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RICE vs PEACE & LOVE- Soft Tissue Injury Treatment

Updated: Sep 9, 2022

"Put some ice on it." - Rest, Ice, Compression, Elevate - is something you have likely heard at some point in your active life.


This Tuesday Tip

is all about sharing some of the research on how to treat soft tissue injuries.

With STG Marathon being 8 weeks out, the miles are getting high.

XC, Football, Soccer, & Volleyball season are really starting up this week as well.

I have talked with many athletes, the past couple weeks, about this.

Which has lead to this post.

Hope you find it helpful!


Quick History Background:

  • 1978) R.I.CE. - Rest, Ice, Compression, Elevation - came about by Dr. Mirkin the author of The Sports medicine Book

  • 1998) P.R.I.C.E. - Protection, Rest, Ice, Compression, Elevation

  • 2012) P.O.L.I.C.E - Protect, Optimum loading, Ice, Compression, Elevation - rest was replaced by optimum loading, this is different for each injury but is as simple as ankle pumps for a rolled ankle (vs no movement with rest). Dr. Mirkin even came out agreeing that the research now shows this to be better than R.I.C.E. for an initial injury.

  • 2019) P.E.A.C.E & L.O.V.E. - adds in so many great components!

PEACE

Immediately after a soft tissue injury, do not harm and let PEACE guide your approach.


P = Protect

Unload/restrict movement for 1-3 days (reduces bleeding, lower risk of aggravating injury)

Minimize rest (prolonged rest limits tissues strength & quality)

Removal of protection & gradual reloading is guided by pain

E = Elevate

Higher than the heart (still recommended as there is a low risk benefit ratio)

A = Avoid anti-inflammatory modalities

Soft tissue regeneration is supported by the various phases of inflammatory process.

Anti-inflammatory medication & ice may have negative long-term affects of the healing tissue.

C = Compress

Be sure the compress still allows a full range of motion at the joint.

E = Educate

The more one can be educated on the injury and treatment plan the better.


LOVE

After the first days have passed, soft tissues need LOVE.


L = Load

Optimal loading without increasing pain, promotes repair & remodeling.

It builds tissue tolerance & capacity of tendons, muscles & ligamentous.

O = Optimism

The power of the brain is amazing.

Stay realistic, but optimistic to improve chances of optimal come back.

V = Vascularisation

Pain free cardiovascular activities increase blood flow to area.

E = Exercise

Restore mobility, strength, & proprioception.

Use pain as the guide to progress exercises.


The treatment of soft tissue injuries, from hamstring strain to ankle sprain, should focus on the long-term outcomes not just the short-term damage control.

PEACE & LOVE also focus on treating the person with the injury and not just treating the injury of the person. Just another reason, I like it so much!


Have you heard of PEACE & LOVE? Better yet - have you given it a try on a soft tissue injury? I would love to hear how it has helped you!



*Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine 2020;54:72-73.

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