What Is on the Horizon? Adding a New Item to Our List: Mechanical Connective Soft Tissue

In the mid 1990s, the specialty of physical medicine and rehabilitation (PMR muscles, nerves, and blood vessels are not considered connective soft tissues [2]. In the history of medicine, the connective soft tissues have not been considered as important as the nonconnective soft tissues (particularly muscle) or bone. This viewpoint is clearly reflected in the definition of physiatrists as provided by the AAPM&R [1], “PM&R physicians are nerve, muscle, bone, and brain experts who treat injury or illness nonsurgically to decrease pain and restore function,” no connective soft tissues are mentioned. However, it should be noted that most of the connective soft tissues, except for skin, function “mechanically” and certain of these mechanical connective soft tissues (MCST), such as intervertebral disks, knee meniscus, rotator cuff tendons, collateral ligaments, plantar fascia, and heel fat pad, play key roles in common musculoskeletal pain conditions and disability. We need to revisit these MCSTs.