Why Rest Alone Isn’t Rehab

Whenever we suffer an injury or experience pain, our first instinct is usually to rest the area. There’s the old doctor joke: “It hurts when I do this.” “Then don’t do that.” In the short term, this advice makes sense. Pain often increases with movement, so avoiding movement can help manage symptoms and reduce the fear of making things worse. Rest reduces pain, but rehab builds tolerance.

The problem is that rest alone does not prepare the body to return to sport or activity. While rest can help calm pain, it doesn’t rebuild strength, tolerance, or confidence. That’s why “rest until it feels better” often leads people right back to pain or re-injury once they try to return.

This is where the idea of relative rest becomes important.

The first two to four days following an acute injury are often the most painful. This is when inflammation is active and tissues are highly sensitive. During this phase, rest is appropriate — especially from the movements or activities that clearly worsen symptoms. But even here, absolute rest isn’t ideal.

Relative rest means avoiding high-stress activities while still allowing tolerable movement. Simple actions like wiggling fingers or toes, moving the joints above and below the injury, or gentle pain-free motion can help manage swelling, maintain muscle activity, and support the healing process without overloading injured tissue. As pain begins to settle, this relative rest gradually shifts toward more direct and intentional loading.

Take a rolled ankle as an example. In the first few days, you might use crutches or a walking boot to reduce stress on the ankle and manage pain. You may also elevate it to help with swelling. This is appropriate rest, but that’s not the end of rehab. Throughout the day, you can still wiggle your toes and bend and straighten your knee. Once pain improves, ankle movement can be added in all directions, first without weight, then with gradual loading. This can progress to gentle isometrics, resisted exercises, general lower-body strengthening, and eventually running, cutting, and change-of-direction work to match the demands of your sport. At each stage, the goal isn’t just to feel better but to prepare the ankle to tolerate what’s coming next.

This is where the SAID principle comes in: Specific Adaptation to Imposed Demands - or more simply, use it or lose it (read more here). When we completely rest for too long, the body adapts by losing strength, conditioning, and tolerance to load. Pain may settle, but tolerance decreases. When activity is reintroduced without rebuilding that tolerance, the body is often less prepared than before, increasing the risk of setbacks or re-injury.

Even small amounts of early loading can help maintain tolerance and limit this deconditioning. As symptoms allow, progressively increasing load is what actually restores strength, confidence, and resilience, not just in the tissue, but also in your ability to trust your body again. Rehab isn’t just about calming symptoms - it’s about making sure your body is ready to return to what you want to do.

If your rehab plan is only rest, you’re likely to stall. A smart rehab plan keeps you moving within tolerance, then gradually builds that tolerance so that when you return to sport or activity, your body is prepared.