF<\/a>. And I have been encouraged by colleagues – so here goes…<\/p>\n There is substantial level 1 evidence that exercise is a powerful therapy for musculoskeletal conditions \u2013 for muscle strains, joint degeneration, sciatica, tendinopathy. The historical rationale to explain the mechanism was \u2018strengthening\u2019.<\/p>\n \u2018Strengthening\u2019 as a mechanism for tissue repair didn\u2019t make sense to me when I was in my busy clinical phase. How did \u2018strengthening\u2019 the hip external rotators remove the pain of ITB friction syndrome? What was it about \u2018strength\u2019 that would remove the pain of a hamstring strain? There is more to tissue repair than ‘strength’.<\/p>\n Mechanotransduction<\/span> is a well-recognized physiological principle that should have much more traction in physiotherapy\/physical therapy courses and in sports medicine. This is how the body adapts to load. Why are Arnold Schwarzenegger\u2019s muscles bigger than mine? His workouts signal his cells to hypertrophy and and multiply as needed and he gets bigger muscles. Why does an elite distance runner have\u00a0 larger blood vessels than a sedentary academic about to have a cardiac arrest? Mechanotransduction is the process.<\/p>\n A negligent sawmiller \u2013 who has lost his distal phalanx \u2014 has a vastly smaller proximal phalanx<\/span> than his or her proximal phalanges on the intact fingers. Same hand, same genetics \u2014 less loading. Mechanotherapy trumps genetics! Note examples from different tissues \u2013 mechanotherapy is a universal principle.<\/p>\n When clinicians prescribe exercise, the loading signals cell to repair and to function in response to load. Turning movement into repair. Clinicians see the power of mechanotherapy daily. Mechanotherapy <\/a>is when you apply the principle of mechanotransduction as a treatment \u2013 analogous to the use of \u2018electotherapy\u2019 or \u2018pharmacotherapy\u2019 (but way more powerful than either of those!). Medial ligament rehab – how does it work? Mechanotherapy. Normal physiology = mechanotransduction; Prescribing targeted exercise = mechantherapy. Simple.<\/p>\n Mechanotransduction has a very well-established scientific basis underpinning the success. Incontrovertible. (5077 citations in Pubmed<\/a>). Stick with exercise loading\u2013 it can take time to work fully. Avoid the temptation to switch to snake-oil formulas<\/a> or funky treatments<\/a>. Trust in millions of year of evolution. The folks who couldn\u2019t heal their own injuries while moving on to the next feeding grounds aren\u2019t with us any more. Mechanotherapy provides a powerful survival benefit<\/a>!<\/p>\n Click here for open access to the paper: Mechanotherapy\u2013How physical therapists\u2019 prescription of exercise promotes tissue repair <\/a><\/p>\n And I discuss this paper with BMJ MultiMedia editor @HarrietVickers on this podcast link: https:\/\/soundcloud.com\/bmjpodcasts\/bjsm-podcast-mechanotherapy<\/a><\/p>\n And you can upload of the graphics from the paper for free as powerpoint slides.\u00a0 If you enjoy the podcast or have tips as to how we can make it better – tweet @BJSM_BMJ<\/p>\n Turning movement into repair!<\/p>\n **BJSM has over 230 podcasts on SoundCloud with over 900,000 listens** Check them out at http:\/\/bjsm.bmj.com\/site\/podcasts\/<\/a><\/p>\n
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