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If you asked a bunch of people “what should you do if you’ve got an injury?” I think the general most common answer (aside from seek professional help) would be “rest.” While a period of rest may well be advisable in certain circumstances with some injuries, we often have a habit of generalizing what we would do for one thing and apply that remedy to everything. In the post I will explain why rest isn’t helpful in the long run when it comes to chronic tendon pain and what you should do instead.
“Tendinopathy does not improve with rest – the pain may settle but returning to activity is often painful again because rest does nothing to increase the tolerance of the tendon to load” – Dr. Peter Malliaras
I will use my “cup analogy” to explain
Imagine your tendon is a cup and activities you do are like pouring liquid in. Pour in too much and the cup overflows and results in pain. When your tendon is injured that cup has shrunk i.e. it can’t tolerate as much before overflowing as a healthy tendon. It’s more like an espresso size cup vs a big mug.
I mentioned the phrase “the poison is the medicine” in the previous blog post. Let me elaborate. The correct rehab exercises are a “healthy stress” a “healthy liquid” that if poured into the cup consistently with the correct frequency, just like watering a plant, will feed it and allow it grow overtime. However, what has to be considered is that while it may be a healthy “liquid” like a smoothie vs a beer, it still has to be factored in with the overall liquid poured in the cup on a daily basis to avoid overflow. This means you may need to modify, reduce tendon loading in some areas to allow some extra room in your cup to “pour in your rehab” without overflowing your cup. Otherwise you just overflow and that’s why dosage is key. You wouldn’t stick a hose in your house plant and annihilate it with a constant bombardment of water would you? This is where mindset and psychology come into play. When we’re in pain we often don’t think straight. We might feel panicked, desperate to get out of pain and in our desperation find a YouTube exercise and do it excessively to try and get your pain to go away as fast as possible.
As much as I wish I could wave a magic wand to make you Achilles tendon pain vanish, it doesn’t work like that. However, that being said, there are some ways to get some symptom relief quickly with tendon pain but this is symptom relief and not cause resolution. You can’t symptom relief your way out of a chronic problem and that’s why no matter how many massages you get or needles you have stuck in you, these treatments do nothing to restore the tendon’s capacity to tolerate load.
So I hope that helps explain and demystify why rest doesn’t really help long-term with these injuries.
Remember, take a breath, close those 500 YouTube tabs with random exercises down and contact a professional who can guide you through the process with a well designed rehabilitation program.
