Following any injury the body needs time to recuperate properly and one of the most important aspects of healing is rest. Although you might be tempted to work through the pain and carry on, this can make the healing process much longer. Accepting that rest is important will help you to plan your recovery better and the good news is that you do not have to give up all physical activities.
How much rest does your body need?
Sometimes it is obvious when a certain activity should be stopped. Following a sprained ankle, for example, you will naturally want to keep off it until any pain or swelling has subsided and rest it for the first two or three days following the injury. Naturally, ice and compression will help to reduce the swelling as will elevation. However, if you have an injury that seems not to be healing or are suffering from unexplained pain, the importance of rest is less evident. Every individual and every injury are different so it is impossible to say exactly how much rest is needed in any given situation. The important thing is to avoid placing undue stress on severely fatigued or injured tissues but to stay relatively active. Bed rest (or total rest) is a thing of the past that no doctor today would recommend.
Why people are reluctant to rest
Many people, especially athletes and sports people, are worried that resting following an injury will cause them to lose muscle or generally get out of shape. This can be counterproductive because failing to rest enough will prevent or delay healing and that is more likely to cause you to lose condition, particularly if you suffer chronic pain as a result. Another objection frequently raised to resting following an injury is the worry that you will gain weight. In fact, calorie intake is much more relevant to weight gain than exercise, so if you are unable to exercise you simply need to reduce your calorie intake to maintain the status quo. Healing is most important and once you have healed properly you can work towards restoring fitness.
Resting properly involves finding ways to stay fit and active without aggravating injured or fatigued tissues. It can be helpful if you focus on rest as a valuable and meaningful strategy rather than as something more negative that cannot be avoided. If you respect the need to rest injured tissues you will be able to focus on activities to keep you in shape in other ways whilst healing takes place.
If your injury or problem does not involve your hips or legs, walking can be excellent exercise to maintain fitness without stress. Swimming is always popular for relative rest as long as you do not have a shoulder injury or certain knee injuries. The water helps to reduce the stress and the risk of further injury. Some types of yoga can also be good methods of relative resting, but the choice of activity is really down to the individual. Even those who do not usually do any strength training in the gym may benefit from trying this whilst they are healing. In addition to being an excellent and efficient way to keep in shape, the precision of the gym equipment helps you to protect your injury during rehabilitation.
When exercise can be wrong
Many patients and health professionals believe that challenging their tissues by indulging in therapeutic exercise can help them recover from an injury. This can be counterproductive in many cases and the tissues can become weaker and more impaired. Before a tissue breaks under a strain it can often become ‘sick’ and fail to keep pace with the maintenance and repair needed to match the strain. When this occurs the tissue becomes unable to tolerate even small stresses, and activities that were formerly fine become a problem. The only way out of this is by resting adequately and giving the tissue an opportunity to recover.
Inadequate rest following an injury can cause people to suffer chronic pain for years. Many people think that reducing their activity levels, or ‘taking it easy’ for a couple of weeks is enough, but this is rarely the case. Even if your doctor or other health professional is pushing you to exercise but you do not feel ready you should follow your instincts. It is likely that your tissues are not ready for the increased stresses yet and trying to do too much too soon can aggravate the injury or even cause further injuries. It has been said that people frequently get hurt whilst trying to recover from being hurt, so this should be kept in mind.
Overuse injuries such as repetitive strain injuries just tend to get worse with more use, so rest is crucial and it is hopeless to think that you can exercise your way out of the problem.
It can be difficult to rest some repetitive strain injuries, particularly patellofemoral pain. In this form of runner’s knee the joint between the femur and the kneecap is affected and is sensitive to both overloading and underloading. Even in optimal conditions healing can be very slow and resting this injury is important but can be very difficult. The patellofemoral joint normally tolerates extremely high pressures beneath the kneecap even when you are not specifically exercising the knees. The intensity of the pressure increases massively under exercise conditions but even when you are not doing much with the joint it is easy to overuse it without even being aware that you are. This is where thinking about actively resting injured tissues, in this case the patellofemoral joint, becomes even more important.
With most RSIs, each workout can be similar to a minor injury from which you have to recover, so it is important to avoid additional stress on tissues that are recovering. Time is needed for recovery but many athletes and other active people are too impatient and commence exercising too soon. This can cause them to feel generally rundown and increase the risk of further injury.
Sometimes activities that do not immediately cause symptoms can still be a problem. An example would be of a runner suffering from plantar fasciitis who stops running and starts cycling as a form of relative resting. Running obviously irritates the condition soon after starting but cycling feels fine so he does this for an hour daily instead of running. Although the runner is unaware of any problems, cycling (especially if clips are used) can also irritate plantar fasciitis, so although it seems fine he is not actually resting the injury and it will not heal.
Some injuries occur in parts of the body that are harder than others to rest. Examples of these include the feet, knees, neck and dominant hand, but unless the tissues are sufficiently rested healing will be delayed.
Unfortunately, it is not always easy to know when an injury has healed. Common problems including tennis elbow, iliotibial band syndrome, carpal tunnel syndrome and whiplash can seem to be completely healed until the tissues have been used for a while and then, after you have irritated the injury, it becomes apparent that they are still vulnerable. The problem here is how to test whether it is healed without causing further damage, but there is no easy answer and all you can do is to try and test it out gently and hope you do not delay recovery.
Previous injuries are prone to further injury and should be protected wherever possible so adequate rest is important. Partially recovering from an injury several times can cause bigger problems in the end, and you may find that completely resting the injured tissues for even a few months is necessary for complete rehabilitation.