09/07/2022
PEACE✌️& LOVE❤️ Instead of Ice🧊 for Soft Tissue Injuries🤕!⠀
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Traditionally, we were taught to initially approach every soft tissue injury through the RICE method, which was Rest, Ice, Compression and Elevation. Over time, we’ve learned that evidence for this approach was limited and becoming outdated, yet the catchy acronym was hard to deviate from.⠀
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As our understanding on the human body evolves and we learn more about its resiliency and adaptability, these two acronyms PEACE & LOVE were introduced from The Running Clinic, Canada🇨🇦 in their BJSM journal article from 2019 (Dubois B, Esculier J-F, Br J Sports Med January 2020 Vol 54 No 2).
PEACE & LOVE is a more proactive approach to allowing the human body undergo its normal inflammatory response to begin the healing process of a soft tissue injury.⠀
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✅Protection: Unload or limit movement for 1-3 days to protect the tissue. Rest should be minimal due to negative impact of prolonged rest.⠀
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✅Elevation: Keeping the injured limb elevated at a height above the heart to assist with flow of interstitial fluids out. Low risk-benefit ratio.⠀
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✅Avoid anti-inflammatories: Using medications such as Advil (ibuprofen) or Aleve (naproxen sodium) that blunt inflammation or icing can have negative impacts on long-term tissue healing. Efficacy of using ice is limited (I used this modality too often in the past🙄), and typically just has a numbing effect for the skin.⠀
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✅Compression: Taping or wraps can be helpful in reducing excess swelling.⠀
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✅Education: There are more benefits with a more active approach to recovery versus relying on passive interventions.⠀
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✅Load: Reintroduce gradual load to the tissue within your tolerance, but don’t ignore any increase in pain.⠀
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✅Optimism: Positive thinking and outlook is associated with better outcomes and prognosis!⠀
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✅Vascularization: Start pain-free aerobic activity to increase blood flow to the injured area to promote your body’s healing process.⠀
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✅Exercise: Restore mobility, strength and proprioception early after injury to improve long-term outcomes.