To Your Health
August, 2009 (Vol. 03, Issue 08) |
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Use It or Lose It
Returning to Normal Life After an Injury
By K. Jeffrey Miller, DC, DABCO
Muscle, ligament and joint injuries typically require some degree of rest as part of the initial plan for care. Rest takes the strain off the injured area, prevents further damage and allows the swelling to settle down.
However, while rest is important initially, you can get too much of a good thing. Rest for prolonged periods of time can cause several problems. Bone begins to lose calcium. After two weeks, muscles begin to lose 3 percent of their strength
per day. Inactivity decreases circulation, slowing the healing process. Depression and anxiety can build with each day of disability.
All support for the validity of the old saying, "If you don't use it, you lose it." In fact, many studies have shown that the longer someone is off work, the less likely they will return to the job held at the time of injury. The bottom line is the quicker you get back to your normal routine, the better. This does not mean you have to go straight back to your full schedule of duties right away. Working with limitations and light duties at first, and then gradually increasing your workload, are good options. Returning to normal activity with restrictions helps avoid the ill effects of prolonged rest without overdoing it.
For example, patients with back pain used to be sent to bed for 30 days. At the end of the month, the patient's original injury had improved and they were sent back to work. This seemed reasonable at the time; however, people began to notice that a great deal of muscle strength was lost during the 30-day period. When the patient returned to work, they were weaker than at the time of the initial injury. This meant the possibility of re-injury was high, particularly for jobs that required repetitive movements, lifting, or other activity-based actions.
Avoiding weakness upon return to activities is a key reason rehabilitative exercises are used more frequently in today's health care plans. Currently, if time off is necessary, doctors aim for three to 14 days of rest. Returning to work with duty restrictions usually follows. This general timeline is important for arm and hand injuries, as well as back injuries. The same types of tissues are involved in each of these areas.
It is a good idea to keep the above in mind if you are injured. An even better idea, of course, is to avoid being injured in the first place. Stay physically fit and follow safety rules to help prevent injuries at home and on the job. Remember, always consult with your doctor following an injury to determine severity and appropriate course of action.
For Dr. Miller's advice on how to treat an injury involving the muscles or joints, including when to use ice and when to use heat, see "Joint and Muscle First Aid" in the April issue of TYH.
K. Jeffrey Miller, DC, MBA,is an assistant professor of chiropractic at the University of Missouri Orthopedic Institute, a branch of the University of Missouri Health System. He is a graduate of Palmer College of Chiropractic and the author of several practitioner and patient texts.
