It is common when we talk about soft tissue injuries such as ankle sprain or pulled muscle that we always think of doing the RICE protocol or Rest, Ice, Compression and Elevation. But this protocol has already been outdated and the research says that this approach lack of strong evidence with regards on healing and recovery of the soft tissue. Then, the protocol becomes PRICE which adds Protection on RICE acronym and then it became POLICE. The POLICE protocol is a modified first-aid method for soft tissue injury which is stands for Protection, Optimal Loading, Ice, Compression and Elevation. This protocol highly encourages safe weight bearing or loading based on the level of pain or symptom in acute soft tissue management.
But all these mentioned protocols are focuses on managing the acute or early stage of soft tissue injury and do not provide any information on how to manage the later stages of the soft tissue healing such as sub-acute and chronic stage.
That’s the reason why recently, Dubois and Esculier (2019), developed two new acronyms or protocol to optimize soft tissue recovery, they call it “PEACE and LOVE”. These protocols include the full range of soft tissue injury management from the early up to chronic stages. PEACE and LOVE focuses on patient education and addressing the psychosocial factors involved such as poor sleeping, anxiety and depression to help the patient to recover faster. Also, it emphasizes the potential hazards of using ice and anti-inflammatory medication during the healing process.
“Immediately after a soft tissue injury, do no harm and let PEACE guide your approach” P stands for Protect which means to unload or restrict movement the injured limb for 1-3 days, minimize rest and let pain guide removal of protection and gradual reloading in the injured part. Then E stands for Elevate, elevate the injured limb higher than the heart mostly recommended every 2 hours during your awake times. A is for Avoid anti-inflammatories modalities such as ice and anti-inflammatories medication which may negatively affect long term tissue healing and impede the natural healing process of the soft tissue which is having an inflammation in the affected area. C is for compression by using a bandage or tapes to manage excess swelling and lastly, E stand for Education mostly provided by medical professionals such as the Physiotherapist which tackles about providing an active approach rather than passive treatment, load management and setting realistic expectations about recovery times.
“After the first days have passed, soft tissues need LOVE”. L is for Load or having an optimal load and gradually resuming normal activities if symptom or pain allows. O is for Optimism or thinking about your realistic goal that you want to achieve and getting optimistic about recovering faster. V stands for Vascularization or doing any aerobic exercise such as swimming, biking or walking as long as the symptom accelerates the healing process of the injured soft tissue. And lastly, E is for exercises provided by your Physiotherapist to restore mobility, strength and proprioception or position sense of your affected limb.
The protocol mentioned above is only a guide for your soft tissue recovery. If you experience an unusual symptom such as having severe constant pain or inability to move or to put some weight on the injured part, it is best to consult your medical professionals such as your GP or Physiotherapist. If you have any concerns or questions about soft tissue injury and recovery, don’t hesitate to go to NRG- Health Clinic at 71 Oxide Street or call us at (08) 8088 2612.
