Why exercise is THE most important part of treatment for musculoskeletal and sports injuries
There is a robust evidence base to support exercise therapy across a range different conditions including tendinopathy, osteoarthritis and back pain.
This is the process by which cells in muscle/ tendon/ bone/ articular cartilage convert physiological stimuli into biochemical responses to promote healing and repair.
When you exercise this causes deformation in tissue cells by way of tensile, shear and/ or compressive loads. This triggers a number of chemical signals within and between cells.
Distant cells also register a change via cell-cell communication.
Genes are then upregulated and protein synthesis occurs ie more tissue is made.
In muscle this occurs via up-regulation of mechanogrowth factor, in tendon insulin like growth factor. This stimulates hypertrophy and matrix remodeling.
In articular cartilage chondrocytes are stimulated and in bone osteocytes are stimulated. This promotes new tissue formation.
The correct dose of exercise is however important. A net loss in collagen content (protein degradation) occurs after an effective exercise dose. This is followed by a net gain in collagen content (protein synthesis).
If we dive in too soon with another exercise stimulus we attenuate that adaptation.
We also want to ensure tissues are working in optimal ranges of movement, using the right contraction type, right load, executed using appropriate timing and as part of the overall kinetic chain. This will help ensure that tissue capacity is sufficient to cope with your specific movement and exercise demands.
We do this by way of a graded and progressive exercise program. Considering your functional and sporting demands.
Manual therapy and hands on treatment can be useful to provide some short-term pain relief. But they MUST be reinforced with an exercise program that enables you the opportunity to really adapt and recover.
In addition to stimulating tissue repair and remodeling, exercise therapy can also help in optimizing biomechanics and promoting exercise induced hypoalgesia/ pain relief.
So embrace your bodies own amazing capacity to heal and develop. Understand it and rehab it.