Why resting after a back injury is a BAD idea…

It’s the age old advice isn’t it!? If you’re hurt, you should rest while your body recovers. There is merit to this statement, but it is very dependant on the type of injury you’re dealing with. When it comes to back injuries we believe that absolute rest is one of the WORST things you can do. Instead, we prefer “relative rest” with an active rehabilitation. Let me explain why.

Back injuries can vary in severity with numerous structures around the spine being the culprit. It could be a muscular strain, a ligamentous sprain, a joint irritation or a nasty disc injury. Whatever structure is stimulating the pain response from your brain, there is normally a secondary effect that is pretty consistent across the spectrum of back injuries, and that is muscle spasm. Anyone who has experienced this will tell you that it absolutely sucks! It involves the compression of all of the tiny blood vessels and nerves that are present within these muscles which creates a large amount of pain. This happens because your brain is smart. It has detected that there is inflammation somewhere in your back which is a sign of potential tissue damage (from the ligaments, joint, disc etc mentioned previously). Generally, these things don’t just get hurt out of the blue. There is normally some force, no matter how big or small, which causes the tissue damage and hence appropriate ‘spasm’ response from your brain. It does this to protect your body. If your muscles are in spasm and you’re currently experiencing pain, it is unlikely that you are going to produce the same movement or force that caused the pain in the first place yeah? It’s your brain’s way of saying, “I didn’t like that, lets not do it again. And if you do, I’m going to send your back a nasty pain so that you don’t do that again. I’m going to keep doing that until I believe that movement is no longer a threat”.

Makes sense yeah? If you sit on your car bonnet in the middle of summer and burn your butt, your brain and body are going to send you signals to not do that again.

But what does this all have to do with not resting? Well, here’s the kicker. If you hurt a disc in your back, and your back seizes up into muscle spasm, resting makes the pain worse!! If your muscles are in spasm, they need to move to get out of spasm! If you’ve got inflammation around a disc in your spine, the muscles around it need to move to circulate the inflammation. So if you don’t move, the muscles stay in spasm and the inflammation pools around the injured site which makes your brain send more spasms! The answer to this is simply, MOVE. This is why we use the term “active rehabilitation” and why all of our practitioners will work with our back injury patients to devise an active movement program to help get them out of pain as quick as possible.

Why “relative” rest and not “absolute’? Absolute rest implies minimal to no movement. We want you to move, but we also want you to be sensible. If you hurt your back lifting a lounge, we don’t want you to go and lift the lounge again the next day with a whole bunch of muscle spasm in your back. It makes no sense. But we also don’t want you to just lay on that lounge you tried to move because you are hurting. Find the middle ground. Go for walks, do some gentle stretching, get up every 30 minutes. Rest. But only relatively.

So if you injure your back, or have a friend or family member who is suffering. Tell them they have to get moving. They will thank you for it later.

As always, it is best to get help from a professional to aid in this process and get you back doing what you love doing as soon as possible. That’s what we do 🙂

BJ

BJ – Senior Physiotherapist

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