Traditionally Western medicine has counselled immobilisation and rest for the pain and tenderness of injury.
However, research over decades has shown[1] that maintenance of the structure and composition of the bony and soft tissues of the skeleton requires repetitive use.
Growing, immature and repair tissues are more sensitive than normal to such work and movement. Sensitivity may decrease with advancing age.
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PRACTICE POINT Injured bone and soft skeletal tissue heals fastest with early loading and movement rather than rest and immobility |
Prolonged rest has an adverse effect on tissue repair and healing; cyclical work (loading) and movement promotes optimal healing. Even for joints recently operated or adjacent to fractured bones, early Continuous Passive Motion is both congruent with that research and has been shown empirically to encourage more rapid healing[2].
Clearly the loading of injured parts can be premature or excessive and must be tempered by reason. However, insufficient research has been undertaken in differing injuries to determine how much work and movement is too much.
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PRACTICE POINT Directed relaxation and regular exercise may significantly improve the work capacity of employees with musculosketal complaints |
In a recent Norwegian study[3], workers with musculoskeletal problems who undertook a programme of supervised relaxation and directed home exercises for thirty minutes thrice weekly had a dramatic and long-term reduction in sickness absenteeism compared with similarly injured workers not involved in the programme.
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