The To Ice Or Not To Ice An Injury?
This topic of ice has been long debated in acute injury rehab. The way we treat injuries is continually changing based on the most up to date research.
The question of when to use ICE on an injury is one that is commonly asked. Common and well-known principles of soft tissue injury management include principles such as RICE and POLICE, but there is so much more to the management and healing of soft tissue injuries. These well-known methods focus on the acute management of soft tissue injuries and do not really provide any information on the sub-acute and chronic stages of soft tissue healing.
New recommendations as of 2019 to optimize soft tissue recovery now include: PEACE and LOVE . These two acronyms (PEACE and LOVE) include the full range of soft tissue injury management from immediate care to the weeks following. It highlights the importance of patient education and addressing the psychosocial factors involved that will aid recovery. It also highlights the potential harmful effects of using anti-inflammatory medication for recovery
The reason for the changes?
Research has since identified that ‘Optimal Loading’ aids recovery through cell regeneration induced by light mechanical loading in the early stages. Subsequently, “Rest” or a lack of movement could be detrimental to recovery.
The Current Recommendation Explained.
“Immediately after a soft tissue injury, do no harm and let PEACE guide your approach”
Avoid activities and movements that increase pain during the first few days after injury. Minimize rest, prolonged rest compromises tissue strength and quality.
Elevate the injured limb higher than the heart as often as possible.
The Inflammatory process is a normal immune response. It helps to repair damaged soft tissues. Therefore avoid taking anti-inflammatory medications as they reduce tissue healing, this includes Ice. Use of ice is mostly analgesic and may disrupt inflammation processes that can aid in healing.
Use elastic bandage or taping to reduce swelling.
Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role. Physiotherapy can help set realistic goals and expectations for recovery time.
“After the first days have passed, soft tissues need LOVE”
Let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load. This promotes repair and builds soft tissue tolerance.
Our brain is more powerful than we give it credit for! Condition your brain for optimal recovery by being confident and positive.
Choose pain free cardiovascular activities to increase blood flow to repairing tissue. Reduces the need for pain medication.
Restores mobility, strength and proprioception by adopting an active approach to recovery. Use pain as a guide to progress, gradually increasing the level of difficulty.
The management of soft tissue injuries, whether it is a hamstring strain or an ankle sprain, should not just focus on short-term damage control. Clinicians such as Physiotherapists should also focus on long-term outcomes and focus on treating the person with the injury and not just treating the injury of the person.
If you have questions about your specific injury and how to properly manage your symptoms we are happy to help!
Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine 2020;54:72-73.
By: Lindsay Atwell. Integrative Care Coordinator. Clinical Pilates Instructor
The Physiotherapist at Integrative Physiotherapy provides high quality assessment and treatment techniques using safe and evidence based techniques to the residents of Barrie and surrounding areas. Our therapists are continually upgrading their skills and taking time to provide you with the one on one care necessary to quickly get you back to the activities you love doing. Comprehensive assessment and treatment techniques are always one on one without the use of assistants or double booking patients to make sure that you achieve your functional and sports goals as soon as possible.
Our therapists would be happy to help you to achieve your goals, get in touch to schedule your appointment. Don’t let pain ruin your day!
Integrative Physiotherapy, Empowering Patients with Personalized Care.