You Can't Rest Your Way to Recovery
How many times have I asked a patient what they're doing for their injury only to have them tell me "rest"? How many times have you gone to the doctor with a nagging pain only to be offered the million-dollar solution of "rest"? Really?! You went to med school to learn that?!
While the body does absolutely need rest to help recover from sickness and injury, it's important to understand that rest will not restore your function. Well, not if your goal is to return to the same level of pre-injury function. Following an injury, rest resolves symptoms but it doesn't cure the underlying problem. Those weak glutes that caused your poor knee tracking and subsequent knee pain while running that 5k will still be weak once you've rested for a few days and the knee pain is gone. That back pain you get when you deadlift that's caused by your poor movement patterns will likely return even after all that rest if you don't address those tight hamstrings.
Additionally, at the cellular level, the main goal of resting is to prevent further injury to the tissue, thus allowing the appropriate cellular markers to come in and do their job of repairing the tissue. However, what we're left with is stiff, tight, and generally less functional tissue. Adding insult to injury is the fact that these cells repair only the acutely injured tissue and leave the surrounding ‘healthy’ tissues to atrophy and tighten up.
The human body is remarkable in its ability to regenerate and repair tissue, however, this tissue is not the same as that which it replaced. Take for instance that horrible cut you got from falling off your bike when you were 10. Yes, your body formed a scab and eventually a scar at that area, but that tissue is structurally different than the previously flexible, pliable, strong tissue that graced your kneecap. The scar left behind from any trauma, be it external or internal, is a matrix of new collagen fibers that is gnarled and twisted into a less than flexible spiderweb of nastiness. Yes, this new skin gets the job done of creating a barrier against the elements, but it's original functionality has been lost. It is no longer as flexible or pliable, as the original tissue. What's the problem with that, you may ask. Well, when the wound is the size of a papercut (those hurt so bad though, don't they) in an area without much movement, realistically there isn't much problem. BUT, expand the size of that tissue damage to a few inches, or place it over moving structures such as the hand or knee or shoulder, and suddenly these restrictions become quite problematic.
I use the example of a cut because it is easy for us to understand what we can see. The fact is though, the same thing occurs at the cellular level when we injure our muscles, tendons, ligaments, and bones. Tissue is broken down only to be replaced by inherently less functional tissue that can serve a stationary role, but comes up short once movement enters the picture.
Effort needs to be put into recovering from injury and restoring the tissue. Scars need to massaged, muscles needs to be mobilized and strengthened, and bones need to stressed. Rest is good for cellular repair, and to avoid learning bad habits secondary to compensation, but if you want to get back to your old life and crazy ways, you have to actually DO something.
My point, yes I do have one, is that you absolutely must be an active member in your recovery process. Do not just attempt to rest away your injuries! With the exception of freak accidents, injuries happen for a reason, be it weakness, tightness, poor movement patterns, etc. These issues and the subsequent havoc they wreak on your tissues must be addressed if you want to fully recover from any injury and prevent it from happening again in the future. You are not Nintendo. You cannot just hit the power button, walk away, and expect everything to work just fine the next time you want to play a game. So, the next time your high school back injury flares up for the 382663 time, get to a PT and get started restoring your function instead of just trying to rest away the symptoms.