Peace and Love
Injured yourself? Maybe you need PEACE and LOVE!
No, we haven’t gone completely potty. PEACE and LOVE are new soft-tissue injury guidelines that have been trialled by physical therapy researchers in Canada that have had some success and that we’ve found really interesting.
In the past the acronym you might of heard is RICE; standing for Rest, Ice, Compression and Elevation. Now this is all well and good for the immediate effects of an injury. Managing inflammation and protecting injured tissues is vital when we first do any damage. However, RICE fails to address the important role that inflammation plays in healing, and the importance of movement and weight bearing in the return to full working order. PEACE and LOVE, whilst being a bit long-winded, guides you from injury back to activity.
So what does it mean?
P for Protect
Rest or restrict movement of the injured area for 1-3 days to minimise bruising, swelling and reduce risk of aggravating the injury. Rest should be minimised as prolonged rest can lead to weakening of muscles and other tissues. Listen to your body and rely on pain as a guide when to start moving the injured area again.
E for Elevate
Elevate the limb higher than the heart to promote drainage and minimise swelling in the area.
A for Avoid anti-inflammatory medication (if possible)
There is some evidence to suggest that anti-inflammatory medications may lead to poor long-term tissue healing. This is because inflammation contributes to soft-tissue regeneration. Reducing this process using medication could impair tissue healing, especially when higher dosages are used over a long period.
There is also a question mark around over-icing injuries. Cold compresses on an injury too often and for too long can impair circulation to the area. A good blood supply is essential to body repair as it’s blood that delivers all those important nutrients needed for the process as well as removing all the waste products.
C for Compress
There is some evidence to suggest that gentle external pressure using taping or bandages helps to limit swelling and bruising.
There is an important difference between swelling and inflammation. Inflammation is (as described above) part of the healing process and the way the body gets nutrients and other substances to the tissues. Swelling is when fluids pool in a limb because their return is compromised.
E for Educate
After the first days have passed, injuries need LOVE
L for Load
An active approach with movement and exercise benefits most patients with musculoskeletal injuries. Mechanical stress should be added early and normal activities resumed as soon as symptoms allow. At this stage it is important to be aware of your body. Pain-killing medication can be very counterproductive at this point as moving more than your stage of healing will allow whilst unaware of your body’s cries to stop could cause further injury. Optimal loading without exacerbating pain promotes repair and strengthens the area.
O for Optimism
E for Educate
V for Vascularisation (Improving blood flow)
Physical activity that increases heart rate is an important part in the management of any musculoskeletal injury. Obviously you need to be very careful not to aggravate an injury, but pain-free cardiovascular activity should be started a few days after injury to boost motivation and increase blood flow to the injured structures. Early mobilisation and exercise improve function and reduce the need for pain medications in individuals with musculoskeletal conditions.
E for Exercise
There is strong evidence supporting the use of exercises for treatment of sprains and for reducing the chance of injuries recurring. Exercises will help to restore mobility and strength as soon as possible after injury. Pain should be avoided and used as a guide for progressing exercises.
So next time you injure yourself, do as John Lennon said and ‘Give PEACE a chance’, because maybe ‘All you need is LOVE’!