What is the definition of rest?
Some injuries need rest. Different injuries need different types of rest. The word rest will mean different things to different people. For some patients – the idea of rest is the worst sentence they could receive. For others – they are happy to respect the process and give their body the time it needs. As a physiotherapist – we need to identify where each person sits on that scale, and figure out how much and what kind of rest each person needs. See below for different types of rest
Rest from training
If you have suffered an injury from training, eg gymnastics, this is a very specific sport with specific movements. An injury may need rest from these specific types of movements, but this does not need you just need to sit around at home. During these times, cross training is important. Often you can find some kind of movement or activity which does not aggravate your injury, and you can do this while you are resting from the aggravating activities.
Rest from a certain movement
Some of our clients will have their pain aggravated by a certain movement, eg low back pain aggravated by bear crawls. This does not mean they need to give up their training altogether. It means that they could benefit from avoiding the painful activity for a week or two, whilst they work on their rehab, and during this time continue with all exercises which are pain free. The client may even be able to continue the movement but use a different strategy – eg change their technique or change the movement slightly. One of my clients was having pain with burpees, but was able to do the burpee by stepping one leg out at a time instead of both at the same time. After a period of rest from the particular movement, you slowly start to reintroduce it, perhaps using a different technique.
Deloading refers to reducing load. Load can be in the form of weights, sets, reps, distance etc. Some clients can find that they can run 5km, but as soon as they go to 10km, they get a niggle or pain. This type of injury does not need rest – rest will only have you decondition and when you try and return to the activity, the niggle comes back. What this client needs to do is continue the distance they can which is pain free (in this example 5km), work on their specific exercises, and build up gradually over the following weeks to get to 10km pain free. Rehabilitation is rarely linear, so you might need to change your plan and increases in loading as time passes.
This is when you need to completely rest the injured area, for example with an ankle of knee you may or may not be in a brace and will use crutches. For a shoulder, elbow or wrist you may be in a sling and have to use your other arm for everything. This type of rest is usually used for broken bones that need to heal or when ligaments need to be in a position to allow for ideal healing. Stress reactions or stress fractures sometimes need a period of non weight bearing to allow for healing.
Emily Georgopolous (APAM)
Masters of Physiotherapy
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