California Orthopedic and Sports Physical Therapy Services, Inc.

California Orthopedic and Sports Physical Therapy Services, Inc. Physical therapy, sports medicine, personal/fitness training, massage therapy, and orthopedic rehabi

COAST Rehab
Experience Makes The Difference

Physical Therapy And Personal Training
For People Of All Ages
COAST specializes in the evaluation and treatment of all musculoskeletal injuries and conditions, and pre/post surgical rehabilitation. COAST is Santa Cruz County's largest physical therapy provider specializing in sports medicine. We are a locally owned and independent private practice serving Santa Cruz County since 1995. The staff qualifications and expertise of our physical therapists, massage therapists, and personal trainers remain unparalleled in the Tri-County region. We invite you to stop by our office during business hours for a tour of our beautiful 3200 square foot facility.

02/04/2026

Heal your injuries faster than ever!

Motion is the new potion, and rest is no longer the best

By Lydia Denworth edited by Josh Fischman

After a slip on the ice, a sports injury, even surgery, most people’s instinct is to rest what hurts. “When you have an acute injury, your body is sending signals through the peripheral and central nervous systems and the immune system to say, hold on, I need to stop doing this so we can allow the tissue to heal,” says Ericka Merriwether, a physical therapist and pain researcher at New York University. Rest, after all, is the first part of the familiar RICE therapy, which stands for “rest, ice, compression and elevation.”

But experts no longer believe RICE is the best strategy for recovery. They especially quibble with the first step: rest. Even Gabe Mirkin, the sports medicine physician who coined the RICE acronym in 1978, has acknowledged that newer evidence suggests other approaches are more effective.

Resting an injury can alleviate pain and may be necessary in the short term, especially for injuries such as muscle tears, which might be exacerbated by movement. In most cases, however, limiting movement does not promote healing. In fact, immobilization causes muscles to weaken and lose stability. An injured body part that is immobilized for too long is more likely to move from acute to chronic pain (that is, pain that lasts more than three months).

Instead of rest, “motion is the potion,” experts say.

Instead of rest, “motion is the potion,” experts say. And it is important to move far sooner than many imagine. Once a physician determines that movement is safe and that there’s no biological reason not to engage in it, it’s a case of “use it or lose it,” says Rianne van Boekel, a nurse and associate professor at the Radboud University Medical Center in the Netherlands whose research focuses on acute and transitional pain.

Studies bear out the early-movement idea. In a controlled trial of athletes with serious soft-tissue injuries, researchers found that those who started rehabilitation two days after an injury instead of nine days later were able to return to sports 20 days sooner (in 63 days rather than 83). In a separate study, those who engaged in progressive agility training rather than static stretching were less likely to reinjure themselves. And in people with low back pain, consistent movement and exercise can improve pain levels, range of motion, strength and tissue repair.

That helps to explain why a popular acronym to emerge as a replacement for RICE is POLICE, in which the O and L stand for “optimal loading,” or putting stress on tissues to induce the cellular changes that optimize recovery. (The other letters stand for “protection,” “ice,” “compression” and “elevation,” so some parts of the RICE approach still hold.)

Putting stress on injured tissues does hurt, and the relation between pain and movement is complex. A person’s responses to pain strongly influence their recovery from injury, researchers say, because the perception of pain has social and psychological elements as well as biological ones.

Injured tissue sends signals to the brain, which is where we perceive pain. “People say pain is in your head, and yes, it is,” Merriwether says. There are also descending pain pathways from the brain back to the periphery of the body that inhibit and modulate the perception of pain.

That is why social environments and psychology play roles. Studies indicate that family caregivers might delay recovery if they do too much for an injured loved one, says anesthesiologist and pain researcher Esther Pogatzki-Zahn of the University of Münster in Germany. And, she says, people who must carry on with their lives—taking care of children or returning to work—often report lower levels of pain than people who don’t. On the psychological front, anxiety is a major risk factor for developing chronic pain after an injury. The more someone fears pain, and the more they avoid moving because of it, the worse they usually become.

To encourage movement and the healing it can bring, pain experts are working to educate people. “Pain reduction is the goal,” Pogatzki-Zahn says. In a 2025 randomized controlled trial of 150 people, nurses delivered one two-hour virtual lesson on pain and nonpharmacological ways to relieve it. Such approaches can include distraction, mindfulness and virtual-reality exercises. Patients who received the pain intervention scored significantly lower on measures of pain catastrophizing after eight weeks than those who were put on a wait list for the class. The first group also had better scores on pain intensity, depression, pain self-efficacy, fatigue and satisfaction with social roles. “The best way to deal with pain is to accept that you are in pain,” van Boekel says.

Painkillers can also help, although the goal should be to take the least amount of medicine for the shortest time possible, van Boekel notes—“enough to be able to move, not to get rid of all the pain.” And she advises taking acetaminophen (Tylenol) rather than ibuprofen (Advil) because it has no side effects at correct dosages.

Researchers are also paying closer attention to how pain is assessed. For instance, the latest studies suggest that clinical evaluations should more carefully distinguish between pain at rest and movement-evoked pain because it turns out patient outcomes can vary according to which type of pain they experience.

There is far more to understand about the role of pain and movement in recovery, but for now it seems fair to call on another familiar saying: no pain, no gain.

Rights & Permissions
Lydia Denworth is an award-winning science journalist and contributing editor for Scientific American. She is author of Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond (W. W. Norton, 2020) and several other books of popular science.

Not only is lighter weight/more reps (high rep low load) as effective as lifting heavy weight, it also causes significan...
01/24/2026

Not only is lighter weight/more reps (high rep low load) as effective as lifting heavy weight, it also causes significantly less inflammation. And frequent/persistent inflammation can be very harmful for the body.

Whether people lifted heavier or lighter weights they got results, the research showed.

Artificial turf is more dangerous than you might think...
12/27/2025

Artificial turf is more dangerous than you might think...

A turf war is raging over artificial grass. Here’s how nervous parents can navigate it.

This is a real issue across the USA and locally.
11/07/2025

This is a real issue across the USA and locally.

Find out which hospitals have the worst track records for overusing these “low-value care” procedures.

11/04/2025

From today's Scientific American newsletter.

Workouts Help Treat Cancer

Strong evidence now supports the use of exercise as a formal treatment for cancer, to the point that it might be more effective than some current drug treatments, writes Scientific American contributing editor Lydia Denworth. As a result, many cancer centers now are looking into how to incorporate exercise support for patients as part of their “standard of care.” The key study, involving more than 800 patients and published in July in the New England Journal of Medicine, drew a standing ovation when presented at an academic meeting. The patients with stage 3 and high-risk stage 2 colon cancer who were assigned structured exercise (along with conventional care) had a 28 percent lower risk of cancer recurrence, new cancers or death compared with similar patients who only got educational material about exercise.

Why it matters: Exercise helps the hormone insulin bind to cells, bringing them fresh energy. When insulin is unable to bind, cells tend to make more of it, which is problematic because cancer cells may rely on the hormone for growth and division. Also, proteins called myokines are released by our muscles during exercise. High amounts of myokines have been linked to reduced growth of prostate cancer cell lines. Finally, mouse experiments show that workouts mobilize immune cells called natural killer cells and T cells to attack tumors.

What the experts say: The integration of exercise into cancer treatment will only be effective if patients receive support such as supervised workout sessions and behavioral change guidance. “You can’t just advise people to do more exercise and expect them to do it,” says Kerry Courneya, a professor of kinesiology at the University of Alberta.

09/03/2025

Think how much better our government would be if brain supplements actually worked...

A great story, especially for those who believe that a person can be "too old" to exercise intensely.
08/05/2025

A great story, especially for those who believe that a person can be "too old" to exercise intensely.

“He’s still discovering what he’s capable of,” his trainer said. “He’s showing what’s possible not just for him, but for you too, for me, for all of us.”

Sad, sad news.....
07/30/2025

Sad, sad news.....

Dr Christopher Labos discusses the lack of health benefits of chocolate, established by the COSMOS study.

05/23/2025

Great news!! Exercise is more important than genes for longevity. You cannot change the genes you are born with, but you can change your exercise.

By Gretchen Reynolds

Seventeen years ago, Eric Topol, a cardiologist and founder of the Scripps Research Translational Institute in the La Jolla neighborhood of San Diego, set out to discover why some people age so well, when others don’t. Aged 53 at the time, Topol considered healthy aging to be of deep scientific — and personal — interest.

He also suspected the answer was genetic. So, with colleagues, he spent more than six years sequencing the genomes of about 1,400 people in their 80s or older with no major chronic diseases. All qualified, Topol felt, as “Super Agers.”

But they shared few, if any, genetic similarities, he and his colleagues found, meaning DNA didn’t explain their super aging. So, what did, Topol and his colleagues wondered?

His new book, “Super Agers: An Evidence-based Approach to Longevity,” is his answer. Synthesizing hundreds of studies about health, disease and aging, his book talks about a future where advanced drugs, biochemistry and artificial intelligence should allow us to turn back the clock and slow how rapidly we age.

Resistance training and grip strength have extraordinary correlations with healthy aging, Topol said.
Already, he says, we can dramatically increase our chances of becoming super agers with a few lifestyle tweaks, such as eating better (avoid processed foods) and sleeping enough (seven hours is good).

But there’s one lifestyle change, he says, that influences aging far more than any other. It also has altered his own life the most.

To learn more, I talked with Topol, 70, about what he’s doing to become a super ager and how the rest of us can do the same. Our conversation has been edited for length and clarity.

So, what is the single most important lifestyle change people can make to age better?
Of all the things we know about, the one that rises to the very top is exercise. In fact, it’s the only intervention in people that has shown any effect on slowing the body-wide aging clock, meaning it appears to change how rapidly we age. Of course, other lifestyle factors, like diet and social interactions, are critically important. But if there is one thing that has the most exceptional evidence for healthy aging, it’s exercise.

What kind of exercise?
For decades, as a cardiologist, I would always be emphasizing aerobic exercise to my patients, whether that was walking or bicycling or swimming or elliptical or you name it. I’d say to get at least 30 minutes most days. And that’s what I did myself. I didn’t really accept the importance of strength training until I began researching the book.

Topol exercises at home to save time and money, using tools such as dumbbells and resistance bands.
And now?
When I saw all the evidence, I became totally convinced. Resistance training and grip strength have extraordinary correlations with healthy aging. And so, well over a year ago, I went from being pretty much a weakling — I never worked on any muscles, except my legs, from doing lots of bicycling and hiking and walking — to now I’m stronger than I’ve ever been in my life, and it’s just been terrific. I’ve got better balance and posture, too.

What’s your strength training routine like? Do you work with a trainer?
Well, I didn’t want to hurt myself and I was definitely a beginner, so I did start off with a trainer a couple of times a week. But now it’s only about once a month. And I tell people, you don’t have to have a trainer. You can find good information about getting started online.

Do you work out at a gym or at home?
I do it all at home. It saves time and expense. I tell my patients, the more convenient and practical your training is, the more likely it is to get done, and that sure works for me. I usually do planks, lunges, squats, sit-ups on a medicine ball, the cobra, and a bunch of other floor exercises. I also use resistance bands. And I’ve learned about the importance of things like balance, standing on a foam pad, that kind of thing.

Do you stand on one leg?
Yes, I do. I also try to touch my shin while standing on one foot. All of this, the strength training, the balance, the rest, it’s made me feel so strong and fit. I feel like I should have done this decades ago.

Topol does resistance training several days a week.
Is it ever too late to start doing this kind of training?
Absolutely not. It’s never too late. This idea that you can’t build muscle or strength as you age is silly. No matter what your age, and I’m not young anymore, you’re fully capable of getting stronger and athletically fit.

You still do aerobic exercise?
Of course. I used to do aerobics six out of seven days a week, for 30, sometimes 40 minutes. Now I do aerobics about four times a week and integrate the resistance training the other days. And sometimes I do both. But it’s still less than an hour. I don’t have enough time to do more and that’s an important point. When I talk to my patients about exercise, we get into the details of their lives. They’re working. They’re tired. So we talk about when they can fit in time for exercise. Do they have a lunch break? Maybe they can go for a brisk walk. Or do lunges at home later.

In the book, you talk about how being outside and being with other people are both important for healthy aging. What about exercising outside with some friends?
Oh, yeah, that’s great. The data suggests that, as we get older, we tend to become recluses. And that’s not good for healthy aging. And being in nature — I never would have thought that would be important for health. But the data are strong. If you can be outside moving around in nature with friends, that’s a twofer, a threefer.

Being outside is good for health, Topol said. If you can, try exercising outdoors, ideally with friends.
What’s the endgame here? It’s not just living longer, right?
No, not at all. The goal is extending our healthspan, our years of life that are without the major age-related diseases, especially cancer, cardiovascular disease and neurodegeneration. What we can see from studies is that you can get seven to 10 years of extra healthy aging from lifestyle factors, especially exercise.

What age do you want to live to?
Well, I don’t have any of the age-related diseases yet. So, as long as that goes on, I’d be happy to get well into my 80s and beyond. I’d say that if you’re 85 and you don’t have any of those diseases, you’ve hit the jackpot. I’m doing my best to get there.

Key point: it is the persistence of high intensity exercise long term that can be bad for you, not intermittent high int...
04/15/2025

Key point: it is the persistence of high intensity exercise long term that can be bad for you, not intermittent high intensity exercise.
Interesting that this picture was used last month for a different article (same publication--Medscape)....I'll blame AI. Or as Education Secretary McMahon says..."A one".

A 30-year twin study finds that moderate physical activity reduces mortality, but higher levels offer no extra benefit — and may even accelerate biological aging.

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