Why does my pain keep coming back after I rest?
Rest can be helpful when you first injure an area. It can help to calm down any inflammation, give the area a break, and reduce pain levels. For many injuries, the pain subsides after a few days of rest.
What people don't know is where to go from there. Should I keep resting? Should I go back to my sport or activity? Should I go see the doctor?
For many, they get back to their normal sports and activities without problems, but for others they get into an injury cycle.
Injury → Rest → Pain relief → Return to sports/activity → Injury
If that's you, it's because resting the injury isn't solving the underlying issue. Let's talk about why.
First, rest can reduce the pain and inflammation in the area by taking pressure off of it. The problem is, that rest doesn't improve your strength, mobility, or mechanics. Working on those things helps to solve the underlying issue of why the pain may have started in the first place.
For example, you are running 30 miles/week and have achilles tendon pain. You decide to take two weeks off to manage symptoms and bring the pain down, but get right back into your normal training load of 30 miles/week afterwards. Well, during that time, your achilles wasn't doing any running or being asked to handle any increase in force. The tendon will most likely not be ready to get back into normal training, and pain will start to creep back in.
This is how people get stuck in the injury cycle for long periods of time.
For chronic injuries, it's better to ask, "What does my body need to work on in order to tolerate this activity again?" Like we mentioned previously, this is getting to the heart of the underlying issue, the WHY you're feeling pain.
Depending on the injury and the person's goals, it may be a mixture of adding in mobility, strength, decreasing the volume of training (aka load management), or addressing mechanics and form. It can also mean modifying or reducing your activity (but not completely stopping it).
The goal is to find a tolerable amount of activity (i.e. mileage, weight at the gym, volume of playing your sport/activity) that you can complete without provoking pain and symptoms. While it's modified, you're working on addressing the underlying factors.
It's important to note that many times, this will require looking beyond the painful area. For example, someone with back pain shouldn't just work on their core and back muscles, but also take a look at how the hips and thoracic spine (joints above and below) are moving. How is the strength of the glutes, pelvic floor, and obliques?
The same concept can be applied to all other areas of the body when it comes to NMSK (neuromusculoskeletal) pains. Your body works as a system, and it's all connected. What you do for one area will influence another.
This is why individualized assessments work best, instead of grabbing a few exercises off of IG/TikTok/YouTube, which will not be personalized for you and your own body.
The approach for everyone will depend on their injury and the person. The goal is to always prepare your body to get back to the things you love, at the level you were doing them before.
At Grohmann Chiropractic and Sports Medicine, treatment is individualized to the person, injury, activity, and goals. Your treatment plan may consist of hands-on manual therapy such as adjustments, massage, cupping, or active strategies such as exercise and activity modifications.
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