Should I rest if I get hurt?

I’ve heard the story over and over again, and it goes something like this: I was playing my favorite sport, or I was gardening outside, or I just went around the corner to… and then my back seized up, or I pulled my hamstring, or my arm went numb. (It doesn’t really matter what got hurt, the fact is something got hurt.) Then this person is supposed to rest for six weeks or eight weeks or a month whatever their primary care doctor doles out as advice, generally with some ibuprofen and maybe ice or heat. All better! 

Nasa F-15B inflight over the Mojave desert

Once the rest moratorium has passed, they go back to what they were doing before because they have missed it terribly, and guess what happens. They reinjure the exact same thing, sometimes the first day back. 

Why didn’t resting work?

Once upon a time, I was playing soccer against a really mean girl. She and I had been battling it out all game long, and then she went to take a shot. I had no choice but to slide tackle her to prevent the shot, the ball went out (I was victorious!) and in the process of getting back up our legs were all tangled up. Furious, she somehow managed to torque one of my legs further (accidentally, I’m sure. Ha!) and I felt that sickening pop in my knee before disentangling. By 8 o’clock that night my knee was swollen up as big as a baseball. Lots of ?&@$!?$&@ poured out of my mouth. 

NASA STS-45 coming to rest after a mission

Little did I know I was about to start a journey of intense frustration.

One that most all of my clients have traveled, often more than once. 

I went to see the first primary care doctor that was available in my clinic. I did not win the lottery with this one. She was not in the least bit physically active, didn’t even know what a plank was, and told me to rest six weeks and take ibuprofen three times a day. if I still wasn’t better then she’d order an MRI, and send me to physical therapy. I told her that wasn’t going to work that as this was the fall, I was a personal trainer, and I was coaching two soccer teams at the time.   I explained that I could run straight ahead, I could run sideways, but ask me to open the front door -a twisting mechanism- and it dropped me. I wanted that MRI right away. 

“What do you mean you’ve been running??” she said. “Rest! Get the inflammation down! If it isn’t better in six weeks, then call me!”  Um, frustrating. 

(Let me caveat this story with the information that this was eight years ago, and a lot of research has come out since, but I STILL hear stories that are similar!)

Well, my life didn’t slow down.

Nasa of STS-45 launching into space

I didn’t play soccer because I couldn’t, but I continued to run, and I continued to see what helped the knee and irritated the knee. I waited the obligatory six weeks and I had my MRI done. I didn’t see the point of taking ibuprofen three times a day as I know it tears up stomach linings, so I iced instead. The swelling came down just fine. I had the MRI sent to a highly respected orthopedist, not an orthopedic surgeon, because if you hang out with surgeons they like to talk about what they are good at: surgery. 

To my great shock he told me that my MRI was “inconclusive”. You could have knocked me over with a feather. I, like all of my clients, wanted a definitive answer! What was I supposed to do with “inconclusive”? Recovering from the shock, I countered with, “Well, of course it’s inconclusive. My knee doesn’t hurt lying down and the position the MRI was taken was lying down. You need a standing up twisting MRI to see what’s wrong with my knee!” He smiled at me, and said, “Do you know how many thousands of baseline MRIs we would have to take to be able to compare loaded twisted MRIs?” I replied, “Well then, get going!”, to which he burst into laughter. More frustration. 

My options were: exploratory surgery (no!) and physical therapy. I told him what had gone down with the primary care doctor, and he told me that “active rest” was more appropriate. That was the first time I had heard that term.  

What did he mean? 

I first scoffed at rest as a great way to recover when I tripped over a study done by NASA about 20 years ago. I was actually so interested in the study I tracked down the actual research at the NASA library and had them mail it to me. The study is trying to figure out what the best way to duplicate zero gravity on Earth in order to help the astronauts prepare for space. As I was reading, I guessed water as the best way to duplicate zero gravity. Water has 20% gravity, so not a bad guess! However, it turns out if you put highly trained astronauts (or athletes) on bed rest for a week, by the end of the week their reaction time has already decreased by 10%. 

Nasa Mission specialist Joseph Acaba on a shuttle exercise bike in space

NASA says bed rest is the best way to duplicate zero gravity! 

Yikes. So resting doesn’t sound like the best way to help recover from an injury. Maybe this “active rest” is a better way? The big question is: What have you done to change what caused the injury in the first place? 

NASA Apollo 13 crew know what zero gravity is

 If the answer is nothing, I am not surprised to hear that nothing has changed when you go to move again. In my case with my knee, I was obviously not as strong on one leg in a rotational direction as I could potentially have been, so that is what I worked on. I also stay away from mean girls. 🙂 

What then can be done to let the injured area heal, but continue to move?  

Aaah, that is the question, isn’t it! Are you familiar with the “reflex arc?”

Stay tuned so we can talk about that next time…..in the meantime let us know what you’ve done to actively recover from an injury in the comments below!

Photo’s courtesy of NASA On The Commons on Flickr