Acute soft tissue injuries include muscle strains, ligament sprains, bursitis and or contusions/bruising. It is important to understand that they can be different in nature and therefore management and treatment of these injuries varies, despite using the same clinical tool framework.
Traditional advice has been RICER- Rest, Ice, Compression, Elevation, Referral) but the latest clinical advice tool has become PEACE- Protect, Elevate, Avoid anti-inflammatories, Compress, Education & LOVE- Load Optimism, Vascularisation, Exercise).
There are many similarities between clinical tools RICER and PEACE & LOVE, however the major difference involves the avoidance of ice. Ice therapy can be administered in many forms including packs, gels, baths and cryotherapy. Evidence suggests ice has an anti-inflammatory and analgesic (absence of pain) effect, therefore it should be considered if there is an increase in swelling at affected tissue and or if pain is present. Fracture or bony injuries should not be managed with Ice.
PEACE & LOVE supports a positive attitude to movement and guided exercise early in the healing phase and allowing the body to recover without ice or anti inflammatory tablets, as these may hinder natural tissue repair. Exercise and loading can appear in many forms, for example, walking, running, swimming, resistance training, weights training, mobility training. Treatment and management of acute soft tissue injury by modified exercise and loading addresses the multiple areas of cardiovascular, musculoskeletal, neuromuscular and immune systems responsible for recovery.
The Facts
- Ice has analgesic effects and Ice reduces bleeding
- Exercise releases hormones that negate depression and ‘downer’ response in acute injury.
- Exercise increases circulation and blood flow bringing nutirents and healing agents to area to promote early healing
- Exercise can prevent further injury/flare ups and deconditioning
- Regaining balance, muscular endurance, co-ordination, flexibility, mobility, neuromuscular control and stability are essential to full recovery of acute soft tissue injury
