Despite their prevalence and personal, societal, and economic burden, MSK conditions are often under-recognized in health policy and care strategies. Prevention, early diagnosis, and effective management, including self-care and physical activity, are essential to reduce disability and support lifelong musculoskeletal health. This is not only important in the context of MSK health in ageing, but also in MSK health in sports and exercise. 

Reframing rehabilitation through self-care and self-healing

In sports medicine, we often focus on physical therapy, pharmacological support, and rehabilitation. But what if one of the most powerful tools in recovery isn’t external, but internal? A growing body of research suggests that activating the body’s self-healing mechanisms, especially in the subacute post-injury window, may reduce pain chronicity, accelerate recovery, and enhance long-term resilience [1 – 3].

“Self-healing is the body’s natural ability to activate interconnected physiological, neurological, and psychological systems to support tissue repair, restore balance, and build resilience, especially in the early post-injury phase.”

This idea, grounded in a biopsychosocial understanding of pain, has profound implications for treating patients with MSK pain. However, it can also benefit athletes and sports professionals. How­ever, it is important to point out that general recommendations in sports medicine regarding exercise, nutrition, and mental health lack precision. Crucially, the distinction between prevention and therapy is frequently not clarified. These are fundamentally different goals: what may work well for prevention, such as eating plant-based proteins, might be insufficient or potentially even misleading when applied as therapy unless it is carefully tailored. Therapy must be contextual, targeted, and patient-centered, a lesson that lifestyle medicine needs to teach more clearly. To this end, we need guided medical education and re-education for both therapists and athletes to ensure effective implementation.

Why chronic pain persists and how to prevent it

MSK pain is common in athletic settings. Most acute injuries heal with time. Yet, up to 50 % of cases develop into chronic pain syndromes, often without clear structural cause. Advanced imaging frequently fail to correlate with symptom severity in many musculoskeletal conditions. That’s because chronic pain isn’t just about injury; it’s about nervous system sensitization, inflammation, stress, psychological vulnerability, and social context. This shift in understanding opens up a new approach: empowering individuals to not only manage symptoms but actively restoring physiological balance.

Self-care, self-management and self-healing

The terms self-care and self-management are well known in consumer healthcare, healthcare and rehabilitation. But a third pillar is emerging: self-healing. This refers to leveraging the body’s natural systems to support repair, regulation, and resilience, particularly in the early post-injury phase before maladaptive pain pathways become entrenched.

Self-healing draws on five interconnected systems:

• Circulatory flow – Enhancing microvascular exchange to accelerate tissue regeneration.
• Nervous system balance – Reducing sympathetic overdrive through parasympathetic activation (e. g. vagal stimulation, breath control).
• Muscular tension regulation – Promoting mobility and reducing stiffness that worsens pain input.
• Inflammation resolution – Supporting the natural arc of inflammation with­out premature suppression.
• Psychological coping – Addressing fear, catastrophising, and emotional dysregulation that fuel chronicity.

The athletic opportunity: bridging the gap between MSK injury and pain chronicity

For athletes and active individuals, this presents a crucial window of opportunity. Many rehab protocols begin at the level of physical function, range of motion, strength, conditioning and proprioception. But recovery isn’t just mechanical. It’s physiologically integrative, incorporating neuroimmune, hormonal, perceptional, emotional, and behavioural aspects. Integrating self-healing strategies early can support more complete recovery, especially when applied in parallel with sport-specific rehabilitation.

Key interventions include

• Graded corrective movement and load management to encourage safe reactivation of tissues and prevent re-injury.
• Thermotherapy, hydrotherapy, and manual lymphatic drainage to facilitate perfusion and waste removal.
• Mind-body techniques such as breath training, biofeedback, and mindfulness to recalibrate stress responses.
• Nutritional strategies targeting inflammation and supporting the gut–immune–brain axis.
• Gait retraining and neuromuscular re-education through motor learning and skill acquisition.
• Electromyostimulation in selected cases to enhance coordination with­out joint overload.

Movement as medicine – but smarter

Exercise remains the cornerstone of MSK rehabilitation, but not all movement is healing. When pain is persistent, central sensitization can make even light exercise uncomfortable. That’s why graded exposure, motor control retraining, and sensorimotor integration techniques supported by visual feedback or coaching are so valuable. However, personalisation in this area is crucial and a “one-size-fits-all” rehabilitation approach does not work for pain that’s embedded in a person’s biology, psychology, and lifestyle.

Self-healing as a paradigm shift: supporting athletic recovery from within

Ultimately, the self-healing framework extends the goals of rehab. It’s not just about “fixing what’s broken” or “getting back to sport.” It’s about cultivating an adaptive reserve physiological, emotional, and behavioural so that the body and brain are better prepared for stress, re-injury, or high-load performance. For sports medicine professionals, this means encouraging athletes to be active participants, not passive recipients, problem solving towards their own recovery. It requires integration of tools and medical devices that support circulatory, neurological, inflammatory and emotional balance. It also incorporates education and self-efficacy into every treatment plan.

In the opinion piece “Mind-Body Medicine Completes Sports Medicine”, one of the authors has previously argued for a broader, more integrated vision of sports medicine, one that doesn’t wait for injury, but proactively strengthens the athlete. He proposes a preventive health model that combines mind-body techniques, stress regulation, physical training, and nutrition to build resilience before breakdown occurs. This “prehabilitation” concept promotes whole-body health and self-awareness as foundational components of modern sports medicine.

A foundational prelude such as the prehabilitation concept supports the inte­gration of self-healing in the whole path­way of sport recovery.

Conclusion

In conclusion, we propose that self-healing is an important part of sport recovery. In our view, self-healing isn’t a mystical concept. It’s a science-grounded and evidence-based call to action to optimise the body’s internal systems during the critical acute and subacute phase, before chronic pain sets in. There are opportunities for applying this concept for patients and athletes alike, as it offers a way to return not just to physiological homeostasis but also to high performance that is safe and sustainable, overall contributing to injury-resilient health. As the demands on the modern athlete evolve, so too must our strategies. It’s time we look inwards for patients and athletes alike.

References

1. McSwan J, Gudin J, Song X-J, Grinberg Plapler P, Betteridge NJ, Kechemir H, et al. Self-Healing: A Concept for Musculoskeletal Body Pain Management – Scientific Evidence and Mode of Action. J Pain Res. 2021 Sep 21;14:2943–58.

2. Mobasheri A. “Self-Healing”: A Novel and Integrated Multimodal Concept for the Management of Musculoskeletal Pain. J Pain Res. 2022 Nov 1;15:3479 – 82. 

3. McSwan, J, Panwar CE, Mobasheri A. Looking Inwards: The Role of Self-Care, Self-Management and Self-Healing in Musculoskeletal Pain. Musculoskeletal Care 2025: e70169. https://doi.org/10.1002/msc.70169.

However, we have become too reliant on prescription medicines and over-the-­counter painkillers. We desperately need alternative and drug-free solutions for pain management. But what if our bodies have an inheret and built-in capacity to heal without drugs? This concept of “self-healing” is gaining traction, and it‘s one that athletes and fitness enthusiasts should begin to pay serious attention to.

The “Self-Healing” Concept

Musculoskeletal (MSK) conditions, including LBP, OA and other forms of joint disease, affect millions of people globally and are leading causes of physical disability. Traditionally, treatments have focused on medications that relieve pain but often come with unwanted side effects. In contrast, “self-healing” shifts the focus to harnessing the body’s own repair systems – working in harmony with the body, not just against symptoms, but in concert with physiological repair systems. “Self-healing” involves activating five key body networks: the nervous system, psychological mechanisms, immune response, microcirculation, and muscle function. By tapping into these networks, the body can naturally manage pain, heal tissues, and restore physiological balance.

Integrating Self-Healing in Sports and Physical Exercise

For athletes and those leading an active lifestyle, understanding how to promote self-healing can potentially be a game-changer. Exercise, mental focus, and nutrition already play pivotal roles in muscle repair, but integrating self-healing strategies into your fitness routine can enhance recovery and prevent injury. Physical activity and improved circulation: Light, consistent exercise promotes blood flow, which carries oxygen and nutrients to tired and damaged tissues. Whether it’s stretching, yoga, or light cardiovascular work, maintaining circulation is key to promoting the self-healing process. Relaxation and nervous system activation: Engaging in activities like meditation, breathing exercises, or simply taking a break can activate the parasympathetic nervous system (the “rest and digest” system), which fosters cellular repair and tissue recovery. This is particularly useful after intense training sessions.

Mind-body exercises: Techniques like cognitive-behavioral therapy (CBT), visualization, and mindfulness reduce stress hormones, such as cortisol, and pro-inflammatory mediators which are known contributors to musculoskeletal degeneration and pain. Mental stress often manifests as muscle tension, and addressing this link through psychological strategies can enhance physical healing. Natural remedies and diet: ­Nutrition is another critical aspect of self-healing. A balanced diet rich in anti-inflammatory foods – like fruits, vegetables, and healthy fats – supports immune function and muscle recovery. Additionally, supplements like omega-3s and curcumin have shown promise in reducing pain and inflammation.

A Holistic Shift in Pain Management

For many years, MSK pain has been managed primarily through the use of prescription and over the counter pharmaceuticals, but the rise of self-healing suggests a broader, more integrative and multidisciplinary approach. Whether you’re an athlete recovering from an injury or dealing with chronic pain from LBP or OA, understanding the interplay between physical, mental, and immune health can significantly affect your healing journey. There is increasing evidence to support the integration of multidisciplinary and multimodal management for MSK pain. This creates a unique opportunity for healthcare professionals to come together and collaborate for the benefit of patients with MSK pain.

In conclusion, “self-healing” is more than just a concept – it‘s a call to action to optimize your body‘s natural, inherent and physiological capabilities. By incorporating multimodal and multidisciplinary strategies such as mental relaxation, proper circulation, immune support, and holistic remedies, you can achieve a more sustainable recovery, improve your performance, and lead a pain-free, active lifestyle. 

References 

1. McSwan J, et al. J Pain Res. 2021;14:2943-58; 

2. Mobasheri A. J Pain Res. 2022;15:3479-82.