Some people may have heard of the acronym ‘RICE’ for an acute injury. This was taught in sports class at schools and was utilised by majority of people with soft tissue injuries. That acronym was then reinvented to RICER, and then PRICE. More recently a different acronym has come to light with the use of current evidence and progression of clinical practice. PEACE & LOVE is the current recommended protocol for physiotherapists for the treatment of soft tissue injuries.
PROTECT
Offload and alter activities for one to three days.
Try to avoid rest but let pain guide you on acceptable levels of activity. Below a 5/10 pain that reduces within 30 minutes to 2 hours is acceptable.
ELEVATE
Raise the injury higher than the heart. This may mean to place the leg up on a stool or rest the arm on something high.
AVOID ANTI-INFLAMMATORY MODALITIES
For tissues to heal optimally the body must undergo it’s usual processes. The inflammatory stage is one of these processes and reducing this stage may lead to longer recovery time. We must avoid the use of anti-inflammatory medication as well as ice. (Have a read of our latest blog post on ice).
COMPRESS
Compression with the use of compression garments or tape can limit swelling and assist in recovery. However, we don’t want the range of the joint to be limited.
EDUCATE
An active approach is best in comparison to a passive approach. Get moving!
Understand the condition and the requirements of recovery.
Set goals and timeframes of recovery.
AND…
LOAD
Injuries heal best when the body is moving, and the tissues are loaded. Loading the injury with optimal exercises will promote recovery. We want to get you back to normal activities as soon as symptoms allow it.
OPTIMISM
Pain is a subjective response of the brain and has a big effect on our recovery. By maintaining positivity, we can lower the perceived pain we feel and promote healing. By encouraging realistic optimism of recovery, research has shown that recovery times can improve.
VASCULARISATION
For tissues to heal they need blood flow. Engaging in cardiovascular exercise has shown to improve function and pain response. Try going for a vigorous walk or some boxing.
EXERCISE
Get moving! The current evidence suggests that exercise therapy is an effective treatment for musculoskeletal injuries such as ankle sprains. Exercise can improve function, mobility, and quality of life.
The bottom line
The main differences from previous acronyms sees the implementation of avoidance of anti-inflammatory modalities, and the emphasis around optimism and exercise. By using this principle you will have the best chance of recovery.
Come see us at Pivotal Physiotherapy & Pilates to get a further assessment and begin rehabilitating in the correct way.
~ Jacob Spencer, Physiotherapist
REFERENCES:
Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine 2020;54:72-73.
Elise Duchesne, Sébastien S. Dufresne, Nicolas A. Dumont, Impact of Inflammation and Anti-inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic, Physical Therapy, Volume 97, Issue 8, August 2017, Pages 807–817, https://doi.org/10.1093/ptj/pzx056