What’s your 1st move when you sprain your ankle, pull your hamstring or sustain a back injury?
Probably pop a few anti-inflammatories and grab an ice pack. And follow the RICE protocol to feel better.
Problem is, Rest, Ice, Compression, Elevation is the old-school, outdated approach to treating sprains and strains.
RICE is out for soft tissue injuries.
New research suggests 2 of the 4 RICE tenets are counterproductive.
Instead, rehab experts apply a new (and equally memorable) acronym for acute soft tissue injury – PEACE & LOVE.
PEACE
Experts recommend PEACE interventions for 1-3 days after injury. The P stands for…
Protect
“Protect” is not the same as “rest.” Resting (i.e. doing nothing) weakens tissue and prolongs recovery.
Protecting the injured tissue means staying active without exacerbating the injury.
For example, I fast-tracked my latissimus dorsi strain recovery with non-aggravating strength and mobility work.
Elevate
There’s weak evidence in favor of elevation; it’s recommended because it reduces swelling at the injured area. Plus, it’s a low-risk intervention with minimal side effects.
Avoid Anti-Inflammatories
Inflammation is a normal, natural step in the healing process. Anti-inflammatory medications arrest inflammation and impair healing.
Common anti-inflammatories include aspirin, ibuprofen and naproxen.
Likewise, ice is no longer recommended for acute soft tissue injuries because it delays inflammation and inhibits natural healing cascades.
Paradoxically, both ice and anti-inflammatories reduce pain. But the “fee” for pain relief is slower recovery.
Compress
Along with elevation, compression survived the “RICE” rollback.
Compression is recommended because it’s proven to reduce swelling and improve quality of life for ankle sprains.
Educate
Expert physios educate clients on recovery expectations for their specific injury.
Proficient clinicians also implement an active treatment approach (like the one outlined here).
Finally, great PTs avoid over-treating patients with the unproven passive treatments that rank low on my PT treatment rankings.
After implementing PEACE for 1-3 days after acute injury, the next step is LOVE.
LOVE
All you need is LOVE… to rehab from injury once symptoms simmer down. Here’s how:
Load
Apply the right amount of load to repair injured tissue – not too little, not too much.
Resume normal activities and reapply load (e.g. running, lifting) soon after injury. Strengthen the injured area without exacerbating symptoms.
Optimism
Optimism is harder to quantify, but research consistently links fast recovery with positive patient expectations.
And this part is crazy – beliefs and emotions are more predictive of recovery than actual tissue damage.
Learn more about the mind-boggling benefits of expectations here:
Adopt This Mindset to The Live 14% Longer
Vascularization
The “V” in LOVE is for vascularization, a fancy term for blood flow. (Apparently the acronym creators decided PEACE & LOBE didn’t have the same ring to it.)
Plenty of complicated treatments purport to increase blood flow to an injured area – cupping, massage, E-stim, percussion therapy.
But nothing works as well as exercise. Pain-free aerobic exercise shunts blood flow to the injured region and relieves pain via exercise-induced analgesia.
Exercise
Exercise is the best long-term treatment for soft tissue injury.
Exercise includes strengthening, mobility work, aerobic exercise, balance drills and sport-specific training.
Further Reading
Not only do anti-inflammatory medications slow healing, they may contribute to chronic back pain, according to early research. Read more in this post:
Do NSAIDS Cause Chronic Back Pain?
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