Give your injury some PEACE & LOVE
May 11, 2023
Long ago in the 1970s athletes began to hear a term for acute soft tissue injury management called “RICE” (Rest, Ice, Compression, Elevation). Designed to reduce pain, inflammation and swelling associated with acute injuries, RICE has since then become a popular method for treating injuries on the sporting field. You may have also heard the acronym “PRICE” which added in “Protect” to address protecting the injured limb from further harm. A few years went by and it changed again with the addition of “Optimal Loading” to now create the “POLICE Protocol”. The original RICE protocol has gone through 4 iterations of modifications and developments, above are the first 3 and the 4th adaptation only came out in 2019 A.K.A the PEACE & LOVE Protocol.
Acute injuries need P.E.A.C.E for the first 48-72hrs
Protecting the area means doing what you can to reduce the chance of worsening the injury. Ways to protect an acute injury is to unload or restrict any painful movements during this time period. This will prevent overstretching the damaged tissue and aggravate the injury along with reducing any swelling.
Just like in previous editions of acute injury protocols, if possible, try to elevate the injured area above the height of your heart to prevent swelling from pooling around the injured region.
Avoid anti-inflammatory factors
This is new addition takes into account that anti-inflammatory medications may delay the healing process as the initial “Inflammatory Phase” is an essential component of healing. Without inflammation, your body cannot clear the damaged debris and begin the healing process.
There is also a suggestion that avoiding ice might be necessary as ice can slow down circulating blood cells which carry the necessary ingredients for cells to heal. Ice also reduces overall blood flow to the area, in which case is counterproductive if you need blood cells (carried through the blood) to heal an injured tissue. If the area is painful, we suggest that you can use ice for 10minutes as it will help take some pain away without disrupting the Inflammatory and healing process.
The role of Compression is to reduce the risk of internal swelling or bleeding within the muscle or limb. This can be done through applying a bandage or taping around the region. You can also visit us here at Instinct Health or your local Pharmacy and ask for a tubular compressive bandage known as Tubigrip.
This surrounds the idea that a physical approach to rehab is much more beneficial to long-term recovery than a passive approach to recovery. If you don’t know where to start, best to see one of our Physiotherapists so they can give you the right exercise strategies to best help you recover.
After 48-72hrs of PEACE give your injury some LOVE
Taking an active approach to rehab such as movement and exercise will allow you to get back into what you’re doing sooner as it reduces the risk of post-injury complications if left for too long.
You should aim to get back into normal activities as soon as able. Walking normally (without a limp) is usually a great starting point. When getting back into exercise, do what you can, provided that your pain DOES NOT INCREASE. This will help your body repair an strengthen plus it builds tissue resilience and tolerance of your muscles, ligaments and tendons.
Did you know how you perceive your injury will also impact your recovery? It can be difficult to stay optimistic when an injury has put you on the sideline or taken you out of the game but focusing on the negative aspect may actually delay your recovery. Trying to focus on the small improvements in function day by day and finding the positives in your recovery will go a long way to helping you get better quicker!
Vascularisation refers to maintaining your cardiovascular (aerobic) fitness and increasing blood flow to the affected area. As such you should begin aerobic exercise for the following benefits:
- Increased blood flow to the affected area
- You’ll find extra motivation with your rehab
- Your function will improve and will be able to work better
- You won’t need as much pain medication
Exercise has a variety of benefits as mentioned above in “Vascularisation”. Exercise therapy can reduce the risk of recurrent injury to the area by restoring strength, mobility and proprioception. Make sure to avoid pushing through pain in the early recovery phase as this will interrupt optimal repair or the damaged tissue. Pain should be used as a guide instead, to slowly make your exercises harder.
As always, if you have suffered an acute injury, one the Physiotherapists here at Instinct Health can help guide you on your journey back to full health and get you stronger than ever.
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