We may all be familiar with the acronyms of RICE (Rest, Ice, Compress, Elevate) and PRICE (Protect, Rest, Ice, Compress, Elevate) when treating an acute soft tissue injury. The rule on the sports field has always been RICE which then progressed to PRICE.
In recent years, however, a better understanding of the physiology of a soft tissue injury has been reached. Physiotherapists and other medical practitioners tend to focus on the acute phase of healing without realising the consequences that acute management has on the sub-acute and later stages of soft tissue healing.
A new acronym published by the British Journal of Sports Medicine in 2019, encompasses management of a soft tissue injury from acute phase, right through to end stage healing. This acronym also brings in to play other factors that may contribute to recovery, as well as factors that may slow down recovery.
How to use P.E.A.C.E for soft tissue injuries
Protection
Avoid activities and movements that increase pain during the first days after the injury (about 3-5 days). Your Physio can advise you if crutches or braces are necessary at this stage.
Elevation
- Elevate the injured area as often as you are able to, ideally higher than the heart.
- void taking anti-inflammatories such as Voltaren, Cataflam etc, as they reduce tissue-healing in the initial phases. New evidence also suggests that one should avoid icing the area initially, as this also reduces tissue healing in the first few days.
Compression
Use compression bandaging, bracing or taping techniques to limit or reduce the swelling. Your Physio can show you techniques of taping that can assist with swelling.
Education
Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature take its course. If you are unsure if you need investigations such as an X-Ray, it is worth contacting your Physio for an assessment and they can advise you if an investigation is necessary.
What does L.O.V.E treatment entail?
Load
Let pain guide your gradual return to normal activities, your body will tell you when it is safe to increase the load. Physiotherapy can be of great use here. Your Physio can assist in prescribing you with exercises that are suitable to your injury from acute phase until complete tissue healing.
Optimism
Condition your brain for optimal recovery by being confident and positive. Trust that your body will heal fully and be confident in its response to activity. Your body will guide you through the natural processes and is built to heal.
Vascularisation
Choose pain-free cardiovascular activities to increase blood flow to repairing tissues. For example, walking, jogging, cycling for an upper limb injury or swimming, walking, cycling for a lower limb injury. Your Physio can also guide you as to what cardiovascular exercise may be appropriate for your injury during the different phases of healing.
Exercise
Restore mobility, strength and proprioception (balance) by adopting an active approach to recovery. This really is where a physiotherapy practice is one of the best places to consult. Your Physiotherapist can help your return to activity, by designing a specific exercise programme for you and your injury and guide you as to when to progress it correctly. Physiotherapy can also aid in regaining mobility using mobility-specific exercises, as well as some hands-on techniques if appropriate.
If you are unsure of how to manage your soft tissue injury, chat to your Physio and they will guide you on your way to recovery.
This article was submitted by Natalie Ruivo-Almeida, the Practice Manager at the Dainfern and Lonehill branches of Lamberti Physiotherapy. Contact her for an appointment to discuss treatment for any soft tissue injury you have experienced.
References