Is Rest Best?

I agree that initially all acute (bash crash strain and sprain) injuries require some degree of rest. This is basically to allow the body's "overreaction" to the trauma to subside. eg swelling, redness, pain heat, and early tissue repair to initiate.
But:
With the growing incidence of lifestyle related disease such as diabetes, and cardio- vascular disease I think it it is vital health professionals encourage you in every way to continue in some form of physical activities as much as possible during the rehabilitation.
Main Reasons:

1. Elite and regular exercisers develop some degree of physiological dependency to their regular bout of exercise. Maintaining some physical activity reduces post injury blues and helps maintain a positive approach to your treatment!!
2. It allows you to maintain contact with the people who are not injured reducing the feeling of being isolated by your injury - particularly teams.
3. As a general population our lack of physical activity is causing serious health problems. Children need all the encouragement possible to keep active and form healthy exercise habits.

Obviously this is dependant on the type and magnitude of injury, so an accurate and quality diagnosis is vital!!
What Is wrong with rest and hope:
Firstly - For one if you do not get a specific diagnosis or list of potential diagnosis this is grounds for concern!!. Without addressing the cause of the problem when you resume activity the problem can simply reocur!!
Second - You need to receive a structure treatment plan and list of objectives to meet, addressing all areas.
Third - Relative Rest is mostly all that is required in this type of scenario. By this I mean prioritizing activity and selecting that most important to continue. eg dropping a school practice and the school games on the same weekend as the rep games!!
Fourth - Let symptoms be your guide!!
If 3 practices are too much drop down 1 practice and stop any running for fitness. "Relative Rest"
Example of what should be avoided:
Little Johnny/Jane is a keen young soccer player (8-14). She/he is in a school team and has made it to the local representative team but he/she develops a painful heel. This gets very sore. It breaks Mum and Dads heart to see Johnny/Jane limping off the field so they take her to a medical professional who advises among other things x2 weeks total rest from all activity and stop soccer for at least 6 WEEKS. No specific diagnosis (general growing pains) was made and a follow up appointment in 1 month was scheduled. At that time pain had settled but reps and soccer had finished!!
(This will probably reduce the pain for Johnny/Jane but increase the pain for mum and dad!!)
Caution:
This is not a general application in all injuries but does suit as a guide particularly for growth and activity related problems.
Evidence!!
As I had just written this article I attended the Waikato Sports' Medicine annual day conference with the focus on youth and sport. To my delight much of what I had chosen to write about was discussed and backed up,by leading sports health professionals and educators!!
Recent studies have shown!!

"Health related fitness trends in children" NZ journal of Sports Medicine Vol 30 No1 2002.
Basic findings:
Comparing todays kids with those of 15 years ago the kids today have reduced cardiovascular fitness and increased skin fold (fat).
"These similar trends if unchecked are a cause for public health concern".
"Physical activity and cardiovascular disease"
Basic findings:
An estimated 1/3 of all cardiovascular problems. (heart attacks, strokes etc) are attributable to lack of physical exercise.
Walking at an average pace for 2 hrs per week reduces the risk of a stroke by 25%.
American Heart association recommends 30 minutes of "moderate intensity exercise on most days for an adult. (This does not need to be in 1 block!!) *Start slow and build gradually.
For further information
- Push Play www.pushplay.org.nz or phone 0800 ACTIVE
- Sports Waikato www.sportwaikato.org.nz or phone 07 838 2657
In a Nutshell:

The point I am trying to make here is that it is not a good idea to sweep all injuries under the carpet treat them all the same and hope with a bit of "rest" will clear things up. Often the cost of inactivity is greater than the cost of relative rest particularly in young kids who need encouragement to stay active.
Get your injuries checked our properly with a good quality diagnosis and structured treatment plan.
Often relative rest is best!!

Keep active, Best Wishes

Andrew Jones

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