PEACE & LOVE for injuries instead of RICE

Traditionally, physiotherapists and clinicians have utilized the easily recognized acronym of ‘RICE’ for injuries. RICE stands for rest, ice, compress and elevate. Although these are suitable things to do when a person has an injury and addresses the immediate acute stage following injury, it doesn’t address the sub-acute and chronic phases following injury.

New research has come out suggesting that instead of using ‘RICE,’ we should utilize ‘PEACE & LOVE,’ which aim to provide some guiding principles that address the complexity of managing injuries.

As we know, rest is not always the solution when it comes to managing injuries, while active recovery and doing what you can within your injury’s limitations play a crucial role in getting you back to your chosen goals and sport sooner.

In this article, we will define the acronym ‘PEACE & LOVE’ to provide you with a more evidence-based and up-to-date approach of addressing injuries.

P – Protect and limit movement immediately following injury in order to minimize swelling and pain in the injured limb or joint. This period of rest and unloading of the injured limb or joint should be limited, as we know complete rest leads to tissue degradation.

E – Elevate the affected limb to above the level of the heart – this is a natural way of minimizing swelling and fluid build-up in the injured limb.

A – Avoid anti-inflammatory medications. Anti-inflammatory medications block and slow inflammation and while inflammation can seem like something bad increasing pain, swelling and inflammatory mediators to the injured limb, this is the body’s natural way of healing itself and damaged tissue. Taking anti-inflammatory medications can inhibit this process.

C – Compression bandages and tape can be used to limit swelling

E – Education from a sports physician or qualified health professional. While this does not seem like a treatment modality in itself, getting the right education on how to manage your injury early on can play a significant role in speeding up the recovery process and improving the healing response.

After you have given your injury some ‘PEACE’ during the acute stages of your injury, it will be time to give your injury some ‘LOVE’ a few days afterwards.

L – Load optimal. As we know, complete rest in the long-term is not the solution to injuries. Re-introduction of loading and recommencement of normal activities, which the injury allows at this stage of recovery is important as your symptoms improve. This is imperative to heal tissue structures such as tendons, ligaments and muscles.

O – Optimism as funny and hippie as it sounds, can play a huge role in psychological recovery. Fear and catastrophizing can have a detrimental impact on the recovery process and set a negative mental tone in your approach to the rehab process.

Vascularization – exercise and movement are critical for pain management following musculoskeletal injury. Cardiovascular activity increases blood flow and circulation to the injured area. The secondary effects of heat also help to additionally increase blood flow to the injured area, while aiding in relaxing muscles.

E – Exercise and movement is paramount in restoring strength, mobility and balance in the injured limb or joint. The intensity and level of difficulty of exercise should be graduated and guided by a qualified health professional.

It may be evident the much of the first principles of ‘PEACE’ are similar to those of ‘RICE.’ However, what ‘LOVE’ addresses is the importance of active recovery and starting to move as soon as possible, which in itself helps with tissue healing, restoring tissue strength and gets you started on the journey back to your former healthy self.