Do You Need More Treatment Or Just More Rest and Recovery Time?


I noticed two important improvements in my body during my recovery from heart surgery.

  1. I did not have ONE headache for over 6 weeks! (I usually get treatment from my colleagues every week as my neck hurts and I have headaches regularly).
  2. My irritating tennis elbow completely disappeared – I had felt it for around 9 months after a vigorous bout of cleaning some skirting boards.

This got me thinking.  How many musculoskeletal problems that we have don’t just need treatment …. they need to have enough REST from the movements that irritate and prolong the pain to allow recovery. How often do we think that because we are getting treatment for a problem, that means we can keep using the affected joint, tendon or muscle and it won’t matter?

I spend hours at my lap top every day – a lot of them producing articles like this for the website! The ‘experts’ say that we spend nearly 9 hours a day on our devices. Is my body in a good, neutral position when I’m doing this? Of course not! I am squinting and jutting my chin forwards so that I can see what I have written; my shoulders gradually rise up by my ears and I can feel the familiar  muscular ache creep up to my head, triggering a headache.


When I was in hospital and since, I was not able to sit hunched over like this. I slept in some funny positions and couldn’t do any exercise but I did not use my lap top …. could that fact have contributed to the lack of headaches? It was only after I felt well enough to produce articles and Newsletters for you that I got a headache and stiff muscles in my shoulders again.

When I treat patients or just do things round the house, I use my right arm all the time. When I was unwell, I did none of those things and suddenly I was aware that I no longer had that irritating ache and soreness in my right elbow when I moved it or used it. Did that enforced rest  allow the irritated tendons to recover?

What are the experts thoughts on rest and  recovery?

Most athletes know that getting enough rest after exercise is essential to high-level performance, but many still over train and feel guilty when they take a day off. It is known that the body repairs and strengthens itself in the time between workouts, and continuous training can actually weaken the strongest athletes.


Rest days are critical to sports performance for a variety of reasons. Some are physiological and some are psychological. Rest is physically necessary so that the muscles can repair, rebuild and strengthen. For recreational athletes, building in rest days can help maintain a better balance between home, work and fitness goals.

What Happens During Recovery?

When we train or just use our bodies in an unfamiliar way or over use a joint, tendon or muscle, we get tissue breakdown, depletion of energy stores in the cells and fluid loss.

Recovery time allows the body to gradually adapt to increasing exercise without muscles, tendons and joints becoming painful and also allows energy stores to be replenished and allows tissue repair to occur. Without sufficient time to repair and replenish, the body will continue to breakdown from intensive exercise or overuse. Symptoms of overuse arise from a lack of recovery time. Signs of overtraining include a feeling of general malaise, staleness, depression, decreased sports performance and increased risk of injury, among others.

We need to Adapt to Unfamiliar Exercise

Adaptation means that when we undergo the stress of physical exercise, or just unaccustomed use of part of our body, our body adapts and becomes more efficient. It’s just like learning any new skill; at first it’s difficult, but over time it becomes second-nature. Once you adapt to a given stress, you require additional stress to continue to make progress. This is why we encourage you to gradually increase the difficulty of exercises we give you.

There are limits to how much stress the body can tolerate before it breaks down and risks injury. Doing too much work too quickly will result in injury or muscle damage, but doing too little, too slowly will not result in any improvement. This is why personal trainers set up specific training programs that increase time and intensity at a planned rate and allow rest days throughout the program.

Short and Long-Term Recovery

Keep in mind that there are two categories of recovery. There is immediate (short-term) recovery from a particularly intense training session or event, and there is the long-term recovery that needs to be build into a year-round training schedule.

Short-term recovery happens in the hours immediately after intense exercise.

Another major focus of recovery immediately following exercise has to do with  optimizing protein synthesis (the process of increasing the protein content of muscle cells, preventing muscle breakdown and increasing muscle size) by eating the right foods. Short term recovery allows soft tissue (muscles, tendons, ligaments) to repair and the removal of chemicals that build up as a result of cell activity during exercise.

Long-term recovery techniques require recovery days after increasing exercise or gardening more than usual or even cleaning the house in a manner that we are not used to – like me cleaning the skirting boards! Athletes know the importance of recovery days and or weeks that are built into an annual training schedule but non athletes need to take changes in activities seriously too and allow recovery of the tissues. We all need to listen to our bodies though and allow recovery to occur. We are not machines!

Remember, tendons in particular do not like change in use. Therefore if you suddenly decide to do unfamiliar jobs or exercise, you need to do so for a short period of time; allow recovery and if any pain arises within 24 hours, you know you need to stop doing that activity for a while and when you go back to it, you need to do it for less time with less intensity. That way your body adapts and does not give you pain that can take ages to recover from. Inflammation has the following effects on the tissues which produce pain:-


Treatment with manipulation, soft tissue techniques, stretching, graduated exercise, mobilisation and advice is really important when you have overdone it, and can reduce the inflammation above, but please don’t forget the need to rest for long enough to allow recovery.