The Envelope of Function: Revisiting the Theory With New Concepts—A Narrative Review

Abstract

Musculoskeletal injuries are a complex multifactorial phenomenon, and several factors can contribute to their occurrence. This review aimed to discuss some relevant and often unexpected elements involved in musculoskeletal injuries and rehabilitation. One of the main factors discussed is the role of physiological adaptation to training in musculoskeletal injury susceptibility. This is probably the most modifiable factor in preventing and treating musculoskeletal injuries. Other factors discussed are the role of genetics in injury susceptibility; the effect of stressors and environmental factors and the way we deal with setbacks; anabolic steroid use as aesthetic and performance-enhancement drugs; nutrition, sleeping, and the imbalance between rest, energy intake, and training; anatomic and biomechanical factors; and the role of systemic disease. Moreover, the topic of unknown factors keeps an open door for future discoveries. This review highlights the importance of understanding the various factors contributing to musculoskeletal injuries and the need for an individualized approach to injury prevention and rehabilitation, from both a historical and a physiological point of view.