Is Rest Really Best?

If you’ve ever had an injury, ache, or pain, often the advice you hear is to take 2 weeks off, rest, ice if needed, then try again. While rest is sometimes a necessary part of recovery, total rest may not heal all types of injuries, and may in fact worsen other issues. Even if you have an injury, doing some type of exercise is usually feasible, and can help maintain cardiovascular health, full body strength, and weight management. When you are experiencing pain, it is important to identify the pain source, so you know best how to allow it to recover. Let’s look at a few different tissue types and how to optimize healing for each. 

Bone 

In a situation like a broken bone or a stress fracture, rest is truly necessary to allow the bone to heal (typically this process takes 6-8 weeks). However in healthy individuals, total rest weakens the collagen structure and causes decreased mineral density. A better way to build bones is a slight increase in compression forces (think walking, running, jumping, weight lifting) to increase bone mineral density and strength. 

Joint Capsule 

The bones of most joints are surrounded by a synovial capsule, which secretes synovial (joint) fluid to lubricate and nourish the joint while acting as a shock absorber. This can be injured or implicated in arthritis, joint dislocations, or if you are experiencing a lot of stiffness. Rest shrinks the capsule and increases resistance to movement. You can improve the health of the joint and joint capsule by moving through the full available range of motion (either by activity or stretching). Physical therapists are trained in techniques to help mobilize the joint capsule if needed as well. 

Ligaments 

Ligaments are structures that connect two bones (example: your ACL in the knee connects the femur (thigh) to the tibia (shin bone)). A period of rest may decrease tensile strength in the ligament, making it weaker. To increase the strength of a ligament, you want to provide progressive tensile strength in the line of force. Resistance training and weight lifting can improve the strength and function of ligaments. 

Tendons 

Tendons connect muscle to bone. This can be a frustrating injury because when the tendon is painful (ie achilles tendon in your ankle or patellar tendon in your knee) it hurts to do most things, even walking. Taking a few weeks off will improve how it feels, but when you try to do more than walking, it flares up again. This is because resting a tendon causes the structure to be a little more disorganized and decreases the strength of the tendon. This can be improved by progressive strengthening to improve the organization of the collagen fibers. The best treatment for tendons is to avoid the painful activity, but to gradually add in strengthening rather than total rest. 

Cartilage 

Cartilage acts as a cushion between two joints. Injuries to cartilage can include meniscus tears or irritations as well as injuries to a disc in the spine. Resting allows for more swelling to accumulate in the joint, which can cause more pain. To improve cartilage strength and function, the best thing to do is to move through the available range of motion as well as add medium load strengthening in a pain free zone. 

The next time you have pain or an injury, it may be necessary to take a brief period of rest, but there are often things you can be doing as you rest from your favorite sport or activity that will help you get back to it sooner than later. Let us know how we can help you!