The Hidden Forces Behind Tissue Breakdown: Understanding Injury Mechanisms and Motor Adaptation
How subacute injuries progress toward chronic dysfunction—and how clinicians can intervene before it’s too late.
Published in Dynamic Chiropractic – September 1, 2025
By Dr. Ken Kaufman, DC | Sports Chiropractor & Educator
Introduction
In the September 2025 issue of Dynamic Chiropractic, Dr. Ken Kaufman continues his six-part series on neuromuscular adaptation and soft-tissue injury with Part 2: “Injury Mechanisms: The Hidden Forces Behind Tissue Breakdown and Motor Adaptation.” This installment explores the critical transition from subacute to chronic injury, revealing how early-phase mismanagement drives long-term dysfunction102823-injury-mechanisms-the-hi….
For clinicians, trainers, and therapists, understanding the biomechanics and biology of tissue breakdown isn’t just theoretical—it’s essential to preventing irreversible damage and guiding athletes toward full recovery.
Subacute Injuries: Repair in Motion
During the subacute phase—days to weeks after injury—the body enters a powerful yet delicate repair cycle. Fibroblasts ramp up collagen production and angiogenesis, but when athletes push through pain or receive incomplete rehab, that healing trajectory bends toward degeneration102823-injury-mechanisms-the-hi….
This is the moment when smart intervention makes the difference between recovery and relapse.
Chronic Injuries: Inflammation Gone Rogue
When repair fails to resolve, tissues shift into chronic dysfunction—fibrotic, vascularized, and disorganized. These chronic states manifest as tendinopathies, bursitis, and ligamentous laxity. Collagen disarray and persistent inflammatory infiltration become the new normal, reducing mechanical strength and responsiveness to therapy.
The key message? Chronic injuries don’t begin chronically—they become chronic through delayed care, poor load management, and incomplete tissue remodeling.
Case Study: Nonsurgical Victory
Dr. Kaufman shares a case involving a 25-year-old pitcher with supraspinatus tearing and bursitis. Using a non-surgical protocol of dextrose prolotherapy, high-intensity laser therapy, and neuromuscular re-education, the athlete restored full pitching mechanics without surgical intervention.
This outcome reinforces the synergy of regenerative and neuromuscular-based care—repairing both the tissue and the movement pattern simultaneously.
The CNS Connection: From the Micro to the Macro
The article emphasizes how injury alters central motor control. When pain or inhibition silences a muscle, the CNS recruits compensators, often over-activating the upper trapezius while under-utilizing the serratus anterior in rotator-cuff pathology102823-injury-mechanisms-the-hi….
These neural adjustments may initially stabilize movement but ultimately distort mechanics, reinforce faulty recruitment, and elevate reinjury risk.
The Clinical Takeaway
“Left unchecked, subacute injuries evolve into chronic dysfunction. The longer the delay in proper care, the more extensive the rehab required.” – Dr. Ken Kaufman102823-injury-mechanisms-the-hi…
To interrupt that cycle:
Identify subacute injury markers early—pain during loading, persistent swelling, or asymmetrical recruitment.
Integrate laser therapy, acoustic shockwave therapy, prolotherapy, and corrective exercise before fibrosis dominates.
Retrain movement patterns concurrently with tissue repair to prevent maladaptive motor coding.
By linking tissue biology with neuromuscular function, clinicians can shift from reactionary treatment to proactive recovery engineering.
What’s Next
In Part 3 of the series, “The Hidden Architecture of Dysfunction,” Dr. Kaufman will dissect how long-standing compensation patterns form and perpetuate chronic pain.
Read the full article here → Dynamic Chiropractic: “Injury Mechanisms: The Hidden Forces Behind Tissue Breakdown and Motor Adaptation”
