Prolotherapy is a treatment used for various musculoskeletal disorders. This approach relies on activating locally resident mesenchymal stem cells (MSCs) through physiological mechanisms. MSCs are pluripotent cells primarily responsible for repairing damaged tissues. These cells are present in all tissues of the organism. While some researchers believe that these cells are organ-specific, others do not share this view. The activation processes of MSCs predominantly occur locally at the treatment site, although some global effects may also be observed. A key event in the treatment involves the controlled induction of a local injury through the injection of various glucose-based solutions into the fibrous connections (entheses). This process leads to several outcomes: – Local extravasation of all blood components – Formation of a clot that serves as a scaffold for future collagen synthesis – Osmotic and chemical effects of the injected solutions – Release of various growth factors and cytokines – Neurohormonal and immunological responses – Local proliferation of fibroblasts, which begin to produce collagen – Differentiation of fibroblasts into myofibroblasts Myofibroblasts possess tensile properties and are capable of altering (restoring) the structure of the local tissue through mechanotransduction and mechanosensitivity. Ultimately, this process contributes to the restoration of organ function within the pre-stressed tensegrity system.