The Problem With “Just Resting It”

Counting down the days since your injury? 

It’s all too common to hear something like “I overdid it, I need to rest it” for musculoskeletal injuries. It is widespread advice in the medical community, and I have a problem with it. It doesn’t work; well if you want to maintain a functional life. 

Where does this advice come from? The R.I.C.E. protocol, which stands for Rest, Ice, Compression, Elevation, came a best-selling Sportsmedicine Book in 1978, by Dr. Gabe Mirkin. He has since stated that this protocol inhibits healing as opposed to helping it as detailed in this article written by Dr. Mirkin himself. Gary Reinl came along and killed the already dying protocol with his argument against ice. If you want to hear an in depth podcast I did with Gary, check it out here. 

I suspect that the “rest” component comes from way further back as it is not only dogmatic, but seems to be instinctual. I suspect that back when we lived in caves, pain and swelling was a protective mechanism to keep the person alive. In other words, don’t go out and hunt today as you will slow down the pack. Or be eaten. 

Most of us don’t have to worry about that and have the luxury of being able to prioritize optimal healing. We can do certain things to ensure that we are not left with permanent strength and range of motion loss. More importantly, the loss of overall function. 

This is where I take a stand against the advice to just “rest”. I do think it’s a good idea to avoid excessively painful movements. But that does not mean to stop all activity within the affected area. However, the real problem is that the pattern goes something like this: Person A gets hurt playing sport B. Sees practitioner C, and told to stop doing sport B, just rest it. If the goal is to just get rid of pain, that can work. However, don’t expect that you’ll be able to get back to sport B without recurrent injury. So if the focus is on only eliminating pain, then over the course of a lifetime, sports and enjoyable activities will slowly be stripped away from that person’s life. “Oh, I don’t squat anymore because I have a bad knee”. Or, “I can’t pick up my grandkids because of my bad back”. 

The goal should be focused on restoring what is missing. Restore the mobility issue or the strength issue, or probably both. You see, pain is a lagging indicator. So if you are missing adequate range of motion of the spine and you then decide to pick up a sport like tennis, the lacking range of motion becomes exposed, and then pain follows. It works in both directions, so if you restore what’s missing, then pain begins to dissipate. 

Put quite simply: 

Pain is the symptom of a greater underlying problem. 

If you don’t address the underlying problem, it will continue to resurface. So you have two options. 1.) Sit on the couch and do nothing. Pain will probably go away. 2.) Fix the root cause and not only will the pain go away, but then you will be able to continue to thrive and enjoy the things you love. 

This reminds me of one of my favorite quotes:

“A ship in harbor is safe, but that is not what ships are built for.”

If you’ve been told to rest, and you are still not able to get back to what you love, let’s get on a call and problem solve what you can do to stay active.