From Acute Trauma to Chronic Instability: Mechanisms, Management, Rehabilitation, and Functional Outcomes

Dear Colleagues,

Acute musculoskeletal trauma represents a pivotal event in the natural history of joint health, often acting as the initial trigger for progressive mechanical, functional, and neuromuscular alterations that may culminate in chronic instability. Across major anatomical districts such as the shoulder, knee, and ankle, traumatic injuries impose a substantial burden on athletes and physically active populations, including recreationally active individuals, with important implications for long-term function, quality of life, and participation in sport and exercise.

Despite advances in diagnostic tools and therapeutic strategies, the transition from acute injury to persistent instability remains a complex, multifactorial process that is not yet fully understood. This Special Issue aims to provide a comprehensive and multidimensional exploration of the continuum from acute trauma to joint instability, emphasizing shared mechanisms and district-specific characteristics, while placing exercise and physical activity at the center of risk, protection, and recovery.

Particular attention is given to the epidemiology of traumatic injuries, including incidence, recurrence, and risk factors that predispose individuals to instability. We encourage contributions that explicitly consider physical activity exposure, training history, movement demands, and workload patterns as determinants of both injury occurrence and chronicity. Understanding these patterns is essential for identifying vulnerable populations and developing effective, scalable prevention strategies for active individuals.

Equally important is the early post-injury phase, where timely and appropriate decision-making can significantly influence tissue healing and functional recovery. Submissions addressing injury biomechanics, imaging, early clinical assessment with a focus on functional outcomes, and evidence-based rehabilitation are welcome, particularly when they integrate early, appropriately dosed therapeutic exercise, graded activity, and load modification to preserve function and reduce maladaptive neuromuscular changes.

A core focus of this Special Issue is exercise-based and training-informed prevention. We welcome studies evaluating prevention programs grounded in exercise science—such as neuromuscular training, strength and power development, proprioceptive and perturbation-based training, technique retraining, and conditioning strategies—as well as implementation approaches that translate these interventions to sport, fitness, and community settings. Clear reporting of program content (dose, progression, adherence, and fidelity) is strongly encouraged.

Rehabilitation is central to restoring stability and durable function. This Special Issue particularly seeks work that strengthens rehabilitation approaches grounded in training principles and exercise science, including progressive loading, periodization, sensorimotor and neuromuscular training, kinetic-chain integration, and individualized load management. Contributions should emphasize criteria-based, return-to-activity frameworks (including testing batteries, movement quality assessment, and participation-appropriate benchmarks) designed to optimize performance, reduce reinjury risk, and support a safe, confident return to sport or recreational activity.

While surgical intervention remains an important option in selected cases, this Special Issue emphasizes evidence that advances understanding and application of conservative, exercise-centered pathways, while also welcoming contributions that explore the biomechanical or functional outcomes of surgery within a continuum of care. By adopting a transversal and integrative perspective spanning epidemiology, acute care, prevention, rehabilitation, and operative decision-making, this collection aims to strengthen clinical reasoning and evidence-based practice in functional morphology and kinesiology across joints and populations.

Original research articles, systematic and narrative reviews, clinical trials, and translational studies are invited to contribute to a unified framework that supports clinicians and researchers in improving exercise-based prevention strategies, optimizing rehabilitation and return-to-activity decision-making, and enhancing functional outcomes following acute musculoskeletal trauma.

Dr. Raffaele Vitiello
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Functional Morphology and Kinesiology is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• acute trauma
• chronic instability
• injury
• rehabilitation
• surgery
• functional morphology
• kinesiology