How many times have you said or heard this sentence?
“I tweaked my (back, knee, shoulder, wrist, etc), but I’ll just give it a few days rest and it should be fine.”
I am here to be the bearer of bad news, it will not be fine.
Yes, in your twenties and maybe even early thirties, rest was a good go-to move. You really did feel like you would rebound from an injury with a few (sometimes just 24 hours) days of rest. Unfortunately, that is not the whole picture. Without proper care, that injury from your twenties will come back to bite you in your forties. I am not saying you should go out for a 5 mile run on your newly sprained ankle, I am just saying you need more than a binge watch on Netflix to help your body heal properly and to prevent future injury and pain from occurring.
When the body experiences trauma, whether it is a torn ligament like an ACL in the knee or maybe just a bad bruise from a hard fall, there is a repair process that immediately turns on and gets down to business. Swelling occurs to help bring nutrients to the area to help speed up recovery of the tissue, bruising may occur as the blood starts to pool in the area, muscles and nerves may start to slightly shut down to help protect the area, and scar tissue starts to build to help make the area tough and resilient against future injury. This is a fantastic auto response to injury. We do absolutely nothing and our bodies just start healing.
Now there is much debate out there right now about the best way to “manage” our response system. R.I.C.E. and Ibuprofen are now being replaced by a more “hands-off” method of letting the body swell and heal itself. I don’t want to dive too deep into this discussion, but it is worth noting that there is some good research coming out that says we need to put the ice pack down and let our bodies do what they do.
What I want to focus on, is after the first 48 hours. When your joint starts moving a little more, the pain has decreased a bit, and the swelling is starting to go down. During this time, it is easy to “take time off” and give your joint a rest, but that will eventually lead you down a path of more injury.
Let’s use the ankle and the following scenario as an example. Let’s say I was out hiking and I rolled my right ankle. It hurts, but not so bad that I can’t get myself back to my car. As I drive home, I can feel it throbbing a little, but I think a day on the couch will cost me less than a few hours at the ER. I head home, prop it up, and let it “rest”. As I am resting, my body is starting the repair process, supplying the injured area with nutrients and building my joint back up. After a few days, I can walk pretty well, I still “feel it a little”, but I am going to work and probably go for another hike within the next few days.
First let’s talk about the joint itself. My body’s repair system is going to try to “toughen up” the ankle joint. While strength is great and can help that specific area from being re-injured, it is also going to inhibit the range of motion I have in my ankle. I may not be able to flex or point my toes to the same degree I could before. Some of my skeletal structure may have shifted when I injured the joint and is now being held in an inaccurate place by this new strength. The rocking motion, side-to-side that my heel normally has is now limited, adding stress to the other soft tissue within the ankle joint and making the muscles, ligaments, and tendons more susceptible to injury.
Now, let’s move away from the joint and look at the impact this is having above and below the ankle. Without proper range of motion in the heel, we will not have proper motion in the foot. That’s 33 joints and over 100 muscles, ligaments, and tendons that now have to change their “normal” to something that compensates for the new ankle range. As we go above the ankle, we find that the knee, a hinge joint, now has a rotational force on it that was normally absorbed by the ankle, but can’t be any longer. This new stress on the knee, puts new stress on the hip, which affects the back, and on, and on, and on.
Due to the “ankle bone is connected to the knee bone” feature of our bodies, it is important to not only rest our injuries, but rehab them to gain range of motion, proper alignment, and level strength. We can start doing this pretty soon after injury, using pain as our guide. Gentle movement or isometrics of the muscles surrounding the joint can help us start activating our nervous system and wake up our muscles. It can also encourage blood flow to the area which will aide in healing.
So going back to the example of my sprained ankle, after the initial rest period of 24-48 hours, I could start moving it by just gently pointing and flexing my foot. Then maybe I cautiously wander into some ankle circles. I could use a band or even a wall to start turning on the muscles by moving my ankle in different motions. This early intervention will not only speed up my healing, but also gives me the best chance of getting my joint back to “normal” and decreasing my chances of pain or injury in another part of the body due to compensation.
The point of the story is that if you have an injury, not acknowledging it or just leaving it alone, will not heal it. You must be proactive in your care and start moving and activating the injured area as soon as you are able. If you are not sure how to begin, find a physical therapist in your area that can help guide you.