Dr Debbie Snell
So – we all know the line, exercise is good for you. Google the ‘health benefits of exercise’ and you can experience the overwhelming power of the information age, with a mere 127 million hits. Clearly the health benefits of regular exercise and physical activity are hard to ignore. But what about when we are unwell, does resting up help? Is rest a helpful ingredient in rehabilitation?
Rest is possibly the most prescribed ‘treatment’ in the history of medicine. We all remember the advice. “Go home and rest”, “take a few days off and rest up.” In rehabilitation, especially after a concussion, rest is routinely prescribed as means of ‘resting’ the brain. In 1951 Dr Samuel Levine an eminent American physician was possibly the first to question the adage “rest to the affected organ is a cardinal principle in the treatment of disease.” Since, researchers and clinicians have been revising their views on the benefits of rest and the management of a number of health problems has been slowly changing as a result.
Take acute back pain for example. Lengthy best rest used to be routinely prescribed by health providers. Following an important study in the 1980s and plenty of supporting studies since this time, we now know that staying active is much better than rest for getting back to usual activity levels. For a long time Doctors prescribed rest for people with mental health problems such as depression until it was recognised that prolonged resting was making symptoms worse. Low levels of activity and resting have also been shown to affect physical and psychological recovery in other health problems such as stroke, heart disease and even some cancers. In concussion management recommending rest until symptoms improve is the hallmark of most treatment programmes. International guidelines for managing concussion in sport for example, include rest as an essential first step although these guidelines are being revised to limit rest to only a few days before slow and gradual controlled return to usual activity and exercise is introduced. Even in healthy people recent studies have shown that after three days of best bed rest people in the studies demonstrated reduced muscle and cardiac conditioning (fitness) and after a week they started getting headaches, sleep problems, mood changes and feeling dizzy. This is a particular problem for recovery after concussion, since common symptoms that follow a concussion are headaches, dizziness, concentration problems, mood changes and sleep difficulties. This means it can become confusing to tease out what might be associated with the concussion and what just might be associated with prolonged rest. However rest for a short period such as a few days immediately following a concussion is still important and return to intense activity is not recommended in the early weeks.
In terms of recovering from a health problem it is important to seek advice from a health provider, so that you introduce and increase activity levels in a safe and controlled way to avoid over doing things too soon and risking injury. If you are experiencing problems after concussion and would like advice about safely returning to your usual activity levels you can ask your GP for a referral to a Concussion Clinic.
