Whenever one observes damage development in a material exposed to repeated mechanical stress, there is one mechanism that comes to mind that would explain how and why this damage is occurring. This process is, of course, material fatigue failure. Fortunately, the fatigue failure theory has been around since the 1840s, and much is known regarding the response of materials to repeated stress (Stephens, Fatemi, Stephens, & Fuchs, 2001). However, the fact that musculoskeletal tissues are located in a dynamic biological environment, in which exposed materials have a healing capacity, provides an important wrinkle in the development of biological tissue damage. This provides us with competing processes that will control musculoskeletal tissue damage development. Unless some new and unique mechanism of damage development from repeated stress is discovered that applies only to biological materials, we must assume the damage part of the equation is controlled by the mechanism of fatigue failure. We know certain aspects regarding the healing portion of the equation, as well, but much more needs to be learned.
This book examines the development of MSDs as a process of fatigue failure of musculoskeletal tissues, but one modified by complex physiological and biochemical processes (including, but not limited to, tissue healing). To our knowledge, no one has considered such an approach toward understanding the causes of musculoskeletal tissue damage nor for understanding how we might better control MSDs and improve overall musculoskeletal health. We acknowledge at the outset that there is much yet to be learned about this extremely complex process. However, there is much that is known, which may improve our understanding regarding the development and control of MSDs.
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