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Manage your injuries with a bit of PEACE and LOVE

Injury management is an essential part of maintaining our physical health. In the past, the RICE method was a popular acronym used to manage injuries.


However, recent research suggests that the PEACE and LOVE approach may be more effective for injury management. In this blog post, we'll discuss the history of the RICE method, why it's outdated, and the step-by-step instructions for using the PEACE and LOVE acronym for injury management.


History of the RICE Method:

The RICE method was developed in the 1970s by Dr. Gabe Mirkin, a sports medicine doctor. The acronym stands for Rest, Ice, Compression, and Elevation. At the time, the RICE method was widely accepted as the best way to manage injuries. However, recent research suggests that the RICE method may not be as effective as once thought.


Research has shown that the Rest and Ice components of the RICE method may actually hinder the body's natural healing process. Resting for too long can cause muscles to weaken, and ice can decrease blood flow to the injured area, slowing down the healing process.



PEACE and LOVE for Injury Management:

PEACE and LOVE are two acronyms that have been developed as an alternative to the RICE method. These acronyms provide a more holistic approach to injury management, focusing on promoting the body's natural healing process.


PEACE:



P - Protect the injured area from further harm or stress. This may involve immobilizing the area or using supports such as crutches or slings.


E - Elevate the injured area to reduce swelling and promote blood flow to the affected area.


A - Avoid anti-inflammatory medication, such as ibuprofen or aspirin, for the first 48-72 hours after the injury, as these can interfere with the body's natural healing process.


C - Compress the injured area with a bandage or wrap to reduce swelling and provide support.



E - Educate the injured person about their injury and how to manage it, including how to properly rest, stretch, and rehabilitate the area.



LOVE:


L - Load management: Gradually increase the amount of weight or activity on the injured area as the injury heals, under the guidance of a healthcare professional.


O - Optimism: Maintaining a positive attitude can help with healing and recovery.

V - Vascularization: Promote blood flow to the injured area through gentle movement and exercise.




Incorporate rehabilitation exercises into a daily routine to improve strength, flexibility, and range of motion.


Step-by-Step Instructions for PEACE and LOVE (example):

  1. Protect the injured area from further harm or stress.

  2. Elevate the injured area to reduce swelling and promote blood flow to the affected area.

  3. Avoid anti-inflammatory medication for the first 48-72 hours after the injury.

  4. Compress the injured area with a bandage or wrap to reduce swelling and provide support.

  5. Educate the injured person about their injury and how to manage it, including how to properly rest, stretch, and rehabilitate the area.

  6. Gradually increase the amount of weight or activity on the injured area as the injury heals, under the guidance of a healthcare professional.

  7. Maintain a positive attitude to help with healing and recovery.

  8. Promote blood flow to the injured area through gentle movement and exercise.

  9. Incorporate rehabilitation exercises into a daily routine to improve strength, flexibility, and range of motion.

Overall, injury management is an essential part of maintaining our physical health. While the RICE method was once widely accepted as the best way to manage injuries, recent research suggests that the PEACE and LOVE approach may be more effective.



References


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

  2. Bleakley CM, Davison G. Management of acute soft tissue injury using protection rest ice compression and elevation: recommendations from the Association of Chartered Physiotherapists in sports and exercise medicine (ACPSM)[executive summary]. Association of Chartered Physiotherapists in Sports and Exercise Medicine. 2010:1-24.

  3. Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, should we call the POLICE? British Journal of Sports Medicine 2012;46:220-221.

  4. Doherty C, Bleakley C, Delahunt E, Holden S. Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis. British journal of sports medicine. 2017 Jan 1;51(2):113-25.

  5. Vuurberg G, Hoorntje A, Wink LM, Van Der Doelen BF, Van Den Bekerom MP, Dekker R, Van Dijk CN, Krips R, Loogman MC, Ridderikhof ML, Smithuis FF. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British journal of sports medicine. 2018 Aug 1;52(15):956-.

  6. Duchesne E, Dufresne SS, Dumont NA. Impact of inflammation and anti-inflammatory modalities on skeletal muscle healing: from fundamental research to the clinic. Physical therapy. 2017 Aug 1;97(8):807-17.

  7. van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, Van Dijk CN, Kerkhoffs GM. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?. Journal of athletic training. 2012 Jul;47(4):435-43.

  8. Singh DP, Barani Lonbani Z, Woodruff MA, Parker TJ, Steck R, Peake JM. Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Frontiers in physiology. 2017 Mar 7;8:93.

  9. Lewis J, O’Sullivan P. Is it time to reframe how we care for people with non-traumatic musculoskeletal pain?British Journal of Sports Medicine 2018;52:1543-1544.

  10. Khan KM, Scott A. Mechanotherapy: How physical therapists’ prescription of exercise promotes tissue repair. British journal of sports medicine. 2009 Apr 1;43(4):247-52.

  11. Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, Straker L, Maher CG, O’Sullivan PP. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. British journal of sports medicine. 2020 Jan 1;54(2):79-86.

  12. Briet JP, Houwert RM, Hageman MG, Hietbrink F, Ring DC, Verleisdonk EJ. Factors associated with pain intensity and physical limitations after lateral ankle sprains. Injury. 2016 Nov 1;47(11):2565-9.

  13. Bleakley CM, O’Connor SR, Tully MA, Rocke LG, MacAuley DC, Bradbury I, Keegan S, McDonough SM. Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial. Bmj. 2010 May 10;340.

  14. La Clinique du Coureur. PEACE & LOVE: New acronym for the treatment of traumatic injuries. Published on 30 August 2019. Available from https://www.youtube.com/watch?v=HGTabgG7GIU (last accessed 25 June 2020)


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