I am sure many of us remember the old acronyms for what to do when we or one of our loved ones rolls their ankle, has a fall or is generally facing some type of soft tissue injury.
Something along the lines of:
RICE, PRICE, PRICER…. involving REST, ICE, COMPRESSION, ELEVATION etc
However, a recent study by the British Journal of Sports Medicine, suggests PEACE & LOVE is the answer to acute injuries and following this will have you back feeling yourself in no time.
So what is PEACE & LOVE…
Today we will go over PEACE and the recommendations that apply to post injury care of soft tissue injuries…
P is for PROTECT:
Immediately after an injury, do no further harm to the area by PROTECTING it.
The BJSM suggests “Unload or restrict movement for 1–3 days to minimise bleeding, prevent distension of injured fibres and reduce the risk of re-aggravating the injury.”
Rest after the 3 day period is not recommended, as prolonged rest may compromise tissue strength and quality.
E is for ELEVATE:
Despite weak evidence supporting the use of elevation, the risk to benefit ration is low, therefore the BJSM suggests to “Elevate the limb higher than the heart to promote interstitial fluid flow out of tissues”. This basically means elevating the limb may help with drainage of unwanted fluid out of the injured area.
A is for AVOID ANTI-INFLAMMATORY MODALITIES:
I can hear you all saying WHAAATT!?
However it is important to remind you all that the various stages of inflammation that our bodies NATURALLY produce are actually INTEGRAL to the healing process.
Due to this, using drugs that inhibit inflammation may negatively affect long-term tissue healing, especially when higher dosages are used.
The BJSM states that “the standard of care for soft-tissue injuries should not include anti-inflammatory medications.”
The use of ICE or cyrotherapy by the BJSM is also questioned, suggesting that “there is no high-quality
evidence on the efficacy of ice for treating soft-tissue injuries” and even using ice as an analgesic could “potentially interrupt the healing process”.
Now we are all aware of this information, we suggest using both modalities sparingly if at all.
C is for COMPRESSION:
The BJSM found that “External mechanical pressure using taping or bandages helps limit intra-articular oedema and tissue haemorrhage” in a recent soft tissue injury. Which basically means that compression after an ankle sprain or something similar seems to reduce swelling and improve quality of life, despite conflicting studies on this modality.
E is for EDUCATION:
Here are The Osteopathic Clinic, we believe EDUCATION is the most important part of every treatment protocol with our patients. It seems the BJSM agrees, suggesting that “all therapists should educate patients on
the benefits of an active approach to recovery.”
Passive modalities, such as electrotherapy, manual therapy or acupuncture, early after an injury have insignificant
effects on pain and function compared with an active approach and according to the BJSM “may even
be counterproductive in the long term”.
This is often why with acutely injured patients at The Osteopathic Clinic, we will give you management including: how to sleep, how to move and rehab to strengthen or offload an injured area.
The osteopath will also give you a realistic timeline on how long your injury should take to heal, taking into account your individual needs. Just as the BJSM states, The Osteopathic Clinic “strongly advocate for setting realistic
expectations with our patients about recovery times instead of chasing the ‘magic cure’ approach.”
So now that we have PEACE explained, check back next week for further explanation on LOVE and how it can help you heal from your soft tissue injuries!
Any questions, comments or queries?
Book an online telehealth appointment with one of our osteopaths so that they can guide you through this process post injury and help you make a plan to get back to doing the things you love.
Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020;54(2):72-73. doi:10.1136/bjsports-2019-101253
Link to full article: https://bjsm.bmj.com/content/bjsports/54/2/72.full.pdf