The science of motion and musculoskeletal health
Load one joint and the pressure reaches the others. Sanomechanics® is the science, and the rehabilitation method, built on that finding.
Developed by Professor Mark R. Pitkin, sanomechanics® explains how forces from movement are shared between the joints, and uses exercises designed to restore the hydrostatic connection between them when that sharing breaks down.
What sanomechanics® means
The term comes from the Latin sanus, healthy. Sanomechanics® is the study of forces generated by motion in the body and how they relate to musculoskeletal health. Professor Mark R. Pitkin made the underlying discoveries and developed from them a structured system of exercises, distinct from other methods of conditioning the body.[2]
The central idea is that synovial joints are hydraulically linked. When a joint is loaded, the pressure on its cartilage does not stay there. It is transmitted hydrostatically to other joint capsules through microscopic channels between the bone surface and the periosteum, the sheath that covers the entire skeleton.[1]
- Load
A joint takes force
Movement or weight raises pressure on the cartilage inside one joint capsule.
- Transmission
Pressure travels under the periosteum
The subperiosteal fluid film carries that pressure along the bone toward neighbouring and distant joints.
- Distribution
Other joints share the load
When the connection works, load is spread across the skeleton instead of concentrating in one joint.
The theory suggests what goes wrong in chronic overload. If the hydrostatic connection between joints is impaired, individual joints carry more than their share. Rehabilitation then means restoring that connection, so the skeleton once again “floats” in its subperiosteal film of fluid.
Measuring pressure in a joint that does not move
Pitkin M, Muppavarapu R, Cassidy C, Pitkin E. Subperiosteal transmission of intra-articular pressure between articulated and stationary joints. Scientific Reports 5:8103, 2015. doi:10.1038/srep08103
In ten rabbits, the investigators placed catheters in two joints at once, under fluoroscopy, and connected each to a pressure transducer. One joint was flexed and extended by hand; the other was left still. Four pairings were tested, including joints on opposite sides of the body. Venous pressure was recorded at the same time to rule out the bloodstream as the pathway.
Transmission rates did not differ meaningfully between near and distant joints.
The smallest p-value attainable with four animals; every pair switched from response to none.
Changes in venous pressure were not significant and did not track the joint readings.
What the study shows, and what it does not. The authors concluded that the subperiosteal space, not the vascular system, carried pressure between joints. The work was done in an animal model with a small sample, and the authors call for larger studies. It establishes a mechanism. It is not a clinical trial of the exercise method.
Video: how pressure is distributed between joint capsules
Play video explanationFrom mechanism to exercise
Sanomechanics® exercises are designed to restore hydrostatic connectivity between joints, so that load is shared across the skeleton again. Their aim is to reduce joint pain and improve mobility.
Responsive to the body
Exercises are chosen and adjusted to what the joints tolerate at the time, rather than following a fixed routine.
Practised anywhere
The exercises need no gym or equipment. They can be done at a desk, at home, in bed, or standing in line.
Regular practice
The method depends on frequent, self-directed practice over time rather than occasional intensive effort.
Physical and psychological
The method, as set out in Biomechanics for Life, addresses both dimensions of rehabilitation.[2]
The book that introduced the method
Published by Springer in 2011, Biomechanics for Life: Introduction to Sanomechanics presented the theory and the exercise technique together, and addressed both the physical and psychological sides of rehabilitation. It remains the primary reference for the method.
- Author
- Mark R. Pitkin, Tufts University School of Medicine
- Publisher
- Springer, Berlin Heidelberg, 2011
- Length
- xv + 132 pages
- ISBN
- 978-3-642-17176-5 (hardcover) · 978-3-642-17177-2 (eBook)
About Mark R. Pitkin
Professor Mark R. Pitkin is the originator of sanomechanics®. His research at the Department of Physical Medicine and Rehabilitation, Tufts University School of Medicine, and at Poly-Orth International concerns the biomechanics of joints and the musculoskeletal system. He translated that research into the system of exercises described in Biomechanics for Life.
References
- Pitkin M, Muppavarapu R, Cassidy C, Pitkin E. Subperiosteal transmission of intra-articular pressure between articulated and stationary joints. Sci Rep. 2015;5:8103. doi:10.1038/srep08103
- Pitkin MR. Biomechanics for Life: Introduction to Sanomechanics. Berlin, Heidelberg: Springer; 2011. doi:10.1007/978-3-642-17177-2
Common questions
Who is the method intended for?
The method was developed for adults with joint pain or reduced mobility, particularly where joints are chronically overloaded. Whether it suits a particular person is a question for that person and their clinician.
Does it replace medical treatment?
No. Sanomechanics® is a rehabilitation exercise method, not a diagnosis or a medical treatment. Anyone with a joint condition should consult their physician before starting a new exercise programme, especially after a recent injury or surgery.
Where can I learn more about the exercises?
Biomechanics for Life: Introduction to Sanomechanics [2] sets out both the theory and the exercise technique. See Publications above.
How strong is the scientific evidence?
The pressure-transmission mechanism was measured directly in an animal study published in Scientific Reports [1]. That study tested the mechanism, not the exercise programme, and its authors call for larger studies. Section 2 above summarises what was found.