Have you ever experienced a soft tissue injury like an ankle sprain or pulled hamstring? They are very common, but do you know how to manage them?
The common advice for years has been “RICE” or more recently “PRICE” which means:
Protection, Rest, Ice, Compression, and Elevation.
However, research has not shown that this allows the best recovery and there is some evidence suggesting that blocking early inflammation may delay the body’s healing process.
In 2019, this led some researchers to propose a new pneumonic for soft tissue injury management called: “PEACE and LOVE.” This pneumonic can help you remember how to care for your injury in the immediately after it occurs as well as it gets better. Initially after injury, you should give your injury “PEACE”, and after the initial phase of 1-3 days, you should give your body “LOVE.” But what does this actually mean? Read on, and I’ll explain more below.
For the first 1-3 days after an injury, give your body PEACE:
P: Protection- Unload or decrease movement of the injured area to minimize bleeding, reduce risk of aggravating injury, and stretching injured fibers; however minimize overall rest as this can lead to weakness.
E:Elevation- Elevate the affected area above the heart
A: Avoid Anti-inflammatory Modalities
Anti-inflammatory medication (like ibuprofen) may affect long term healing by inhibiting the healing process. Use of NSAIDs should be limited except as needed to manage pain and swelling.
Avoiding Ice: Ice is mostly for pain relief but it may also delay the healing process through disrupting inflammation, and the formation of new blood vessels.
C: Compression- Using tape or elastic bandages can help limit swelling and bleeding
E: Education- Be aware, taking an active approach to your recovery will help more than passive modalities (rest, ice, etc).
Continue your recovery, letting pain be your guide, by giving your body LOVE:
L: Load- Begin a gradual return to your normal activities as soon as you are capable. This helps promote tissue repair.
O: Optimism- Try to keep a positive outlook on recovery and know your body can heal. There is research that shows fear and anxiety about an injury can delay your recovery.
V: Vascularization- Start with pain free aerobic exercise within a few days after your injury to increase blood flow to the injured area
E: Exercise- Exercises for strength, range of motion, and proprioception of your injured area will help you return to your favorite activities and decrease the risk of re-injury.
Are you dealing with a chronic injury, or just want some more guidance on how to return to your normal life after a recent injury? Feel free to reach out for a consultation with a Doctor of Physical Therapy. We can help determine how to get you back moving freely and back to your best.
References:
Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: Update of an evidence-based clinical guideline. Br J Sports Med2018;52: 956.
