For many years we have treated injuries for example ankle sprains, muscle tears or strains with acronyms involving ICE, RICE, PRICE and POLICE. All of these has focused on the acute treatment of the injury and thus we need to focus more on the sub-acute and chronic stages of tissue healing.
IMMEDIATELY after the injury, do no harm and let PEACE guide you…..
P-stands for protection of the effected area and this normally involves 1-3 days of unloading or restricting movement to prevent further damage and minimize bleeding. Resting for to long can compromise tissue strength and quality.
E- Elevation the limb higher than your heart promotes reducing swelling in the area and thus easier for healing to take place.
A-Avoiding the use of anti-inflammatory medication for the first 3-5 days. The first phase of healing is the inflammatory phase and taking anti-inflammatory medication has shown to delay the healing response. You are much better off taking pain killers such as Panadol if you have pain.
C-Compression has shown to be beneficial in stabilizing, decreasing swelling and decrease pain.
E-Education on the benefits of an active approach for recovery is very important. Knowing what the do’s and don’ts are as well as understanding of the injured structure, phases of healing and specific outcome are very important for optimal recovery.
After the first day or 2 the injury needs LOVE….
L-Loading without exacerbating of pain is important to promote the repair, remodeling of injured tissue and building the load (tolerance and capacity) taken by tissue.
O-Optimistic patients are associated with better outcomes. Physiological factors such as fear and depression may present as barriers to recovery.
V- Vascularization refer to increasing blood flow to the area by early movement and exercises that promotes healing. Pain-free aerobic exercises should be started soon after the injury as possible. This has also shown improvement in physical function, faster return to work and reduce the need for pain management.
E-Exercises to strengthen structures around the injury or that may have had an influence on the injury. Managing injuries is also a long-term process and long-term outcomes need to be addressed with exercise review and progression.