Karim Khan

henninglangberg.files.wordpress.com
  • No tags were found...

Patellar tendinopathy - the VISA experience - Henning Langberg

Karim Khan

MD, PhD, FACSP


Is this presentation for you?


How does the body

adapt to load?


4 steps to understand

mechanotransduction


Well-


Gap Junctions

Cadherins


Ion Channels

Surface Receptors

Caveolae


Ion Channels

Gene Expression

Chromatin

Nuclear Lamina



Integrins

Focal Adhesions


Microfilaments

Microtubules

Intermediate

Filaments



Collagen

Proteoglycans

Fibronectin

Basement

Membrane


Reminder of where we are!


4 steps to understand

mechanotransduction


Mechanotransduction


Case:

How do the squat

exercises work ?


Consider our

patient with

Achilles tendon

pain as just one

example


Consider our


1. Mechanocoupling


t = before

contraction

or heel drop


Shear on cell

with heel

drop


That was


4 steps to understand

mechanotransduction


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The heel drop stimulates integrins

to flip and this triggers signaling

pathways


The nucleus is signaled to create

mRNA


The nucleus is signaled to create

mRNA


The nucleus is signaled to create

mRNA


The nucleus is signaled to create

mRNA


The nucleus is signaled to create

mRNA


The nucleus is signaled to create

mRNA


Ribosomes create protein

Ribosomes


Ribosomes create protein

Ribosomes


Collagen extrudes from matrix

Ribosomes


Collagen extrudes from matrix


Collagen is repaired


4 steps to understand

mechanotransduction


Communication

is biochemical

via Ca & IP 3


Summarising Tendon cell-cell


Tendon cells




they love to

communicate!


Summary of

mechanotransduction


Would you please indulge

me a one-slide animation


loading

mechanotransduction?


Marrow

cavity

(posterior)

Anterior shin


Brief recap of the effect of

mechanotherapy on tissues


Inappropriate load:

Too much or too little

Normal

tissue

Complex regulatory

processes involve IGF-‐1,

TGF-‐-‐6, VEGF,

neuropeptides, etc.

Pathological

Promotes: Cell

proliferation, protein

synthesis, ideal proportions

of extracellular matrix

Appropriate load:

Promotes tissue repair (mechanotherapy)


Practical question


Pain monitoring model

0 5 10


Last 5 slides


All credible but how confident are you?


0 5 10


Google


How does exercise work then?


Broadly applicable

More magazines by this user
Similar magazines