Magnesium deficiency and its interaction with the musculoskeletal system, exercise, and connective tissue: an evidence synthesis.

Background: Regular physical exercise is an essential part of a healthy lifestyle, maintaining and strengthening public health. Recently, a steady increase in the number of recurrent musculoskeletal injuries occurring during physical exercise is being diagnosed. A serious risk factor for such damage is initial connective tissue pathology. Pathognomonic dysplastic phenotypes, indicating a particular susceptibility to injuries, were established. The decisive role in increasing connective tissue disorders severity is attributed in part to magnesium deficiency that is one of the most common deficient human conditions. Objective: To present the magnesium role in connective tissue homeostasis for pathogenetic substantiation of magnesium correction in persons with predisposition to musculoskeletal injuries. Methods: An analytical review of recent data published between January 2004 and December 2023 in the electronic resources such as Global Health, ScienceDirect, Elsevier, Medline, Embase, PubMed-NCBI, RSCI Scopus, Cochrane Library, e-Library, Google Academy, and CyberLeninka was conducted. Data analysis was performed from January 2023 to December 2023. Results: The analysis of the obtained data allowed to identify the main pathogenetic mechanisms of magnesium deficiency effect on connective tissues, including RNA cell destabilization, inactivation of hyaluronan synthetases, modulation of hyaluronidase activity, stimulation of matrix metalloproteinases, deactivation of elastase, realization of autoimmune reaction, lysyl oxidase, and transglutaminase activation. These processes result in increased degradation of collagen, elastin, and hyaluronan polysaccharide chains; reduction of cross-linking of fibrous structure; and intensification of inflammatory processes. This leads to defective connective tissue formation and increases sensitivity to physical stress and the risk of injury. Active magnesium participates in almost all biochemical reactions of connective tissue metabolism, and the impossibility of its synthesis in the body requires sufficient intake of this element with food and water. In the case of moderate-to-severe magnesium deficiency, it is pathogenetically reasonable to prescribe magnesium supplementation, which should take into account comorbidities, severity of deficiency, and age. Conclusion: Regular therapy with magnesium preparations helps to improve the mechanical properties of connective tissues, prevent the progression of dysplastic disorders, reduce the risk of injury, and maintain health during physical exercise. [ABSTRACT FROM AUTHOR]