Mechanotransduction: The Importance of Stress on Tissue Repair

• Autor(a) principal: Lima, Luís; Centro Médico de Aveiro, Aveiro, Portugal
• Data de Publicação: 2017
• Outros Autores: Jesus, Diva; Serviço de Medicina Física e de Reabilitação, Hospital da Senhora da Oliveira, Guimarães, Portugal, Lima, Ana; Medicina Geral e Familiar, USF Alto da Maia, ACES Maia/Valongo, Portugal, Ermida, Vera; Serviço de Medicina Física e de Reabilitação do Centro Hospitalar Tondela-Viseu, Viseu, Portugal, Pacheco, Adriana; Escola Superior de Educação Física - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil, Pacheco, Ivan; Diretor Médico da Federação de Futebol do Rio Grande do Sul, Brasil, Caldas, Jorge; Serviço de Medicina Física e de Reabilitação do Centro Hospitalar Tondela-Viseu, Viseu, Portugal
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.254
• topic: Mechanotransduction, Cellular; Regeneration; Stress, Mechanical; Wound and Injuries; Lesões; Mecanotransdução Celular; Regeneração; Stresse Mecânico

In clinical practice, it is usual for clinicians to recommend rest for several days up to weeks following a sports injury. The athlete is frequently advised to remain inactive beyond the acute inflammatory period, often starting rehabilitation several weeks after the injury. Prolonged inactivity is not usually the adequate treatment for muscle, tendon, ligament and cartilage injuries, whether chronic or acute. An extended period of total suspension of the normal mechanical load decreases the structural tissue resistance and may induce acute or chronic lesions when resuming normal sports activity.In musculoskeletal system pathological conditions, it is important to introduce at an early stage the exact benefic load since excessive or scarce loads may be injurious. In acute lesions, mechanical stress should take place soon after bleeding control and the initial inflammatory stage. The mechanical stimulus’ role on the regulation of cellular and matrix components proliferation and maintenance is important not solely in the bone (as described more than a century ago in Wolff’s law), but in all living tissue, including skin, neural tissue, hematopoietic and musculoskeletal systems. The anabolic and catabolic cellular activity is also regulated by mechanical stress on the cell surface. The conversion process of a mechanical signal in a chemical or biological response is called mechanotransduction.In this narrative review, the authors address several typical sports injuries affecting different tissues in the musculoskeletal system, for which prolonged rest, although often recommended, has been shown not to be the most appropriate treatment. Finally, they put forward treatment proposals in which the initial rest is replaced by the exact beneficial load, in light of mechanotransduction’s principles.