Why Working Harder at PT isn't Speeding Up Your Recovery
Updated: 6 days ago
My second ankle surgery was going to go better than the first. I had decided that before they wheeled me in.
So I did everything they told me. Crutches, no weight on the foot, and the boot on 24/7. Yes, even in bed. My foot and I spent over a month in that boot together, and by the end no one was happy about it.
When PT finally started, I was ready. My life shrank down to three places: work, PT, and home. Every exercise got done, and I never missed an appointment. I was going to walk smoothly again. Hiking and yoga were waiting for me, and I planned to get there fast.
What I couldn't see was the mistake underneath all that effort. Every ounce of it went into work and the exercises, and none of it went into rest. That one habit was slowing me down.
Maybe this sounds familiar. You want to walk without thinking about every step. You want your Saturday hike back, or your spot on the yoga mat. So you work hard at recovery, and rest gets whatever time is left over, if any.
You come by this honestly. Effort has always paid you back. You studied more and your grades went up. You put in the hours and got the promotion.
Recovery seems to work the same way, because almost everything gets counted. Your therapist measures how far the joint bends and your exercise sheet tracks reps and sets. Each follow-up visit checks what you can do now that you couldn't do last month.
However, rest doesn't show up anywhere. Nobody hands you a sheet that says "Sit on the porch for 20 minutes. 3 sets."
So, of course, your effort goes where it can be seen. That's what a smart, driven person does with a goal. The instinct is a good one. It just needs a new target.
One you see this mistake, it's one of the easier ones to turn around. Below, I'll walk you through why all effort and no rest slows recovery down, and three simple ways to make room for rest. Let's break it down.
The myth: more effort brings better results
In my head, rest was just the time between the things that counted. Looking back, my body was trying to tell me otherwise in three ways.
Your body takes the rest anyway. By the weekend, I would collapse. My body took the rest I hadn't given it all week, whether I agreed or not. I read that as being tired. It never occurred to me that it was information. I see the same pattern with the people I work with: a hard week, a lost weekend on the couch, and then Monday starts the whole thing over.
The exercises land on a worn-out body. Then I got away for a vacation on a warm island, and my body just let go. I slept better than I had in months. My muscles relaxed, and I realized how clenched they'd been.
Research backs this up. In one study, 106 people recovering from knee replacement were split into two groups. Both groups got standard PT, and one group also did a simple relaxation exercise on days 1, 2, and 3 after surgery. The relaxation group had less pain, stronger thigh muscles, and less fear of moving than the PT-only group1.
Let me say this again so you don’t miss it: relaxing helped the strength work.
Constant checking makes pain feel bigger. On that island, I stopped keeping score. I wasn't checking what hurt and what didn't, or wondering which exercise was working. Fresh mango, warm sunshine, and the feel of sand between my toes had my attention instead. Researchers have found that focusing on pain tends to make it feel more intense, while shifting attention elsewhere can ease it2. When every hour is spent on guard, your body never gets a break from bracing.
Time on the island was my aha moment. I had been doing all the work my ankle asked for, and almost none of the work that the rest of me needed.
So what does it look like to give your effort toward rest?
What to do instead: give rest the same effort you give PT
Keep your drive and focus. Those are some quality tools. Point some of it at the hours between appointments, because recovery happens there, too: when you sit in the sun, when you sleep, when your shoulders drop away from your ears.
I recognize that most people can't hop on a plane mid-recovery, and you don't need to. Small pieces of what that trip gave me can come home with you.
Put rest on the list. If PT gets a time slot, rest gets one too. Write it down, right next to your exercises. Driven people are very good at doing what's on the list. That's exactly why this works. What’s your favorite kind of rest? 20 minutes on the porch after dinner? 10 minutes of journaling? Something else?
Count the whole day. At night, ask what your body got today besides work and exercises. A slow dinner, without rushing, counts. So does a conversation with a good friend, or an early bedtime.
This changes what a good recovery day looks like. Looking back at my ankle recovery, the days I would have called lazy were often the ones my body needed most. When you count the whole day, a short PT session plus a long nap stops feeling like you're falling behind.
Take breaks from checking. Pick a stretch of time, maybe one evening, where you don't scan for what hurts. If you notice anything new, sharp, or getting worse, inform your care team. The rest of the time, let your attention wander somewhere kinder, like a movie, a puzzle, or a long phone call.
The island taught me this one without my asking. I didn't decide to stop checking. I was just too busy enjoying the mango. You can set that up on purpose at home, one evening at a time.
When I work with someone in my Surgery Recovery & Reset program, this is often where we start. The island taught me this one without my asking. I didn't decide to stop checking. I was just too busy enjoying the mango. You can set that up on purpose at home, one evening at a time. Most of the people I work with are great at the work. What they need is someone telling them that rest is part of the recovery plan.
Eventually, I got back to yoga, to hiking, to my workouts. I still think about how much sooner my body might have let go if I'd given rest a spot on my list from the start.
When rest gets real effort, the days start to feel different. You come home from PT and sit down without the guilty itch to do one more set. Your shoulders drop. Sleep comes a little easier. The exercises start to feel like they're building something, instead of just wearing you out.
"But if I rest, won't I fall behind?"
That's the fear, isn't it? Ease up and you'll lose ground.
Consider rest part of your PT. The exercises still happen, and they land better on a body that isn't worn out. That was the piece I missed. I gave my ankle everything, and the rest of me got whatever was left.
Rest counts
Putting all your effort into PT and none into rest is one of the most common mistakes I see, especially in people who are good at working hard. Put rest on the list. Count the whole day. Take breaks from checking.
My body had been asking for rest for weeks, and it took a plane ticket and a beach chair for me to finally hear it. Your version can be much smaller than an island. It might be 20 minutes on the porch a few times this week.
Want help finding where rest fits?
If you're working hard at recovery and still feel stuck, let's talk. Book a free call at turnstonewellness.com/contact. We'll look at your week together, and you'll leave knowing one place rest can fit, starting tomorrow. If you want more support after that, I'll walk you through how the Surgery Recovery & Reset program works.
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Sources
1Eymir M, et al. Relaxation exercise therapy improves pain, muscle strength, and kinesiophobia following total knee arthroplasty in the short term: a randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 2022. https://pubmed.ncbi.nlm.nih.gov/34230983/
2Zhang W, et al. Hypervigilance to pain may predict the transition from subacute to chronic back pain. Journal of Pain Research, 2025. https://www.dovepress.com/hypervigilance-to-pain-may-predict-the-transition-from-subacute-to-chr-peer-reviewed-fulltext-article-JPR
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