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Reading through many of the posts in the biomechanics forum I have often been struck by how the scientific focus on measurements of moments, forces, etc seems to dry up when if comes to explaining the mechanics of the injury.
The splat injury, eg hitting a fly with a hammer, is at one level easy to understand but the vaste majority of injuries presenting to the podiatrist are often very complex and difficult to understand (Why there and not an inch to either side? Why today and not yesterday or tomorrow? Why during the recovery and not during the major effort? etc).
Sometimes the explanation that the injury is the result of the application of forces greater than the tissue/structure, etc could tolerate, doesn't seem adequate.
Mechanobiology seems to be an approach which is likely to lead to more comprehensive, rational answers to etiology, pathology, therapy, etc.. of a whole range of pathologies across a broad spectrum of the podiatric domain, including callus and corn, diabetes, rheumatology, sports medicine.
I did a search of the site (Podiatry Arena) and found one reference to mechanobiology which suggests to me that the subject has not, so far, come within the focus of the profession.
Does podiatric mechanobiology exist? Is it separate from podiatric biomechanics?
Best wishes,
Bill
PS For those who, like me, are totally or relatively new to the subject I am attaching part of a definition taken from Wiki. The references or bibliography following the Wiki article make a good introduction to the subject.
Mechanobiology is an emerging field of science at the interface of biology and engineering. It focuses on the way that physical forces and changes in cell or tissue mechanics contribute to development, physiology and disease. A major challenge... is the understanding of mechanotransduction - the molecular mechanism by which cells sense and respond to mechanical signals.
A PDF copy that Karim Khan (Sports Doc) wrote on Mechanotherapy is attached from the BJSM.
It certainly is a really interesting topic and I think there will be much discussion about the process as clinicians and researchers attempt to work out what the right "dosage" is for particular tissues and injuries with regard to utilising mechnotransduction for rehabilitation. I suspect the process is quite subject specific though like most things we deal with....so working out the appropriate loading required to get the desired molecular remodelling may be tricky.
Regards,
Athol
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Reading through many of the posts in the biomechanics forum I have often been struck by how the scientific focus on measurements of moments, forces, etc seems to dry up when if comes to explaining the mechanics of the injury.
The splat injury, eg hitting a fly with a hammer, is at one level easy to understand but the vaste majority of injuries presenting to the podiatrist are often very complex and difficult to understand (Why there and not an inch to either side? Why today and not yesterday or tomorrow? Why during the recovery and not during the major effort? etc).
Sometimes the explanation that the injury is the result of the application of forces greater than the tissue/structure, etc could tolerate, doesn't seem adequate.
Mechanobiology seems to be an approach which is likely to lead to more comprehensive, rational answers to etiology, pathology, therapy, etc.. of a whole range of pathologies across a broad spectrum of the podiatric domain, including callus and corn, diabetes, rheumatology, sports medicine.
I did a search of the site (Podiatry Arena) and found one reference to mechanobiology which suggests to me that the subject has not, so far, come within the focus of the profession.
Does podiatric mechanobiology exist? Is it separate from podiatric biomechanics?
Best wishes,
Bill
PS For those who, like me, are totally or relatively new to the subject I am attaching part of a definition taken from Wiki. The references or bibliography following the Wiki article make a good introduction to the subject.
Mechanobiology is an emerging field of science at the interface of biology and engineering. It focuses on the way that physical forces and changes in cell or tissue mechanics contribute to development, physiology and disease. A major challenge... is the understanding of mechanotransduction - the molecular mechanism by which cells sense and respond to mechanical signals.
Wikipedia
Bill, Athol and Colleagues:
I can't really get excited that the term "mechanobiology" is really anything more than something that the International Biomechanics Community has already been researching and writing papers and books on for at least the past half century. Just because we haven't talked about it much here on Podiatry Arena doesn't mean it doesn't exist.
For example, when I was doing my STJ axis research at Penn State eight years ago, the head of the Penn State Biomechanics Lab, Neil Sharkey, PhD, was doing most of his research on the cellular response of mouse bone to genetic influences, stress, hormones, exercise etc using a very expensive micro-computed tomography unit that could examine the microscopic structure of bone.
One of the problems with this field is that it is highly specialized and assumes an understanding of cell physiology, response of the cellular tissues to mechanical stimuli, hormones and other factors and a good idea of how forces, stresses and strains are transmitted internally within the body's musculoskeletal components during exercise, rest and, even, during weightlessness. Finite element analysis is critical for understanding how stresses and strains are transmitted within the body's tissues. If you want to learn more about these issues, I suggest you read outside Podiatry Arena, since there is a whole "non-podiatry" world of biomechanics out there...if you only take the time to look for it.
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I attached a piece from the BJSM recently. The authors are some friends of mine here in Northern Ireland. They talk about an update being needed for the 'PRICE' acronym to include 'optimal loading' for accelerated rehabilitation using the mechanotherapy theory. So POLICE instead of PRICE. The rest component is removed.
Bleakley et al. published a study on accelerated lateral ankle sprain rehab to back up the theory. (Will try and post later).
I hope a better understanding of loading and subsequent tissue remodelling on a molecular level will help accelerate the rehabilitation of other injuries we commonly deal with in the future. One thing I have noticed as a result of the mechanotherapy papers published lately is the physios I work with moving away from using machines to add energy to injured tissue and a move towards mechanical therapy or modified early loading of the injured tissue. Specific adaptation to imposed demand make sense to me.
I attached a piece from the BJSM recently. The authors are some friends of mine here in Northern Ireland. They talk about an update being needed for the 'PRICE' acronym to include 'optimal loading' for accelerated rehabilitation using the mechanotherapy theory. So POLICE instead of PRICE. The rest component is removed.
Bleakley et al. published a study on accelerated lateral ankle sprain rehab to back up the theory. (Will try and post later).
I hope a better understanding of loading and subsequent tissue remodelling on a molecular level will help accelerate the rehabilitation of other injuries we commonly deal with in the future. One thing I have noticed as a result of the mechanotherapy papers published lately is the physios I work with moving away from using machines to add energy to injured tissue and a move towards mechanical therapy or modified early loading of the injured tissue. Specific adaptation to imposed demand make sense to me.
Hope you have a smooth flight over. I'm looking forward the the BSS in Manchester in a few days!
Athol
Athol:
See you in a few days.
Personally, I think that the advent and increased utilization of MRI scanning in injuries and in pre-screening for injuries in elite athletes is giving us a much better appreciation of what is happening at the cellular level, especially in the case of the stress reaction or stress phenemenon in bone. The lecture I am currently polishing up for BSS while on layover here in DC will discuss the cellular level injury at the medial tibial cortex and tie it in with MRI and with bone physiology to explain the process we know as medial tibial stress syndrome and medial tibial stress fracture.
Here is one of the "must read papers" that I will be talking about on Friday at BSS 2012. Anyone got a pdf copy for everyone to read before the seminar?
Quote:
Am J Sports Med. 1995 Jul-Aug;23(4):472-81.
Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system.
Fredericson M, Bergman AG, Hoffman KL, Dillingham MS.
Source
Department of Functional Restoration, Stanford University Medical Center, CA 94305, USA.
Abstract
Medial tibial pain in runners has traditionally been diagnosed as either a shin splint syndrome or as a stress fracture. Our work using magnetic resonance imaging suggests that a progression of injury can be identified, starting with periosteal edema, then progressive marrow involvement, and ultimately frank cortical stress fracture. Fourteen runners, with a total of 18 symptomatic legs, were evaluated and, within 10 days, referred for radiographs, a technetium bone scan, and a magnetic resonance imaging scan. In 14 of the 18 symptomatic legs, magnetic resonance imaging findings correlated with an established technetium bone scan grading system and more precisely defined the anatomic location and extent of injury. We identified clinical symptoms, such as pain with daily ambulation and physical examination findings, including localized tibial tenderness and pain with direct or indirect percussion, that correlated with more severe tibial stress injuries. When clinically warranted, we recommend magnetic resonance imaging over bone scan for grading of tibial stress lesions in runners. Magnetic resonance imaging is more accurate in correlating the degree of bone involvement with clinical symptoms, allowing for more accurate recommendations for rehabilitation and return to impact activity. Additional advantages of magnetic resonance imaging include lack of exposure to ionizing radiation and significantly less imaging time than three-phase bone scintigraphy.
Here is a pdf on MRI pre-screening of tibial stress reaction injuries from a few of the same authors.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I suppose that having just discovered mechanobiology I am like a kid with a new toy.
Thanks for your attachments, as the actress said to the Bishop.
Best wishes,
Bill
Bill,
Maybe it`s the cocktail of codeine and amotriptoline I`m on (for a dose of the band of roses from hell), but your recent jocular posts put a smile on my pain riddled face
Here is one of the "must read papers" that I will be talking about on Friday at BSS 2012. Anyone got a pdf copy for everyone to read before the seminar?
I`ll second that. Looking forward to your lecture, Kevin.
Here is one of the "must read papers" that I will be talking about on Friday at BSS 2012. Anyone got a pdf copy for everyone to read before the seminar?
Attached.
See you guys on Friday
(or maybe Thurs at the bar A-hole? Text me when you're there)
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(or maybe Thurs at the bar A-hole? Text me when you're there)
Thanks for the paper, Ian. Pam and I are already here at the Manchester Hilton, currently at the 23rd floor Executive Lounge enjoying some drinks and a great view of the lovely city of Manchester. See you Friday.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
This whole discussion rather reminds me of an annecdote from my academic mentore (Professor Charles Oxnard) - about the time he attended an engineering mechanical principles course at The University of Salford (Manchester). All the other delegates were there with box girder bridge issues, or similar. He arrived with a bag of still bloody butchers bones. He came away having coined the phrase "the three dimensional tyrany of cancellous bone morphology".
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
Coming over Early Friday morning this time Griff so catch you then.
Athol
Jealous. Have a beer for me folks
__________________
I see you girls checkin' out my trunks
I see you girls checkin' out the front of my trunks
I see you girls lookin' at my junk, then checkin' out my rump, then back to my sugarlumps
Maybe it`s the cocktail of codeine and amotriptoline I`m on (for a dose of the band of roses from hell), but your recent jocular posts put a smile on my pain riddled face
Cheers,
Bel
Thanks Bel.
This time it has just been by chance that my humour has matched your illness and your prescription.
Next time you are ill if you could let me know before hand the nature of the illness and the prescription I will attempt to match them with the humour.
Best wishes,
Bill
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Having recently found this thread as I discovered mechanobiology, I am intrigued by the fact that although most papers on this subject involve cellular level research, the definition includes "tissues". Many of these papers involve cellular structure as well as the need to engineer it.
I'm theorizing that human mechanobiology would be a science that combines structure in the form of architecture with biomechanics (as you would like to define it) and the need to engineer a living structure.
Would practicing mechanobiology force us to interject more architecture into Biomechanics as you claim to have some interest in structure and position but not enough for me.
The terminology also concedes that we are effecting our engineering upon a biological structure and not some metal hinge or wooden bones and toes reducing the import of engineering diagrams and newton's primary laws which aren't always obeyed biologically. A bird defies Newton's Primary Law of Inertia when dropped from a height by flying in the opposite direction using secondary laws of aerodynamics.
As in cellular mechanobiology, human mechanobiology would allow tissues and structures to be studied for the purpose of prevention, performance enhancement and quality of life upgrading instead of waiting for a complaint as in TS.
Dennis
Mechanobiology
Linear Mode
