Use it or lose it! (Make your body adapt to recover from injury)

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The human body is adaptable in both a negative and positive way. In the past, rest was prescribed for injury but was it the the right thing to do?


Short answer:


Probably not.


Why? I feel better when I rest so that's good, right?


Not necessarily.

Think about it. Do your muscles get stronger with rest? Do your bones get stronger? Do your tendons?  Do you get fitter? No!

In fact the opposite occurs. So that can't be good can it?


Muller et al (1970 found that after 8 days of resting, muscle strength reduced by 2-6%.

Most injuries are caused by cumulative overload to a structure, which basically means they are loaded beyond their physical strength. So taking this on board does rest work?

No, because the tissue that is injured will actually get weaker, which of course, causes more of the same problem that actually caused the injury in the first place.



A great example is the Achilles tendon. Here you have a structure that on average takes between 6-8 times your body weight when you run (Pierre-Jerome 2010).

Research has found that although rest makes it feel better in the short term it will actually make things worse in the long term (Malliaras et al 2013). The evidence actually shows that you need to progressively load the tendon which stimulates healing and makes the structure stronger. It also makes it more able to tolerate the forces applied to it, therefore making it more resistant to injury: Loading of tendon creates an upregulation of insulin-like growth factor (IGF-I) & this stimulates healing (Khan & Scott 2009).


So what constitutes load for an injured Achilles tendon?


Bohm et al (2015) found that loads greater than 70% of a maximum voluntary contraction for isometric loading and 70% 1 repetition maximum for isotonic loading that continues for a 12 week period leads to greater tendon stiffness and therefore more tolerance to load.

Another example is bone density issues like Osteopenia and Osteoporosis. People with these conditions shy away from impact and loading activities for fear of breaking a bone but again this will just make the bone weaker. Here too, evidence shows that if you load the bone you can actually increase the bone density and reduce your risk of fracture: Resistance training & jumping exercises increased bone density in men with low bone density (Hinton et al 2015).

So the case for not resting and instead loading (carefully and progressively) your injuries is the best policy.  I would however, advise being assessed first to ensure that you are doing the correct thing for your injury before starting any loading program.


So if you want to get assessed and looked at, then you can contact me on any of the following:

Telephone: 01782 771861
Mobile: 07866195914
Email: mathewhawkesphysiotherapy@gmail.com



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