Acute Injury Management and Exercise

Most individuals are familiar with the acronym “RICE” as being the recommended treatment for acute soft tissue injuries. However, there has now been a shift in this recommendation, with the newer “PEACE & LOVE” acronym being the one to follow.

PROTECT: After an injury, the recommendation is to temporarily protect the area that is recovering. The timeframe for protection is dependent on the type of injury. As always, the goal is to restore normal strength and function to assist you in returning to enjoyed activities in a graduated manner. Long periods of rest can actually lead to prolonged recovery as a result of altered movement patterns and reduced strength, so early mobilisation is key.

ELEVATE: Elevating the affected area uses gravity to assist in the reduction of swelling present in the site of injury. Therefore, elevate the area above the level of the heart as often as possible.

AVOID anti-inflammatory drugs & ice: Inflammation itself isn’t necessarily the “bad guy”, so taking anti-inflammatories can prolong the recovery process. If you do require pain medication outside of anti-inflammatories, it is best to discuss this with your GP. Evidence for the use of ice remains unclear. Some studies suggest that ice has a pain-reducing effect. However, the evidence is vague when it comes to the impact it has on swelling.

COMPRESS: Use elastic bandage or taping to reduce swelling.

EDUCATE: Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role.

LOAD: Let pain guide your return to normal activities. Loading the tissue optimally actually assists with the recovery process and re-building tissue tolerance and capacity. The key here is optimising load so that you are strengthening these tissues without excessive aggravation of symptoms, and this is where your Physiotherapist and Exercise Physiologist can come in handy. Your body will tell you when it is safe to increase the load.

OPTIMISM: Psychological factors such as fear, catastrophising and low mood can all act as barriers to your recovery. Through the recovery process, optimism and understanding the recovery timeframes assist with keeping realistic expectations of your recovery. Remember that recovery isn’t always linear and there may be small hurdles along the way, which are part of the normal recovery process. The task is to condition your brain for optimal recovery by being confident and positive.

VASCULARISATION: Cardiovascular exercises are extremely important during the recovery process to assist with facilitating blood flow to the injured area, but also to assist with reducing swelling and in turn, pain. Therefore, choose pain-free cardiovascular activities to increase blood flow to repairing tissues.

EXERCISE & Enjoyed Activities: As always, restore mobility, strength and proprioception by adopting an active approach to recovery. The goal is to restore normal function using exercise to achieve your goals and enable you to participate in your enjoyed activities.

References: Dubois B and Esculier JF. (2020). Soft tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine.