Therapies for weak muscles

The Balgrist

It is estimated that ten percent of the costs of health care in Switzerland (or an equivalent of 500 billion Euros per annum in the EU) being associated with lost work is related to injury or dysfunction of the musculoskeletal system

Surgical and subsequent rehabilitative interventions are an important part of the therapy that re-establishes musculoskeletal function.

The Laboratory for Muscle Plasticity at Balgrist University Hospital aims to bring light into the mechanisms that govern skeletal muscle function in health and disease with the goal of translating the findings into more effective clinical applications. This includes projects that asses the consequences of musculoskeletal injury, as well as subsequent surgical interventions and rehabilitation on skeletal muscle 1. This is a major health topic as the associated inactivity and unloading produces a pronounced loss in strength and fatigue resistance of striated muscle. In consequence, the control of certain movements and posture may be hard to impossible and requires appropriate surgical and rehabilitative measures to reinstate mobility and quality of life. Research on the conditioning of muscle performance in Sports Performance has shown that this process is driven by mechanical and metabolic stimuli. Genetic factors (so called gene polymorphisms) importantly affect this adaptation2. This indicates that gene polymorphisms contribute to the inter-individual variability of the response to surgical interventions and rehabilitation.

Research projects: The emphasis of the research team lead by Prof. Martin Flück at Balgrist is put on major musculoskeletal affections that arise in the context of the Orthopedic Clinics at Balgrist Hospital. A special focus is put on resolving the contribution of gene polymorphisms to inter-individual differences in the healing of muscle with re-attachment of the ruptured rotator cuff tendon, and the strengthening of skeletal muscle with rehabilitative exercise in patients. The aim is to develop personalized forms of interventions that maximize muscle adaptation. The latter approach is based on our previous work that points out the important exercise-intensity and exercise-type related influence of gene polymorphisms on the muscle response to the leisure type Sports activities 3. This opens a venue to tailor the therapeutically effective exercise intervention for patients which otherwise would demonstrate little plasticity to a generic exercise stimulus and for which pharmaceuticals alone do not work due to the importance of activity-induced muscle metabolism for muscle adaptations.

Patient-lead research: By the end of 2015 the laboratory has translocated into new research facilities at the Balgrist Campus ( The key ingredient of this State-of-the-Art facility is an open-space landscape where research and development into musculoskeletal medicine is integrated under one roof between clinicians, biologist, engineers, and industry. The facility situates in the vicinity of the orthopedic hospital at Balgrist; thus providing a pipeline for a reality driven approach that re-integrates questions from bedside to bench and return to the patient. The laboratory for muscle plasticity is looking for potential partners that may want to exploit the research options presented in the future Campus in the frame of collaboration.

1 Muscle Injuries in Sports – Müller-Wohlfahrt HW, Ueblacker P,Hänsel L, Garrett WE, Georg Thieme Verlag, ISBN: 9783131624710.
2 Flück M (2013). Diagnostics of endurance performance on the level of gene expression. Sport-Orthopadie – Sport-Traumatologie,29(3):203-213.
3 van Ginkel S, Amami M, Dela F, Niederseer D, Narici MV, Niebauer J, Scheiber P, Müller E, Flück M. Adjustments of muscle capillarity but not mitochondrial protein with skiing in the elderly. Scand J Med Sci Sports. 2014 Sep 28. doi: 10.1111/sms.12324. [Epub ahead of print]

Professor Dr Martin Fluck
Laboratory for Muscle Plasticity – University of Zurich
Balgrist Campus AG
Tel: 0041 44 510 7350


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