Biophysical Stimulation in Athletes’ Joint Degeneration: A Narrative Review

Abstract

Osteoarthritis (OA) is the most prevalent degenerative joint disease and the main cause of pain and disability in elderly people. OA currently represents a significant social health problem, since it affects 250 million individuals worldwide, mainly adults aged over 65. Although OA is a multifactorial disease, depending on both genetic and environmental factors, it is reported that joint degeneration has a higher prevalence in former athletes. Repetitive impact and loading, joint overuse and recurrent injuries followed by a rapid return to the sport might explain athletes’ predisposition to joint articular degeneration. In recent years, however, big efforts have been made to improve the prevention and management of sports injuries and to speed up the athletes’ return-to-sport. Biophysics is the study of biological processes and systems using physics-based methods or based on physical principles. Clinical biophysics has recently evolved as a medical branch that investigates the relationship between the human body and non-ionizing physical energy. A physical stimulus triggers a biological response by regulating specific intracellular pathways, thus acting as a drug. Preclinical and clinical trials have shown positive effects of biophysical stimulation on articular cartilage, subchondral bone and synovia. This review aims to assess the role of pulsed electromagnetic fields (PEMFs) and extracorporeal shockwave therapy (ESWT) in the prevention and treatment of joint degeneration in athletes.

Joint Cartilage in Long-Duration Spaceflight

“…Extracorporeal shock wave therapy (ESWT) applies single pressure waves to promote biological healing processes through mechanotransduction. It was shown to improve cartilage and subchondral bone characteristics in OA [ 102 ]. Pulsed electromagnetic fields (PEMFs) were also shown to have positive effects on articular cartilage, subchondral bone, and synovia [ 102 ].…”

“…It was shown to improve cartilage and subchondral bone characteristics in OA [ 102 ]. Pulsed electromagnetic fields (PEMFs) were also shown to have positive effects on articular cartilage, subchondral bone, and synovia [ 102 ]. Just as LIPUS, both methods have not been used in spaceflight or analogue studies and might potentially be of interest as countermeasures during long-duration spaceflight in case of cartilage degeneration if conventional exercise does not suffice.…”

Challenges and Solutions for Musculoskeletal Disorders in Athletes

“…This latter is a topic of growing interest, considering that vitamin D modulates several functions of skeletal muscles, including tissue repair after injury, through vitamin D receptor expressed in satellite cells, and that vitamin D deficiency, reported also in athletes, results in fast-twitch fiber atrophy, fatty infiltration, and fibrosis. Finally, the Special Issue addresses commonly used non-pharmacological interventions for sport related MSK injuries, including therapeutic exercise and physical agent modalities for the management of EOA [18][19][20]. The development of EOA is a cause of concern for all people involved in sport practice, even if many open questions remain about its definition, natural history, and diagnostic criteria with relevant issues also in term of treatment strategies and timing of interventions [21].…”

The Influence of Athletes’ Age in the Onset of Osteoarthritis: A Systematic Review

“…13,14 Chondral injuries are often present in younger athletes, and can lead to early-onset OA. 15 Moreover, cartilage injuries are not always symptomatic: more than half of asymptomatic athletes have a full-thickness defect. 16 Traumas are also frequent in sports, and exert an important impact in the pathogenesis of OA.…”

“…Sports which involve twisting, turning, and jumping impart high stress to the joints, which may accelerate the onset of OA 13,14. Chondral injuries are often present in younger athletes, and can lead to early-onset OA 15. Moreover, cartilage injuries are not always symptomatic: more than half of asymptomatic athletes have a full-thickness defect 16.…”