The presence of physiological stress shielding in the degenerative cycle of musculoskeletal disorders

The health of physiological tissue is governed by the continuous conversion of mechanical stimulus (stress) to bio-chemical response, a concept known as mechanical homeostasis. If this regulatory imperative becomes flawed, it may be detrimental, and consequently invoke or encourage the progression of various musculoskeletal disorders. This notion is corroborated by the quantification of altered function and irregular mechanical properties found within the articulations of such phenotypes as cerebral palsy. Although the divergence from healthy to irregular tissue behavior is likely multifactorial, the presence of imbalanced mechanical properties may promote the concept of physiological stress shielding. Extrapolating upon the stress shielding phenomenon may allow inferences to be drawn with respect to the pathomechanisms of progressive disorders. Further, recognition of this association may also provide a new platform from which to interpret the impact of conventional treatments aimed at such syndromes and, in turn, perhaps support new therapeutic avenues. (C) 2010 Elsevier Ltd. All rights reserved.