Out with “Rice”, in with “Peace & Love”
I'm sure most of us have heard of "Rest, Ice, Compress and Elevate(RICE)" after an injury and when that advice came out it was the best research available at the time. However, it's a bit outdated and recently published literature tells us that ice isn't the best for recovery. New research* suggests the "PEACE and LOVE" approach to soft tissue injuries, which emphasizes a more active and proactive healing process.
PEACE is the immediate care for the injury. It stands for: Protection, Elevation, Avoid anti-inflammatories, Compression, and Education.
Protect: unload - or rest - the area during the acute phase of healing, or the first 1-5 days.
Elevate: elevate the area above the level of your heart if possible.
Avoid anti-inflammatories: both ice and medications should be limited, as they can reduce the rate of tissue repair during the initial inflammatory phase of healing.
Compression: compression can be beneficial, but make sure that good circulation and movement can occur at the joint!
Education: this is more of a nudge for professionals helping with the injury, but knowing WHY and HOW you will progress through your return to activity helps keep expectations realistic and progression occurring appropriately.
LOVE after the first few days of injury care, give the body the love it needs: Load, Optimism, Vascularization, and Exercise.
Load: Motion is lotion! Return to movement as symptoms allow but do not push through pain. Instead, choose exercises that are pain limited or pain free to promote proper remodeling of healing tissues, reduced psychological load in response to injury, and maintain overall wellness.
Optimism: stay realistic but positive! Our brains are powerful and when catastrophizing thoughts take root, recovery rate can slow.
Vasculatization: lean into pain free mobility and cardiovascular movement to improve circulation to the injured area. Research shows that incorporating these modes of exercise reduces level of discomfort and need for pain medication.
Exercise: progressive, pain free exercise reduces compensations, improves balance, muscle recruitment, strength, mobility and hastens optimal return to previous level of function.
So next time you find yourself with a slight injury keep these things in mind and don't forget to reach out to your coach for additional guidance!
*Dubois B, Esculier J- F. Br J Sports Med 2020;54:72–73