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What on Earth is Mechanotherapy?


"It’s why your muscles get stronger (and grow) when you lift weights, and why astronauts all get osteoporosis while in space, and it’s one of the biggest keys to your recovery from pain and injury!"


Your body is in a constant state of balance and change, with a constant turnover of cells and chemicals. It’s always turning over old cells and replacing them with new ones. For example, did you know that you get a completely new skeleton every 7 years!?! (This is actually true, as your body will turn over calcium in the cells gradually, so by about 7 years it will have turned over all the calcium in your bones, therefore having an entirely new set of calcium ions making it up about every 7 years)


The term “Mechanotransduction” describes an ongoing vital process in the body (just as breathing and circulation). When we breathe we are constantly replacing Carbon dioxide for new oxygen. With mechanotransduction you body is in a constant state of flux with it’s physical and connective tissues. Responding to the world around us to maintain optimal levels of connective tissue required for activity. We respond to load and stimulus, and this makes our body adapt and remodel.


Mechanotherapy is simply "the employment of mechanotransduction for the stimulation of tissue repair and remodelling".

Put simply, it is the use of load and mechanical stress to help us heal, repair and strengthen... And therefore reduce pain and improve function.


Now your body is also a little bit lazy – as in it is entirely designed to conserve as much energy as possible. Because of this, your tissues (bones, muscles, ligaments) will only be as strong/dense as they need to be to do whatever you do all the time.


As the old saying goes “use it or lose it”


And this is absolutely true in the human body.


We all know that if we lift weights and do strengthening exercises, we get stronger and our muscles will grow. If we stop doing these things for a period of time, then our muscles start to lose mass.


This is also why astronauts get osteoporosis. In space (a zero gravity environment) there is no load on any of your tissues. Because of this, all your tissues start to atrophy (waste away). Muscles start to waste and bones get weaker and lose density.


And Why??? Because in the absence of load, there is no stimulus to adapt and maintain your tissues, so they weaken (remember your body is trying to conserve energy, so it won’t waste any more than it has to on making new bone and muscle).


(There was a study apparently performed by NASA to measure the effects of complete bedrest on the human body, to try and simulate the effect of zero gravity. Among other things they found that the human body would lose 1-2% of muscle mass PER DAY with complete bed rest! This is very important in the context of recovery from injury and illness if we let people lay around in bed too long).


Now it’s not just your muscles that respond to the load placed on them. All the tissues in your body can respond to loading to encourage them to become stronger (or more resistant to force and load)


We know that as well as muscle, your tendons (that attach your muscle to your bones) also get stronger with load training (strengthening, etc). This in terms can make them less prone to pain and injury.


Now this is where it gets really important to understand the benefits of load – even your joint cartilage can benefit from loading to promote healing, remodelling and adaptation.


Yes, even if you already have arthritis, the careful and systematic application of loading through therapeutic exercise can help to make your cartilage stronger, and in turn less painful.


This is one of the keys to the benefits of exercise for painful conditions like arthritis. Despite the fact that, for years, the common advice was to do less and avoid activity. While exercise does also strengthen muscle and this is important for arthritis pain too, the actual changes you can make to the cartilage with the correct exercise is amazing!


Now exercise won’t magically cure your arthritis so your x-ray looks like a 20-year-old again. What you can expect is improved resilience and tolerance to load and activity. This means you are able to do more with less pain. And isn’t’ that really what everyone wants? Arthritis isn’t about how it looks, but how it feels and what you can do.


So, what this means for everyone out there is

1.       If you don’t use it, you’ll lose it!

2.       The correct exercise and strengthening are an effective treatment and healing modality in itself for many types of conditions

3.       Load and exercise are highly beneficial for many painful conditions, and is actually very effective in reducing pain.

4.       Avoiding activity, and bed rest, is actually pretty bad for you. Unless necessary, you should try and maintain a certain level of activity no matter what is going on.

5.       If you already have osteoporosis, perhaps a career as an astronaut isn’t the best choice


Julian Bowen


Julian is a Director and manager at BodyWise Physiotherapy.  He has spent  over 13 years working exclusively in private physiotherapy practice, and estimates he has performed close to 40,000 individual treatments in that time. He has worked with everyone from Paralympians,  elite athletes, WAFL Footballers, the Defence Forces and weekend warriors, to thousands of everyday people with all manner of issues.  He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries. 



References:

Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair

British Journal of Sports Medicine 2009;43:247-252.