The two most common messages that I repeat to my patients when they are involved in the rehab process that are:
"Hurt does not equal Harm" and
"If you do not move it, you lose it."
It is a normal tendency that when you are in pain, to remain still, rest, and not stress the injured area. In fact, this is very appropriate in the very early stages to take it easy after an accident. However, the avoidance of activity should only last for several days.
In the first one to three days, you should use ice, compression, and rest to ease the inflammation, but then after that time period, it is time to get to work.
There are rare exceptions. If you suffered a severe condition such as a fracture, a tendon rupture or a critical disc herniation leading to spinal cord compromise, it is possible that increased activity can make you worse. HOWEVER, these rare conditions are relatively easy to diagnose with physical exams, X-rays, and MRIs. When these conditions are identified, they usually require a splint, cast, or early surgery.
In the vast majority of injuries, the pain is related to muscle, ligament, or cartilage damage that should heal naturally. There is swelling or inflammation that needs to decrease. The tissue fibers need to heal back together and remodel their connections. It is what our body and nature are designed to do.
These injuries are internal, you cannot see it, but you can feel it and it hurts. When you cut your skin, you know it is not permanent, because it heals. A similar process is happening on the inside. However, many times these injuries are more complex and cause a great deal of pain.
The goal of recovery is to promote the ideal healing conditions. This involves:
1) Increasing Blood Flow
2) Strengthening the Surrounding Muscles
3) Promoting physical function to reduce the likelihood of chronic pain
To accomplish this, movement is critical. Active therapy, exercise, and motion-based activities are the key to success.
As a pain medicine doctor, I recognize that it hurts to move after an injury. It is my goal to find various strategies to reduce pain in order to help facilitate movement in therapy, whether it involves medications, medical devices, or procedures. I generally cannot eliminate pain, but the goal is to lower the pain enough to keep my patients active.
Pacing is critical. If a certain activity proves too painful, DO NOT GIVE UP! Instead, adjust. Work with your therapist to make adjustments. In our practice, Amber Nauman, DPT, our superb physical therapist provides personalized one-to-one recommendations to find exercises appropriate to your pain level and abilities. She focuses on making gradual progress based on each individual's needs. We currently offer PT in our Bala Cynwyd location.
In the end, if you embrace activity and pace appropriately, you will allow your body the best chance for recovery.