After an injury, the most important thing to do is rest, right? Actually, while it may seem like a good idea in theory, it isn’t such a great one in practice, especially when trying to recover from musculoskeletal (muscle and skeletal) injuries.
Joseph Buckwalter MD, from the Department of Orthopedics of the University of Iowa, notes that following injury or surgery, optimal restoration of the musculoskeletal function requires understanding the effects of motion and loading on the healing of bone, tendon, ligament, articular cartilage, and skeletal muscle.
After a musculoskeletal injury, the injured tissue undergoes three stages in the process of healing: the inflammation stage, the repair stage, and the remodeling stage.
During the inflammation stage, your body has a cellular and vascular response to the injury. In the repair stage, your body replaces necrotic (dead) or damaged tissue with new cells and matrix. Lastly, during the remodeling state, the site of injury is reshaped and reorganized as the body the removes, replaces and rearranges the cells and matrix of the repair tissue.
Keeping the injured site at rest is helpful during the inflammation stage and part of the repair stage, however, once the remodeling stage begins, if the site remains inert, your body will not repair the injury in an optimal manner. Instead, the treatment of tissue injuries with prolonged rest delays recovery and can cause irreversible changes in tissue strength in function.
Early motion of tissue injuries maintains the structure and composition of normal bone, tendon, ligament, articular cartilage, and muscle. If the injured area is immobilized to for too long, the patient will lose significant bone density, often requiring many months to regain. In some individuals, especially older people, bone density may never return to its previous level following long periods of immobilization. Here, one of the most important things to note is that immobilization of joints eventually causes irreversible damage.
On the other hand, immediate or excess mobilization of injured muscles may increase scar formation, so some rest is necessary.
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So, what is the best thing to do, then? Simply put, finding a safe middle ground—one that includes neither too much rest nor too much activity—is the best way to safely and properly recover from musculoskeletal injury.
Doctors agree that the ideal way to treat musculoskeletal lesions is to engage in a short period of rest immediately after the injury, and then begin carefully using and exercising the afflicted muscles.
Remember, prolonged periods of rest can actually be (sometimes permanently) detrimental to the very muscles and bones you are trying to heal—and that overexerting them immediately after an injury can be just as damaging. In the case of musculoskeletal injuries, balance is the key to successful rehabilitation.