According to the World Health Organization musculoskeletal (MSK) conditions affecting muscles, bones, joints, and related tissues are the leading contributors to disability worldwide, impacting over 1.7 billion people. These conditions, including osteoarthritis, back and neck pain, and injuries, can limit mobility and reduce quality of life, particularly as populations age.
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.
Autoren
,B. Pharm, Cert IV TAE, is the Director and Founder of PainWISE. A multiaward-winning clinical pharmacist, educator, and pain management innovator, she is the former President of the Australian Pain Society and a Fellow of the Pharmaceutical Society of Australia. Joyce is recognised nationally and internationally for pioneering cost-effective health pathway designs and value-based care models, with a decade of collaborative partnerships alongside the Australian Department of Health.
BSc (Biotechnology), Hons., PhD is a medical communications specialist, Director and Founder of Panwar Health. She has a long-standing interest in translational pain research and education.
ist Diplom-Sportwissenschaftler mit Professional Master’s Degree in Sports Medicine sowie postgradualen Weiterbildungen in Mind-Body-Medizin (Harvard Medical School), Psychoneuroimmunologie und Lifestyle Medicine (American College of Lifestyle Medicine); Verleger der sportärztezeitung.
is a certified sports scientist with a professional master's degree in sports medicine and postgraduate training in mind-body medicine (Harvard Medical School), psychoneuroimmunology, and lifestyle medicine (American College of Lifestyle Medicine); publisher of the sportärztezeitung.
is Professor of Musculoskeletal Biology in the Research Unit of Health Sciences and Technology, within the Faculty of Medicine at the University of Oulu in Finland. He is a Past President of the Osteoarthritis Research Society International (OARSI).
