When you hurt yourself, it’s easy to assume the best remedy is rest. We’ve been told this for decades. But modern research over the past 25 years shows that while rest is sometimes necessary, prolonged rest beyond 1–2 days can actually slow recovery.
Why? Because resting too long without appropriate, guided movement leads to muscle wasting, stiffness, and slower healing — ultimately prolonging your recovery.
So where does hands-on treatment like massage, dry needling, manipulation, or mobilisation fit into the recovery process?
Hands-on treatment is never the only form of treatment required for recovery
Unfortunately, no massage, dry needling, or joint mobilisation will make your muscles stronger, improve your motor control, or give you the ability to lift, push, or pull—which are essential movements for daily life.
That’s where exercise-based rehabilitation becomes crucial.
To truly recover and return to normal function, your body needs progressive strength training, tailored to your injury and phase of healing.
It’s important to respect the body’s healing timeline — especially when scar tissue is forming. In the early days, this tissue needs protection. But over time, it must be challenged and loaded in a controlled way to promote long-term strength, flexibility, and resilience.
Movement is medicine—even early on
After the first 1–2 days of rest, activating your muscles in a controlled, regular way is one of the best steps you can take toward recovery.
Take a typical lumbar disc bulge. Low-range, extension-based exercises can often be a great starting point. These movements help:
- Encourage the inner disc nucleus to centralise, supporting the healing process
- Activate surrounding muscles in a safe and supported way
At this point, scar tissue is still forming and remains immature and fragile and it needs to be protected. But early movement is healthy and encourages your brain to say very early on “it is okay to move and I am safe to do so”.
The role of hands-on treatment in the early days
In the first 1–2 days after an injury, hands-on treatments like massage, mobilisation, or manipulation are usually not recommended. These treatments increase blood flow to the area which in the early inflammatory stage can actually worsen symptoms and delay healing.
That said, in my clinical experience, gentle lumbar manual traction can help speed up early recovery for a lumbar disc bulge, but only combined with appropriate advice in regards to appropriate positioning to avoid further injury (and facilitate early healing) and exercises that are safe.
So, when is hands-on treatment useful?
Hands-on treatment starts to shine after the early healing phase—usually around the 3-week mark, once scar tissue begins to mature and strengthen.
At this stage, the body is producing type I collagen, which forms the basis of long-term repair. But this process is often haphazard—scar tissue can build in unhelpful directions, not always in an effective way.
This is where hands-on techniques become valuable:
They break down excess or misaligned scar tissue to help restore smooth, functional movement.
For example, after a common ankle sprain, many people lose the ability to bring the foot up (known as dorsiflexion). Mobilisation, stretching, or manipulation can help restore this vital motion, which is key to walking, running, and regaining full foot function.
But you can’t stop there…
Even at this later stage, hands-on treatment is NOT effective without an appropriate strength program to facilitate recovery and protection of the muscles around the injured area.
A good strength program spans at least three months, gradually progressing from:
- Basic motor control and activation
- To restoring functional strength
- And eventually preparing your body to cope with daily demands and reduce reinjury risk
In short, hands-on treatment is a valuable support tool—but never a replacement for movement and strengthening.
References
- Pengel, M. L. H., Herbert, R. D., Maher, C. G., & Refshauge, K. M. (2003). Acute low back pain: Systematic review of its prognosis. BMJ : British Medical Journal, 327(7410), 323. https://doi.org/10.1136/bmj.327.7410.323
- Searle A, Spink M, Ho A, Chuter V (2015) Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials. Clinical Rehabilitation 2015, Vol. 29(12) 1155–1167 https://www.hsrd.research.va.gov/meetings/sota/pain/Exercise/ExerciseWG_Searle.pdf
- Waddell, G., Feder, G., & Lewis, M. (1997). Systematic reviews of bed rest and advice to stay active for acute low back pain. The British Journal of General Practice, 47(423), 647. https://pmc.ncbi.nlm.nih.gov/articles/PMC1410119/
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