Integrative orthopedic recovery
Injured tissue heals under two influences: the load you place on it, and the biology around it. We treat them together, from one chart, with a physician and a physical therapist who talk to each other.
Two clusters, one plan
Select any item to see what it means. The four topics at the bottom are where the two meet.
Physical therapy and sports rehabilitation
Mechanical and biomechanical
Physician-led regenerative peptide care
Cellular and biologic
Select any item above to see what it means in plain terms.
Tendons and muscles adapt to load they can tolerate. We set the dose of load and raise it as pain and strength testing allow. Eccentric work and heavy slow resistance are two common ways to do it.
Physical therapy pillarAfter an injury or surgery the nervous system often recruits muscles late or too little. We retrain timing, control and balance so strength is there when you move.
Physical therapy pillarHands-on techniques restore joint motion. We also look from foot to hip to trunk, because a stiff ankle or weak hip can overload a knee or a tendon.
Physical therapy pillarResearchers study these peptides for effects on repair pathways. Nearly all the evidence is from animal and lab studies, and neither is FDA-approved for orthopedic use.
Read the BPC-157 guideTendons and ligaments are mostly collagen, made by fibroblast-type cells. Mechanical load is the best-established signal for this. Some peptides are tested on the same cells in the lab. Whether that helps people is unproven.
See how tendons respond to loadSome compounds act on the growth hormone axis. They are not approved for recovery, they affect blood sugar and fluid balance, and they need monitoring.
Read the secretagogue guideWhere the two meet
Where this fits at Nova
Nova Medical Centers began in occupational health: care for work injuries, testing and rehabilitation for working adults. Regenerative sports medicine extends that clinical base to people with long-running tendon, joint and post-surgical problems.
Physical therapy is still the foundation, and the same standard applies throughout: a licensed clinician examines you in person, explains the evidence, and follows up.
Our clinical base is occupational care, covered in workplace health and occupational medicine.
What we will and will not claim
Mechanical loading is the best-established driver of tendon and ligament recovery, and rehabilitation is the foundation of every plan here. The biologic side is newer. Most of the research on peptides in tissue repair is from animal and laboratory studies, and none of the peptides discussed on this site is FDA-approved for orthopedic use.
So we say what is known, what is not, and what a physician will and will not consider for you. A peptide is never a substitute for rehab, and some people should not use one at all.
Our physical therapy team begins every plan with testing and a dosed loading program. A physician decides whether physician-supervised peptide therapy belongs in your plan at all, and sometimes it does not. Before any decision, read the five questions to ask before starting peptide therapy. Our occupational health roots are also why we publish practical guidance on workplace ergonomics.
Individual results vary and no outcome is guaranteed. This page is general information, not medical advice.
About the clinical team behind this page
Dr. Michael D. Schreiber is an osteopathic physician. He applies osteopathic principles to musculoskeletal diagnosis and rehabilitation, looking at the whole kinetic chain when judging how a joint or tendon problem developed, and advises on how physician care and physical therapy fit together. He is a graduate of the Chicago College of Osteopathic Medicine of Midwestern University, class of 1992.
Dr. Arnaldo Manuel Mora is Medical Director and leads clinical governance at Nova. His background is in internal and occupational medicine. He oversees diagnostic intake, baseline laboratory review and the safety standards that apply before any prescription therapy, including pharmacy sourcing and contraindication screening as described in our safety guide.
Medical disclaimer: The information on this site is for education and does not replace a consultation, diagnosis or treatment. Peptides are prescription-only at Nova, are prescribed only after an in-person physician evaluation, and are not FDA-approved for orthopedic use. Full credentials are on our physicians and clinical governance page.
Keep reading
Individual results vary and no outcome is guaranteed. Peptides discussed on this site are not FDA-approved for orthopedic use, and a physician decides after an in-person evaluation whether any is appropriate.