Acute Injury Management:
How many times have you been told to RICE, or Rest, Ice, Compress and Elevate, after rolling an ankle, spraining your knee or straining your calf? This was the protocol after research conducted in 1978, the same year the original Grease movie was released! Times have changed and research has evolved since then and the current protocol for an acute injury management includes PEACE and LOVE.
Immediately after an acute injury remember: PEACE
P - Protection
Unload or restrict the movement of the injured area for 1-3 days to ensure no further damage is done to the injury.
E - Elevation
Elevate the injured limb above the level of the heart to promote fluid draining out of the area to avoid excess swelling.
A - Avoid - anti inflammations
In the early stages, inflammation can help to repair injured tissue and is a normal part of the healing process. Tissue healing can be impacted negatively restricting inflammation via medication.
C - Compression
Taping or bandages to reduce swelling inside the joint and tissue haemorrhaging can improve quality of life and level of function.
E - Education
Education from a physiotherapist on active recovery approaches, and realistic expectations.
After a few days of an initial injury, remember: LOVE
L - Load
Gradually increase your load until you return to normal activities allows for adaptations in muscles, tendons and ligaments to promote repair, remodelling and improving tolerance. Pain should not be more than a 3-4/10 during active rehabilitation.
O - Optimism
Having a positive approach to rehabilitation and optimistic outlook is associated with better patient outcomes and a better prognosis.
V - Vascularisation
Pain free aerobic exercise (cycling, swimming, walking, rowing, ski erg) should be started a few days after sustaining an acute injury to promote blood flow to increase tissue healing, reduce pain, increase motivation and promote return to work.
E - Exercise
Completing exercises to rehabilitate an injury reduces the chances of suffering recurrent injuries. Exercises help to restore strength, range of motion and proprioception. Pain does not mean that you are creating further damage, however if the exercises are causing a level of pain above a 3-4/10 they should be modified.
Practising PEACE and LOVE can help to reduce pain and promote tissue healing allowing for an earlier return to everyday activities such as return to work or return to sport! If you have an acute injury, come in and see one of our expert physiotherapists at Healesville Physio and Sports Medicine.
Dubois, B., & Esculier, J.-F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), 72- 73. https://doi.org/10.1136/bjsports-2019-101253
Mirkin G., Hoffman M. (1978) The sports medicine book. 1st edition. New York: Little Brown and Co.