“Take a couple weeks off,” is a common phrase given by friends, family, and even medical professionals after you bring up an injury. Sometimes, taking the time off can help the pain go away.
Other times, weeks and months are taken “off”, but the pain persists once you start activity again. It can even be worse!
What do you do? Is Physical Therapy the answer?
At Zona Physical Therapy, we pride in keeping our patients as active as possible during their healing phase. Whether it is CrossFit, running, gymnastics, or cutting hay, activity makes you more resilient. And when you stop, you become less resilient.
Another short term downside to rest is what we call psuedo-healing. This means that when you don’t perform your activity you feel pain-free. And no pain= you’re healed.
But you know that isn’t the case. Not at all.
Let’s take a male CrossFitter experiencing knee pain with squatting for example. If he stops squatting, the pain goes away. Whenever he returns to squatting, the pain comes back.
Rest isn’t working for him. Why?
It usually boils down to three reasons:
- The patient’s pain generators are not addressed with rest
- The patient has compensation or mechanical loading issues that rest does not fix
- The patient will return to 100% load after rest
1. The patient’s pain generators are not addressed with rest
Let’s say, after an examination, his physical therapist finds out that he has a patellar tendonopathy.
The physical therapist treats the knee and the pain goes away with squatting in one visit. His knee could have been overly sensitive and just need to desensitization and healing.
This may be the end of the treatment, but more times than not, there is a loading issue that created the problem in the first place.
2. The patient has triggers, compensations, or mechanical loading issues that rest does not fix
This could mean there is a muscle that isn’t working like it should and should be activated beforehand to handle more of the load during squatting. This is a huge reason why physical therapy is better than resting.
There could also be a trigger that is still done outside of squatting that is aggravating the knee. If you don’t know what a trigger is, go back to our previous articles to learn more.
Resting doesn’t catch the triggers, compensations, or hypersensitized tissues. An examination does.
3. The patient will return to 100% load after rest
If you feel good after resting for 2 weeks, you decide to hit an 20 minute EMOM (every minute on the minute) of 1 front squat at 295 lbs. Aaaaaand your knee starts hurting again.
This is similar to not running for 2 weeks, and then hitting 13 miles of pavement. You’re body won’t be prepared and you can resensitize your pain generator.
I’ve seen many athletes that get frustrated at this point because they feel like they’ve done everything they can, but the pain persists. But they haven’t done everything.
They haven’t had a full examination to determine the pain generator, loading issues, and how to load properly. In our hypothetical scenario, this CrossFit male ends up requiring 1-3 visits. The pain ends and frustration and scaling also leaves with it.
Conclusion: Physical Therapy is Better Than Resting
We see that physical therapy is better than resting, especially for healthy active people. If you’re frustrated because you’ve tried resting or scaling and it hasn’t worked, reach out and see if you need a thorough examination.