You are experiencing pain and every person you know has given you their opinion on what you should do. You’ve even googled and the answer you keep hearing is that you should rest from the activity that is causing you pain.
But what exactly does that mean? How much rest should I get? Do I stop everything and just sit or lie down?
I think there is confusion over rest because rest implies that you should do nothing. And doing nothing is definitely not going to help you reduce your pain.
A better term is load management.
Load management
A simple definition of load management would be the process of finding the balance between reducing the strain on the painful/injured body part whilst simultaneously training or strengthening it to increase its capacity for handling load.
Every body part and tissue inside the body can handle a certain amount of strain, this is called tissue load capacity. Push it beyond this capacity without preparing it and it becomes load intolerant. i.e. Painful.
The golden rule with load management is that the body handles slow and gradual load much better than quick increases.
Load management 101 for the Sportsman
You are not only a sportsman. When you experience pain during sport, you have to consider other factors that may be contributing to your pain like you’re an office worker, a mother, the weekend gardener.
Remember slow and gradual allows the body to adapt so increasing your training in this way is the safest way to avoid pain or injury.
It should be <10% increase in mileage/sessions per week.
Another way to look at it is acute versus chronic load. Acute load is mileage/sessions for 1 week. Chronic load is the average mileage/sessions over 4 weeks (divide by 4). Acute divided by chronic load should be between 0.8-1.3. Anything above 1.5 seriously puts you at risk of injury.
If you are already in pain, you need to reduce the activities that are causing pain but slowly start to increase the tissue capacity by starting strength training. Obviously a physiotherapist can help you know which exercises to do and help you find that balance.
Load management 101 for Persistent pain
If you are suffering from persistent pain such as back pain, it all depends on how load intolerant you are. If every small move shoots pain through your body, you are at a point of severe load intolerance. If only a few specific actions hurt, it is mild load intolerance.
First you have to start by finding out what activities cause pain such as sitting bent over or leaning over the basin to brush teeth. The next step is to avoid these positions or activities. You can also find ways to adjust your body position during these activities or support the body in a way that reduces the load while you perform them.
Regularly taking load off during the day by adopting healthy postures will begin to calm the tissues down.
The golden rule for persistent pain is to unload as often as possible during the day.
When the tissues are less load intolerant, the process of slowly adding exercises will begin to help the body adapt and improve tissue loading capacity. We don’t ever stop at just resting or avoiding the pain, the body needs to increase its capacity and strength to avoid future episodes of pain.
Conclusion
Weak muscles with low endurance are a major contributing factor to lack of tissue capacity for load. Pure rest will make muscles weaker, reducing tissue capacity which doesn’t remedy the problem
Other factors that contribute to lower tissue capacity for load are higher stress, poor sleep, poor diet, weight gain, negative self-speak and high cholesterol
Getting older, genetics like hyper mobility and hormone imbalance also play a part.
So no, rest is not the only answer to helping with your pain. Load management on the other hand is the answer and also understanding that you are the sum of many factors, not just your sport or work or hobbies.