Last week, I explained why rest alone is not rehab. This week, I want to address the other side of that conversation: resting isn’t being lazy. While we often feel the need to be actively doing something throughout our entire rehab, rest can be a valuable tool when used appropriately. Rest isn’t the opposite of rehab, but rather a part of it.

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.

I generally don’t like using the term “best” when it comes to discussing exercises. Exercises aren’t good or bad, and there isn’t one “best” movement - everything requires context. Exercise selection should be based on the individual person’s goals, current ability, available equipment, comfort, and preferences.

“Stress” is used in the strength and conditioning, training, and rehab world with a negative connotation. We hear people say, “don’t do the knee extension machine because it stresses your knees” or “deadlifts put stress on your low back.” While said with good intentions, there is a lot of context missing in these statements. Rather than viewing stress as only bad, we need to look back at the SAID principle to see how stress can be a good thing.

An important concept I apply to my rehab, borrowed from the strength and conditioning world, is the SAID principle, which stands for Specific Adaptations to Imposed Demands. What this means is that how and what we train determines how our body adapts. Or even simpler, we get better at what we do.

One of the harder parts of the rehab process from the practitioner side, and what makes rehab sometimes more of an art than science, is knowing when we accept pain during the rehab process.

One of the most frustrating parts of dealing with an injury is when it takes us away from the things we enjoy- sports, training and daily movement. Sometimes the pain itself forces us to stop, but even when it’s manageable, many people still choose to stop.

The load-capacity framework can also guide our treatment plan and what we work on in our rehab. As a reminder, injuries occur when a load on your body exceeds your body’s capacity to handle it. That leaves us with two main ways to help someone- decrease the load or increase their capacity.