You may have heard of the common first aid acronym RICE – standing for Rest, Ice, Compression and Elevation. However, research from the British Journal of Sports Medicine has shown that this acronym has limited potential to improve post-injury outcomes.

So, what should we do instead? The new medical acronym developed by the British Journal of Sports Medicine is called “PEACE and LOVE”. These guidelines improve your ability to manage acute injuries –  from the initial first aid procedures to long-term strategies to maximise recovery outcomes.  

Read on to find out more about what each letter stands for. 

 PEACE is for immediate care – think first aid at the site of injury and the initial 1-3 days of the recovery process.

• Protection – protect the area from further injury by avoiding activities that produce pain. Complete rest should be avoided as it slows down the recovery process. 
• Elevation – elevate the affected limb above the level of the heart to reduce swelling and drain excess fluids. 
• Avoid Anti-Inflammatory Drugs – common anti-inflammatories such as ibuprofen prevent the body’s natural healing process from occurring. Redness, heat and swelling indicates blood is travelling to the affected region to help it heal.
• Compression – try taping or bandaging the injury to reduce joint swelling and promote blood flow.
• Education – Educate yourself about your injury and the recommended approach to recovery (our physios can help with this!) Avoid over treatment or quick fixes. Let your body do its thing! 

LOVE outlines the stages of subsequent management to optimise recovery outcomes and help you get back to your favourite activities as quickly as possible. 

• Load – Start moving as soon as possible. “Loading” means adding weight, pressure or resistance to a movement and promotes repair and remodelling. Let pain guide you – optimal loading should be pain free. 
• Optimism – Your attitude towards injury determines recovery more than the actual extent of injury does. Be realistic and avoid catastrophising. 
• Vascularisation – Begin pain-free aerobic exercise to increase blood flow to the region. Cardiovascular activity reduces the need for pain-medication and improves joint function. 
• Exercise – Exercise restores mobility, strength and proprioception (brain-body connection). It might seem counterintuitive but moving around is one of the best things you can do for soft-tissue injuries. 

Where did the ice go?

When injured, everyone rushes towards the cold pack or bag of peas. Icing an injury can be an effective way to reduce swelling, however research shows that cold therapy isn’t always the way to go. Swelling is an indication the body is doing its job and creating the best possible environment for recovery. Ice can limit natural inflammatory processes and reduce blood flow to the area, inhibiting tissue repair. So, think carefully before pulling out the ice pack – and use other options such as compression instead.

Need guidance? 

Make sure your injury gets the right amount of PEACE and LOVE. Our physios can provide you with a toolkit of strategies and exercises to guide your recovery process: 

• How to begin loading without exacerbating pain
• Options for aerobic exercise that work with, not against, your injury
• Adapt exercise programmes to suit your stage of recovery
• Reduce the need for pain-medication or surgical intervention
• Join group exercise classes to help you stay motivated 

References: 

Dubois, B., &  Esculier, J. F. (2019, April 26). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine. https://bjsm.bmj.com/content/54/2/72