Rest it or rehab it?

Somebody tells you to rest it. You rest it. It feels better. You go back to what you were doing and within a fortnight you're exactly where you started.

If that sounds familiar, the problem probably isn't you.

What rest actually does

Rest reduces symptoms. That's real and it's useful, particularly in the first few days after an acute injury when tissue genuinely needs to settle.

What rest doesn't do is build anything. Muscle that isn't loaded gets weaker. Tendon that isn't loaded loses capacity. Balance and control fade surprisingly quickly. So after a fortnight off, the pain has gone and your tissue can handle less than it could before.

Then you return to the same activity that caused the problem, with less capacity than you had at the time. That's the loop.

What rehab does instead

Rehab means loading the tissue in a controlled way, at a level it can handle, and increasing that gradually as it adapts.

It usually looks like this:

• Settle it. Reduce the aggravating load, keep moving where you can, get symptoms down to a manageable level.
• Load it. Start putting force through the tissue deliberately. This is the bit people skip.
• Build it. Increase what it can handle beyond where you were before the injury.
• Test it. Check the capacity is genuinely there before returning to full activity.

So when is rest the right answer?

Rest has its place:

• The first few days after an acute injury, particularly with significant swelling
• Bone stress injuries, which need genuine offloading
• Anything where you've been told to by a surgeon or doctor
• The occasional week when life is chaotic and something has to give

Even then it's rarely complete rest. Relative rest, meaning less of the thing that hurts and more of the things that don't, is usually better than sitting still.

How to tell which you need

If a few days off has settled it and you can build back gradually, you may be fine. If you've done that twice already and it keeps returning, resting a third time is unlikely to produce a different answer.

That's the point to get it looked at properly, so somebody can work out what capacity is missing and how to put it back.