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The musculoskeletal system generates, absorbs and transmits force, enabling functional movement. Given this mechanical role, it follows that musculoskeletal tissues adapt to mechanical demands. Mechanical forces direct musculoskeletal cellular activities, altering tissue mass, structure and/or quality (figure 1).1 The net result is altered tissue-level stresses and strains to applied loads and, subsequently, altered injury risk.
Therapists have long identified the therapeutic potential of mechanical forces. Nearly every rehabilitation intervention introduces mechanical forces, irrespective of whether they are generated extrinsically (eg, via external modalities) or intrinsically (eg, via physical activity). These ‘mechanotherapies’ harness musculoskeletal mechanosensitivity to induce adaptation; however, how the adaptation occurs remains underappreciated.
Khan and Scott2 previously introduced readers of BJSM to the concept of mechanotransduction, whereby biophysical forces are converted into cellular and molecular responses. For …
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