by Bozhidara Georgieva

Humans evolved to move in all climatic conditions and geographical features, and to overcome hard physical challenges.

Thousands of years ago, people crossed Africa's savannahs and deserts, hunted in the frozen tundras and mountains of Ice Age Europe and Asia, discovered a route to North and South America and remote corners of the world such as Australia and New Zealand. Our musculoskeletal apparatus is adapted for such an active lifestyle, a perfect machine for survival.

But no matter how sophisticated this machine is, our lifestyle inevitably influences its performance. This became visible at the moment when people abandoned their life as hunter gatherers and started to settle down. The development of crafts such as pottery, weaving, construction, connected to spending long-hours in unnatural body position, started to influence human anatomy. Today archaeologists can easily deduct whether the inhabitants of some ancient settlement engaged in certain crafts by simply analysing the traces left by these on the people's bones.

The trend is also present among us, modern people. The only difference is that we don't sit in front of pottery wheels and weaving looms. Instead, we spend hours in front of the desktop or in the car, or lounged in front of the TV. Due to the peculiarities of our civilisation, we are much more immobile than the previous generations. And this is already visible in our musculoskeletal system. Deprived of systematic physical activity, it has started to adopt to sedentary living. Bad posture is only the beginning. A recent survey showed that people under 30 who spend a lot of time crouched over their smartphones develop a spike-like growth in the lower back of their skulls. This is the body's natural reaction to try to preserve its natural balance. According to another survey, in a couple of decades the elbows of teenagers have become narrower, a somewhat unexpected result of sedentary living.

The lack of adequate physical activity, which is so typical of modern people, is a serious factor for follow-up problems. Bones lose their strength faster and are more vulnerable to trauma due to insufficient muscle mass.

A significant part of the musculoskeletal problems affecting modern people are the result of the increased life span. Osteoporosis, for example, which is loss of bone density, is most common among elderly women. Arthrosis is the result of the wearing out of cartilage tissue and joints with time and movement, and is the most common type of joint inflammation. The lack of cartilage connected to it leads to a direct contact between the two bones and symptoms like pain, stiffness, swelling.

Until not that long ago patients suffering from types of arthrosis such as coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint), had to accept their condition and to stick to painkillers and antiinflammatory medicaments. Today people suffering of a grave stage of these conditions have a radical solution: replacement of the natural joint with an artificial one. This treatment used to take a lot of time and had risks of complications, but modern medicine found a way to perform the procedure with minimal blood loss and risks of complication, and fast recovery.

"Coxarthrosis and gonarthrosis are treatable and the surgeries are successful, says Dr Orlin Filipov, MD, specialist in endoprosthetics and reconstructive ortopaedy and chief doctor at Vitosha Hospital (Sofia, 108B Simeonovsko Shose Blvd, round-the-clock: 02/962 22 92, "With a surgery that lasts a little over an hour, the patient is freed from pain and soon returns to their normal life."

The search for effective noninvasive methods for treatment of serious conditions of the musculoskeletal apparatus is among the leading trends in modern medicine.

For 6 months now, Avis Medica Hospital (Pleven, 7 Kosta H Pakev, phone: 0888 508 049, successfully applies an innovative method for treatment of damaged cartilage tissue in the hip and knee joint. Developed by the Italian professor Antonio Graziano, the Rigenera method uses a small sample of the patient's ear cartilage, of which a micro-graft of vital cells and growth factors is extracted. "This suspension nourishes the damaged cartilage tissue, stimulates regeneration and restores cartilage tissues damaged by arthroses," explains Dr Robert Halvadzhiyan, MD, head of the Orthopedy and Traumatology Unit at Avis Medica. "The procedure is single and can be performed in outpatient care, if the requirements for sterile environment are met. The suspension is injected in the damaged joint, in the next 2 days the pain dies down and the patient is able to continue with their ordinary life. The cartilage is completely recovered after 6 months, when the patient can return to active sport." Dr Halvadzhiyan and Avis Medica orthopaedics team trained in the method in Torino and are impressed by the success of Rigenera. "Our experience in the past half year indicates to us that it should be the first choice before deciding on a hip and knee endoprosthetics," adds Dr Halvadzhiyan.

Sport and regular physical activity are one of the ways to reduce the risks of musculoskeletal problems. The benefits of physical activity can hardly be overestimated – increased immunity and tone, stronger bones, cardiovascular system in a good shape, reduced body weight and the health risks that come with it.

But sport also has risks for the ones who practice it professionally or for recreation. Sprain and strain of muscles and tendons, broken bones are common among people who exercise regularly. Some of the sport traumas are the result of strong and unfamiliar physical activity. Others, however, appear due to repetitive activity, such as tennis (or golf) elbow. In spite of its name, the condition does not affect only people who practice these two sports.

The increased number of physically active people globally inspired the development of modern sport medicine. Like other fields of medicine, it, too, is looking for ways to offer adequate and modern care, including noninvasive treatment.

"In contemporary sport medicine opportunities for nonsurgical treatment of traumas outnumber the ones 20 years ago," says Dr Encho Stoyanov, founder of Physio Sportiva Clinic for Sport Medicine (Burgas, Zornitsa, VIP Complex Perla, Block 2, Entrance 1, ground floor, phone: +359 877 325 461, "As in other fields of medicine, here, too, development is targeted towards benefits for the patient – less invasive treatment, but with good results. Let's not forget that 85% of traumas need no surgical intervention, but proper diagnostics and right approach in treatment, and not the usual advice 'Take these painkillers, apply this cream and you will be fine' that patients hear so often. Such an approach, however, only masks the problem," explains Dr Stoyanov. "The advantages of non-surgical treatment of sport trauma are manifold for the patient. It significantly reduces the recovery period. The patient gets 'back in the game' faster, including on the workplace. Thus they feel more adequate both to themselves and the others," adds Dr Stoyanov. "Physio Sportiva Clinic offers to its patients a variety of different therapeutic options for problems of the musculoskeletal system aiming at optimal regeneration of tissues and fast return to normal rhythm of life and physical activity. We are thankful to our many patients who trusted our experience and skills and who value what we do for them."

The combination of active lifestyle, reasonable exercising, healthy eating and maintaining an optimal body weight, and the most advanced achievements of medicine are a sure way to stay in good shape and to enjoy healthy musculoskeletal apparatus. Although our lifestyle predisposes us to suffer a number of diseases, we continue to evolve – towards being healthy and moving easily. Our forefathers who conquered the savannahs, the deserts, the mountains and the tundras to settle six continents, would be proud of us.


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