This weeks Blog of The Week comes from the thesportingjoint.com on how rest can actually hinder some injuries. What are your thoughts? As ever, tweet us your comments!
To rest is to rust!
I’ve pretty much heard all the sayings out there with regards to injury.. ‘if it came on it’s own, it’ll leave on it’s own’, ‘rest cures all’, ‘stretching fixes everything’. But imagine your car breaks down, you park it in the garage for 3 weeks, and then 3 weeks later expect to drive it, as normal as soon as you back it out of the driveway.., a solution to the problem? Doubtful! To rest is to rust, and if you don’t use it, you’ll lose it! As mentioned before in my post ‘Where injuries come from’, unless someone has run into you or something very specific has happened like a fall, your injury has probably been coming on for a long period of time, with an ‘incident’ being the ‘straw that broke the camel’s back’.
A good physiotherapist should be able to advise you on which injuries need total rest, and for me, these include only injuries where any activity will make the condition significantly worse by causing further damage… usually if there is a lot of bruising and swelling and the joint can’t function properly. Painkiller’s alone will never ‘fix’ an injury, it is merely removing the symptoms. Imagine we’re back in your car that isn’t working so well. A warning light comes on on the dashboard.
a) take it to the garage to be fixed
b) park it in the garage for 3 weeks and hope the problem goes away
C) take out the warning lightbulb and carry on anyway.
Masking your symptoms will only cause you problems in the future, and avoiding any painful movements can also lead to your pain becoming chronic (longstanding). There is a very complicated mechanism how this occurs which I’ll avoid boring you with, but it’s a similar concept to what happens to someone who loses a limb and experiences ‘phantom limb pain’. The painful, injured portion of the limb is removed but the brain still perceives pain in the area as if the limb is still there.
If you have a sore knee and you avoid bending it at all costs, eventually, even when the pathology of the knee is cleared up, if you still avoid bending the knee ‘just in case’, your knee most likely will still be sore, as you have made your brain hypersensitive to the area… super aware of it, and everything about the way you move and operate will be to avoid bending that knee!!
Disclaimer: Obviously I have not assessed your injury so this comes with a massive disclaimer that this is VERY GENERAL ADVICE and that you should get any injury checked out by a qualified, experienced physiotherapist/ sports therapist/ sports physician/ orthopaedic surgeon and I will not be held accountable for anything that goes wrong!
My advice to you is that if you injure yourself:
1. Try to move the area as soon as possible. Now this does not apply to a broken bone, I am talking if you pull a hamstring!
2. If weight-bearing is painful still try to maintain some sort of range of movement at the affected joint, and also the joints above and below the injured area.
3. Ice it.. Check out my icing protocol (only for the brave!)
4. If you can walk try to get back to your normal gait as soon as possible, try not to favour whatever is sore. Even if you are just doing things slower, try not to avoid using the injured area as this will also give you injuries elsewhere!
5. I think that pain up to 4/10 (ten being you’re passing out from pain, 0 being no pain) with whatever you are doing is fair. So if bending your knee is a little sore at 2/10 and you can still do the whole movement, then do it! Remember it’s about telling your brain that it’s ok to use the sore area, and not to catastrophise too much about it.
6. If your joint is swollen, put it up whenever you are not standing on it. Get some compression on it (not overnight or your fingers/ toes will go blue and drop off!).
7. Start stabilising exercises as soon as possible. When there is pain, your stabilisers switch off so it’s important to get them firing again as soon as possible.
8. Try to stay cheerful. Surround yourself with positive people who are not going to blow things out of proportion for you. The happier you keep your nervous system, the better things will be in the long run. It might sound very airy fairy, but trust me! Drama is bad. Laughter is good.
9. With any injury your activity levels will decrease (but hopefully I’ve convinced you not to stop moving completely!). Try not to hit the chips or the chocolate or booze as consolation, as putting on weight will only hamper your return to sport.
10. Get help. Get a rehabilitation plan from someone qualified. GPs are not trained in this area so your local practice will not be able to help you. Waiting lists in the UK are huge for physiotherapy and often by the time your appointment finally comes up, you have chronic pain. My advice is if you can head to a good, private physio for a couple of early appointments to at least start the ball rolling with your rehabilitation. ‘a stitch in time, saves nine’, and will be the best money you’ve ever spent!