There have been many revisions regarding the best practice guidelines for the management of acute injuries throughout the years. Research development is continuous and upgrades our understanding and management of tissue injury.
The newest acronym that guides acute injury management was created by Blaise Dubois and Jean-Francois Esculier and published to the British Journal of Sports Medicine in 2020. This new guideline emphasizes the benefits of early mobilisation (the action of making something movable or capable of movement) for tissue repair and how some frequently-used methods during the acute stages of an injury may jeopardise tissue healing.
The guideline is broken down into two stages: PEACE (initial and very acute management) and LOVE (guiding the care to follow).
PROTECT
Extended periods of rest are not recommended as this may compromise the quality of tissue healing. However, this guideline does recommend limiting movement directly after the injury, and for the first 1- 3 days after injury to prevent stressing injured tissue during the early phases of healing. This can be achieved via strapping or bracing. In addition, injured structures can be offloaded using crutches when necessary.
ELEVATE
Although high quality evidence is lacking, elevation of the injured area above the level of the heart may play a role in improved circulation and swelling management. This intervention (action taken to improve a medical disorder) has proved to be a low risk strategy to manage acute injuries.
AVOID ANTI-INFLAMMATORY METHODS
Inflammation after injury involves various cellular activities that regulate tissue repair. This is the body’s natural healing process. Ice and anti-inflammatories used to manage pain and swelling work by decreasing inflammation. However helpful these strategies may be in reducing symptoms, it may compromise tissue healing in the long term and patients are advised to avoid ice and anti-inflammatory medication where possible.
COMPRESS
There is evidence that externally-applied pressure around the injured tissues assists in swelling management. This compression can be achieved via bandaging or taping.
EDUCATE
Once the injury has been diagnosed, education on the nature of the injury and expected duration of rehabilitation plays an important role in expectation management and can improve rehab adherence.
After acute injury management on the field, the “LOVE” process can begin. This is where the player can be thoroughly assessed and rehabilitation can begin. This stage emphasizes the importance of optimally loading the injured tissue, optimism towards recovery, aerobic exercise and specific physical activity to promote a safer and quicker return to play. Read more about Sports Physiotherapy here.
References:
- Dubois, B. and Esculier, J.-F. (2020) ‘Soft-tissue Injuries Simply Need PEACE and LOVE’, British Journal of Sports Medicine, 54(2), p. bjsports-2019-101253. Available at: https://doi.org/10.1136/bjsports-2019-101253.