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 potentially 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”

P=PROTECTION

Avoid activities and movements that increase pain during the first few days after injury.  Minimize rest, prolonged rest compromises tissue strength and quality.

E=ELEVATION

Elevate the injured limb higher than the heart as often as possible.

A=AVOID ANTI-INFLAMMATORIES

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.  The use of ice is mostly analgesic and may disrupt inflammation processes that can aid in healing.

C=COMPRESSION

Use an elastic bandage or taping to reduce swelling.

E=EDUCATION

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.

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.

 

Winter Blues

“After the first days have passed, soft tissues need LOVE”

L=LOAD 

Let pain guide your gradual return to normal activities.  Your body will tell you when it’s safe to increase the load.  This promotes repair and builds soft tissue tolerance.

O=OPTIMISM    

Our brain is more powerful than we give it credit for!  Condition your brain for optimal recovery by being confident and positive.

V=VASCULARISATION  

Choose pain-free cardiovascular activities to increase blood flow to repair tissue.  Reduces the need for pain medication.

E=EXERCISE

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.

BOTTOM LINE:

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!

References:

https://www.physio-pedia.com/Peace_and_Love_Principle#cite_note-:1-1

https://www.lakkyphysio.co.uk/make-peace-love-not-rice

https://www.physio-network.com/blog/ice-for-acute-injury/

the Running Room

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

Integrative Physiotherapy is a Barrie-based clinic that believes in a one-on-one patient-centred, manual therapy (hands-on) approach to physiotherapy. We aim to empower our patients by providing quality care that is personalized to each patient in an interactive and friendly manner. Through the use of the best available treatment techniques, we aim to provide exceptional care so that each patient feels engaged and motivated.

Our therapists are continually upgrading their skills and taking time to provide comprehensive assessment and treatment techniques that 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, Book Your Appointment to get started.  Don’t let pain ruin your day.

Integrative Physiotherapy, Empowering Patients with Personalized Care.