Another question for the PT's out there...

[OakLeaf]

Oakleaf-did you have to stop biking? I hope you will tell me no....

At the time I wasn't bicycling, but because they kept prescribing rest, rest, rest, I had to stop motorcycling, and yeah, that was awful.

BUT. The pain wasn't so bad that it would've interfered with my ability to brake, steer or pull the throttle, and in retrospect I don't think rest accelerated the healing at all. Even though I told every health care practitioner I saw how the injury occurred, I think the treatment they prescribed was more appropriate to a strain or sprain and not a simple bruise, and I don't think they ever really isolated how much of my pain was from the nerve and how much was from the tendon.

JME, with a really freakish sort of injury (picked up a stepladder the same way I'd always done, and the edge of the step put the full weight of the ladder right onto that soft tissue). Even touching a ladder totally freaks me out, now, never mind I have a phobia of falling!

I have a strong suspicion that some of the PTs didn't believe that resting was a good idea, but were deferring to the orthos. And in turn, because it wasn't a surgical injury, the hand surgeons basically didn't even want to know me. I've had that experience before - if it's not surgical, the orthos just say "no activity outside of PT," when that turns out to be really damaging, and the best thing is to keep the muscles strong and the joints loose by normal activity. Hopefully I've learned my lesson about that if I get another injury.

Still, I think the possibility that time alone will heal - and rest may not - is something to be discussed frankly with practitioners. Especially with something like a hand, which not only is a MAJOR interference with ADLs, but wound up causing tendinitis in elbows and wrist because of shifting all the work of that hand to other joints, doing things backwards and upside down, etc. Probably didn't help my TMJ either, because of all the stuff I had to hold with my teeth.

I recommend everyone going without one hand for three hours, just once, just to see what it's like.

[KnottedYet]

I have a strong suspicion that some of the PTs didn't believe that resting was a good idea, :

... we don't let anyone rest....

Just kidding, actually we want people to rest during the inflammatory phase, about a week post injury. Once the tissue leaves the big inflammatory phase and enters the repair phase we start kicking 'em in the heinie to begin gentle motion, progress to tissue loading after that during the tissue remodelling phase (stop kicking and start using the whips and chains), etc.

If someone is repeatedly injuring themselves (RSI or the like) we do intervene then. "It only hurts for a week after I juggle bowling balls, the rest of the time I'm fine, really!" Call a halt to the bowling ball juggling, let the tissues get over the inflammatory phase, then begin specific strengthening and body mechanics education until the patient can handle the weight of accelerating bowling balls without tearing something.

(two of my more unusual patients were circus performers. not jugglers, though, that's just my hypothetical patient for my illustration here)