PEACE AND LOVE - managing sports and musculoskeletal injuries

PEACE and LOVE is not just a wish for the world…. It is the new acronym or “catch phrase” proposed to help guide the actions and rehabilitation to manage sports and musculoskeletal injuries.

Most people are familiar with RICE: Rest, Ice, Compression and Elevation!

Research over the past few years has indicated that RICE may be outdated, and soft tissue injuries require a more complex approach to optimise recovery.

Dubois and Esculier (2019) have proposed PEACE and LOVE.

PEACE and LOVE comprise the full range of soft tissue injury management, from immediately post injury to subsequent treatment in the weeks to follow. It focusses on factors that will aid recovery as well as information on what to avoid.

PEACE

Acute soft tissue injuries need PEACE!

P = Protect

- Do no further harm to the injured area. Depending on the injury type and severity this may include unloading (ie. Crutches/sling) or restricting the movement for a few days.

- This may reduce further bleeding as well as the risk of aggravating the injury.

- Crucially, it is important to limit rest as prolonged rest influences the tissue strength and quality. The nature of the injury as well as pain guide the removal of protection and commencement of gradual reloading. We at Elite Physio can assess the injury and recommend the optimal time frame and level of protection that would not just help protect the injury but avoid unnecessary complications and prolonged recovery times.

E = Elevate

- Elevate the injured limb higher than the heart.

- This helps to reduce the swelling in the area.

A = Avoid

Avoid Anti-inflammatory medications!

- Your body responds to an injury with an inflammatory process. The inflammatory process is your body’s natural response to support soft tissue healing and regeneration. Anti-inflammatory medication may inhibit the inflammatory process and delay or impair healing.

C = Compress

- Swelling and bleeding can be limited by using compression such as taping or bandages.

- Compression should be applied as soon as possible after the injury.

E = Educate

- Appropriate education about your injury can decrease anxiety and frustration. It is important to protect the injury, however it is just as important to start moving and loading the injury as soon as appropriate. Progressive rehabilitation guidelines tailored to suit the different phases of healing helps to avoid a prolonged recovery.

LOVE

After the initial days have passed, soft tissue injuries need LOVE.

L = Load

- After the initial phase of protection, soft tissue injuries benefit from an active approach with movement and exercise.

- Normal activities should continue or be adapted as soon as symptoms and pain allow for it.

- Loading the injured structure within limits of pain assist with the cell repair and remodelling. Loading helps to increase the tolerance and the strength of tendons, muscles, and ligaments.

O = Optimism

- Our brain plays a significant part in rehabilitation. Depression, anxiety and fear have been described by researchers to play a significant role in symptoms and limitations after an injury, leading to prolonged recovery time.

- Pessimistic patient expectations negatively influence outcomes and prognosis of an injury.

- It’s important to stay realistic, yet optimistic.

V = Vascularisation

- Injury management needs to include cardiovascular activities.

- Pain free activities that increase your heart rate, also increase the blood flow to injured structures.

- Early mobilisation and aerobic exercise play a vital role as a motivation booster, as well as assisting with maintaining fitness levels. It improves function, getting you back to work/sport earlier and reduces the need for pain medication.

E = Exercise

- The benefits of exercise are endless, but after injury it is crucial. The correct exercises will help restore mobility, strength and coordination and even reduce recovery time.

- At Elite Physiotherapy we will advise you on the most beneficial exercises and give you a program tailored to your injury, aiding / guiding you back to normal life and sport.

DISCLAIMER:

Not all injuries are the same. We recommend consulting with one of our experienced physiotherapists for a thorough assessment and diagnosis.