New Ideas on the ‘Cell’ and Implications for Musculoskeletal Medicine

“Once you learn to quit, it becomes a habit.   – Vince Lombardi

From the American Association of Orthopaedic Medicine Conference, April 19th, 2012

Donald Inger (MD, PhD, Harvard Pathologist, Researcher), gave a compelling lecture entitled, “Tensegrity, Mechanotransduction and Regenerative Medicine”. He talked about how the cell is constructed more like a “tent” with continuous tension holding it up which is contrary to conventional ideas we learned in medical school on how the cell is constructed “like a balloon” of chemicals. Inger shows through his experiments that mechanical forces are as important as chemical/genetic factors in determining the fate of a cell. Without the appropriate amount of tension and compression of the cells’ micro-structure – also known as “tensional integrity” – there is programmed cell death. Therefore, development and cellular growth is an interaction between the mechanical forces, mechano-transduction and chemical/genetic elements.

Now, that’s a mouthful…

So, what are the implications of this paradigm shift in our thinking on the construction of the cell which is seen in virtually all of the sub-specialties in medicine? In the area of orthopaedic medicine, this concept is echoed in the reports of researcher David Rabago, MD at the University of Wisconsin, Madison, who says prolotherapy together with exercise approaches for musculoskeletal pain (for example, chronic mechanical low back pain, or recalcitrant tennis elbow) are thought of as a “whole protocol”, supporting the notion and importance of mechano-transduction or the mechanical input to be performed in conjunction with prolotherapy treatments to have a successful outcome for the patient.

What does this mean to patients ?  The slogan for the American College of Sports Medicine (ACSM) pretty much sums it all up: “Exercise is Medicine”. Yes, movement, the mechanical operation of joints, tendons, ligaments, and muscles… all make a vast difference in sustained, cellular health. In other words, along with prolotherapy or OMM, your physical therapist and your daily physical workout commitments are key in supporting our treatment for your full recovery.

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