By: Dr. Ashley Bertorelli, PT, DPT
I was inspired to write this blog post today after doing a progress report visit with one of my patients, who is doing SO much better than Day 1 of PT. This person is an active 50-something year-old person who came in to see us after months of encouragement from their partner to do so. They were finding that the “wait and see/rest it out” approach wasn’t working for them.
Here’s the basic background:
This person was living with years of hip and lower back tightness that eventually progressed to pain, limiting the person’s ability to run, workout, lift, and participate in physical activity. Getting out of a car was painful, rolling over in bed was painful, squatting and crouching was problematic. This person would take weeks or months off from working out, trying the “rest and heal” approach, but every time they returned to activity again, BAM, the pain was back. They repeated this pattern over several years, but slowly instead of the pain going away with each rest period, it would get progressively worse, involving other parts of the body and having a negative ripple effect throughout the joints and muscles of the body. They would feel a little weaker, a little more deconditioned, a little tighter with each rest break, instead of better. They were starting to consider things like “maybe I shouldn’t be working out at all?”
Why rest breaks don’t work for a lot of people:
If your pain is caused by an acute strain, sprain, or injury, relative rest is part of an effective rehab process. If your pain is chronic, underlying, nagging, and not acute (acute means just happened within the past few days or weeks), resting will not work.
WHY?? Pain and stiffness in these subacute and chronic cases is due to joint stiffness, muscle weakness/tightness, myofascial restrictions, and/or faulty movement patterns that don’t improve with rest, but actually get worse. Resting a weak muscle makes it weaker. Resting a stiff joint makes it stiffer. Resting tense myofascia makes it more tense. Then every time you try to get active after a rest period thinking you’ve done yourself a favor, the pain comes back immediately. And sometimes it comes back worse than before, or even in new places. That’s very frustrating!!
So what to do?
Once this person got into PT, we recognized that a lot of the issues were related to an old ankle injury and residual poor ankle mobility, which caused movement pattern compensations, which later then combined to create hip joint pain and back tightness. Once we addressed these areas, mobilized and stretched tight joints, and released tight muscles, along with providing a targeted home program, we were able to get the different joints, muscles, and myofascia of the body working together instead of against itself. This person has been able to continue working out at higher levels, squatting like never before, and getting better instead of worse with physical activity.
The Wait/rest it out approach would have never fixed this person’s problems, as simply resting doesn’t restore joint mobility or fix faulty movement patterns. In fact, it would have created more tightness, more weakness, and more imbalance over time.
If this sounds familiar, and you need a great PT to evaluate you and come up with a plan to address your body’s unique strengths and weaknesses to establish an effective plan of care, give us a call or contact us through our site’s contact page. Stop waiting, stop resting it out, and get back to living again!
In good health,
Dr. Ashley Bertorelli