Icing injuries has been a long-standing practice in the field of musculoskeletal care. But is it the best method available?
Over the years, we’ve had a TON of acronyms to help us through treatment after an injury. Depending upon how old you are, you’ve probably heard one of the following:
1. Rest Ice Compress Elevate (RICE)
2. Protect Rest Ice Compress Elevate (PRICE)
3. Protect Optimal Loading Ice Compress Elevate (POLICE)
4. Movement Exercise Analgesics Treatment (MEAT)
In my opinion, the recommendations have gotten better over time. However, the latest acronym is my favorite so far, mostly because it does a nice job of summating good overall care for most of our injuries. You should notice that ice is no longer a recommendation! There is speculation that it slows down blood flow, delays healing and extends recovery time.
Recent information found in the British Journal of Sports Medicine suggests that all we need is PEACE (what to do immediately after injury) & LOVE (what to do for treatment).
Protect
After many injuries, it may be useful or necessary to brace or get off of the affected body part for a short period of time to avoid excessive swelling or re-injury. Rest should be brief and bracing should only be as necessary.
Elevate
To assist in keeping swelling to a minimum, elevate the injured body part above the heart when possible. This will allow gravity to assist in removing excess fluid and assist in blood flow.
Avoid Anti-inflammatories
This includes medications and ice. Many people mistakenly view “inflammation” as a bad thing, but in reality we need it in order to get better. Inflammation is vital for proper repair and stopping/altering the inflammatory process may have negative side effects. Pain and swelling can be dealt with in other ways, as you will see.
Compress
Wrapping or taping the injured area will help to stem the accumulation of swelling, relieve pain and improve overall quality of life during the process.
Educate
It’s important to understand, potential limitations and the benefits of active recovery (properly applying exercise). Well-intentioned, yet misguided patients rely heavily on the internet for advice, instead of consulting a qualified healthcare provider. Full recovery can only occur with the patient’s help!
Load
Eventually, it will become crucial to start appropriately physically stressing the injured area, also called exercise. This will help to improve blood flow, improve strength and ensure nerve communication with the brain to the body part. Active exercise is necessary to help with repair and healing.
Optimism
Sometimes it’s easy to get frustrated, upset or depressed after injury. it’s important to maintain a positive outlook regarding recovery. The science is clear, people who think they are going to get better have a much better chance of doing so! It may also help to reduce pain.
Vascularization
Injured body parts need blood flow to heal. During an injury, sometime blood flow becomes lessened and can lead to prolonged healing and pain. Improving circulation through movement is extremely helpful at speeding recovery.
Exercise
Like we said above, this may be one of the most important steps in the treatment process. Even if the injury doesn’t “hurt” any longer, there may be other factors, like decreased strength, poor stability or weak tissues that may put you at risk for another injury. Exercise can help to offset this and make you more resilient to injury in the future.
In the end, PEACE & LOVE is a great approach to managing a soft tissue injury. But, in reality, the smartest thing you could do is consult with me about how to get you out of pain, back up to strength and enjoying life again. I’d be happy to be on your healthcare team!
