Management and care of musculoskeletal soft tissue injuries can be complex due to tissue type, different healing responses and timeframes, as well as severity. To guide the management principles of early management, you may have come across several acronyms that have been used over the years including:
- ICE (ice, compression, elevation)
- RICE (rest, ice, compression, elevation)
- PRICER (protect, rest, ice, compression, elevation, rehabilitation)
The principles these anacronyms advocate have been relied on for the early acute phase of musculoskeletal soft tissue injury for many years.
There has been little attention given to a guideline that can be followed from the immediate care, through the subacute, to chronic phases of the injury type we are referring to, that is based on contemporary scientific evidence. That is until now…
Let us introduce you to the concepts of P . E . A . C . E . and L . O . V . E .
P PROTECTION
Avoid activities and movements that increase pain in the first few days after injury.
E ELEVATION
Elevate the injured body part higher than the heart as often as possible.
A AVOID ANTI-INFLAMMATORIES
Avoid anti-inflammatory medication and icing as they both reduce tissue healing.
C COMPRESSION
Use elastic bandage or compressive stocking to reduce and manage swelling
E EDUCATION
Educate yourself and avoid unnecessary passive treatments and unnecessary investigations. Don’t rely on ‘urban myth’ to guide your injury management.
L LOAD
Let pain guide your early gradual return to function. Your body will tell you when it is safe to increase load.
O OPTIMISM
Be confident, positive and optimistic. Condition yourself to be realistic and accepting of the temporary interruption that injury causes.
V VASCULARISATION
Choose pain-free cardiorespiratory activities to increase blood flow to the healing tissues.
E EXERCISE
Restore mobility, strength and proprioception by adopting an active approach to recovery.
Physiotherapists are the experts when it comes to musculoskeletal soft tissue injury recognition and comprehensive management. There is more to it than immediate post-injury care. Careful consideration of progression and return to full function across daily life activities, occupational demands and recreational goals is all part of what physiotherapists aim to achieve for you, not to mention prevention of reinjury.
