What should I do to my acute injury?
SHE'LL BE RIGHT ?
JOG IT OFF ?
PEACE & LOVE
Historically, the acronym RICER (Rest, Ice, Compression, Elevate, Referral) was used for basic injury management. These principles have evolved with recent research and challenge the use of ice - which is currently used globally as a modality for pain relief and injury recovery. Recent research indicates that Ice can be a great pain killer, but does not change the success of tissue healing in acute injury – therefore it should be used as required, but not necessarily as a blanket treatment.
What’s the most effective treatment?
Previously the use of RICER focused on the acute management, however, PEACE & LOVE includes acute, subacute and return to sport phases of rehabilitation. Immediately following the injury PEACE is used to protect and avoid further injury, and to promote nutrient supply and waste removal in the tissue. Following peace, LOVE allows appropriate loading of the tissues to promote repair, remodelling and to build tissue tolerance to daily and sports specific movements.
The PEACE protocol helps guide initial treatment in the first few days. The first step is to PROTECT the injuried tissue from further harm. Protection can be achieved through splints, bracing or reducing time spent in painful positions. ELEVATION may also feel like a protective position, and is helpful in the reabsorption of excess swelling around the injury. AVOIDING ANTI-INFLAMMATORIES – unless directed by your GP/ specialist – they may in fact slow tissue healing. COMPRESSION through the use of tubi-grip and bandages can be helpful in controlling of swelling and allowing more comfortable movement. The last step is EDUCTATION about your condition – at Southside Physio we will always educate you about your condition, it’s prognosis and all the right steps required to get better.
The LOVE protocol is used to guide the individual back to normal daily function and sport after tissue healing has commenced. This approach allows a gradual and consistent progression back to activity while not overloading tissues. LOAD should start with simple weight bearing during walking or activities of daily living, then slowly build up to sport specific movements. We will guide you through all of your load management throughout your rehab. OPTIMISM is about a positive mindset, becoming more than your injury and setting goals with your physio that will see you back to doing what you love. It is well known that more positive people have better outcomes for injuries and experience shorter hospital stays. VASCULARISATION means to improve blood flow to the injured site, can be achieved through massage and dry needling, but also through regular exercise like swimming, cycling, and in some cases walking/jogging. Aside from the benefits of tissue healing, higher levels of cardiovascular fitness and muscle strength reduces your risk of being injured.
In summary, PEACE and LOVE is more than just the acute management of soft tissue injuries. This new and evidence-based approach is directed at maximising long-term outcomes and ensures that we treat YOU – not just your acute injury.
This information has been summarised from the BMJ journal article - with more information at: https://blogs.bmj.com/bjsm/2019/04/26/soft-tissue-injuries-simply-need-p...
The infographic for PEACE and LOVE can be seen below.