Many people are terrified of admitting an injury because they will have to take “time off”. This is usually associated with losing condition, putting on weight or losing flexibility. This means that they eschew the “Rest” that they know they should take because there is something more important going on. You know the deal... A major performance, an exam, a casting for your dream job... Sound familiar?
Sitting through class icing your foot is not only not much fun, it also does not give a very good impression to those you are trying so desperately to impress.
However, stack a few of those injuries on top of each other, and the body starts to struggle. Why? Well, because muscle around any area of pain starts to waste away very quickly, and you can often see visible atrophy (muscle loss) just 4 days after an injury.
This is basically due to a protection response from your brain.
In order to experience less discomfort, your brain can use a strategy where it selectively does not feel the injured area so much, in order to experience less pain. However, with less feedback, there is also less feed forward, in that there will be also less contraction of that muscle due to the dulling of the nerves leading to it.
This is where “Relative Rest” comes in. It is basically a way to protect the injured area while continuing to train the rest of your body, and it has two main focuses.
The first is resting the injured area to avoid any more damage. So stopping jumping, pointe work, walking... whatever activity causes pain or movement of that area. This may involve using crutches, a boot, some taping, or simply wearing supportive running shoes and not jumping in class.
This does NOT mean that you rest every other area of your body, in fact, resting one area should give you much more time to push the rest of your body!
This is also a great way to actively show your teacher that you are doing all that you can to get back into class, so they will usually be a lot more sympathetic!
Many people who are “off” due to injury do not spend nearly enough time on their rehabilitation as they should. My guideline is that you should be doing at least half of the hours you would normal dance in rehab. This may be a lot of hours! But it can include appropriate cardiovascular exercise, flexibility work, specific strengthening exercises, and exercises to improve your technique.
Especially if you have a foot injury that requires you to be “non-weight-bearing” (i.e. on crutches or in a boot) we do a lot of work on the hips and back, and on improving the height of leg in your extensions with floor work. This is a great time to eliminate any bad habits that may have crept in and surprise your teacher when you return to class!
How do you know what to rest from? Well, for some people this will be guided by pain. Basically avoid doing anything that hurts, even a little bit. Constant irritation of an area will really interfere with its healing. However, in situations like a stress fracture, you may also have to avoid things even when they are not sore, to allow full healing. For serious injuries like this you must be guided by your therapist.
However, it is also important however to not immobilise a joint that does not need to be immobilised! This is why a correct diagnosis is so important. Sometimes gentle movement in specific directions is essential for healing, so while you may be restricted from doing some movements, others may be very important to do.
The second part of relative rest should actually include careful activation of the muscles around the area (if it is safe to do so) to keep the connection alive between your brain and the muscle active. This can make a HUGE difference to how quickly you can return to full capacity when you are allowed to use that area again, and can prevent other associated injuries from developing.
This may include Mirror Therapy, use of an EMS machine or simply careful isometric activation of a specific muscle in a specific way. For more information about any of these treatments, please contact us at Perfect Form Physiotherapy.
Having a rehab program that works on the principle of “Relative Rest” means that you can rest the portion of your body that is actually injured, allowing the natural healing process to work it’s magic, but that you can still work the rest of your body. This means that you can rehabilitate your injury, and correct all of the factors that caused it, before returning to class in a sensible way. Your rehab program should actually make you stronger and more flexible than just before you were injured!