The muscle in rehabilitation

After orthopedic surgery, skeletal muscle will enter the rehabilitation process in weakened condition due to the following characteristics. After use of a tourniquet during surgery, the muscle suffers ischemia/reperfusion damage due to oxidative stress, resulting in structural impairment. The resulting immobilization leads to muscular atrophy, with a loss of calcium homeostasis and oxidative stress being of etiological significance. Degeneration of muscle fibers as well as regeneration occurs in muscle while still immobilized. After remobilization, the muscle has impaired functional capacity and frequently shows disturbances in its innervation pattern. High mechanical loading should therefore be avoided, and electrical stimulation may be applied to facilitate recovery. Considering the role of oxygen radicals, supplementation with vitamin E appears generally recommendable.