PEACE AND LOVE AT STATE 11

A "soft tissue" injury is any kind of injury that doesn't involve the bones. So strains, sprains, pulls, twists, twinges and aches and pains would generally all be classed as a soft tissue injury.

 

Over the years, there have been many different recommendations for how to treat soft tissue injuries, and you might have heard some of them - acronyms like "ICE", "RICE" and "PRICE" are all quite commonly known.

A new way to treat soft tissue injuries

 

Science and medicine have moved on, and understanding of how best to treat soft tissue injuries has improved and changed. The new acronym to help you heal quickly and well from a soft tissue injury is "PEACE & LOVE", and although it's aimed at medical professionals treating soft tissue injuries, it's perfectly usable by people with injuries.

 

Immediately after an injury, you should make sure no further injury occurs, and let PEACE guide your approach. Here's what PEACE stands for:

 

P: Protection

Avoid activities and movements that increase pain during the first few days of injury.
You should this because you're looking to minimise any bleeding, and stop the injury getting any worse. You should only do this for the first one to three days. Don't spend too much time resting, because that can actually weaken the injured tissues further.

 

E: Elevation

 

Elevate the injured limb higher than the heart as often as possible.
This depends a bit on the injury. There's very weak evidence to suggest elevation helps with much at all but there's even less evidence that it makes things worse. However, you shouldn't look to elevate a ligament or tendon injury. This is because ligaments and tendons have poor blood flow naturally, and elevating them reduces the blood flow even more. Blood is how the various "healing cells" get to the injured area, so slowing it down even more isn't great for ligaments and tendons.

 

A: Avoid Anti-Inflammatories

 

Avoid anti-inflammatory medications as they reduce tissue healing. Avoid icing too.
As much as we're taught that inflammation is bad - it's actually part of the healing process. It's necessary for you to heal properly, even though it can look ugly and feel a bit uncomfortable. Using anti-inflammatories can actually slow down healing and mean that the healing that does happen isn't as good.

 

As for icing, there is no evidence that this helps with healing at all. Sometimes applying ice to an injury can make it go numb which in turn makes it feel more comfortable - but the level of cold required to do this can also damage the already injured tissue. So no anti-inflammatories, and no ice!

 

C: Compression

 

Compression (like taping or bandaging) can help reduce bruising. There's very little evidence to show that it helps, but people with ankle sprains report feeling more comfortable if the ankle is compressed.

 

E: Educate

 

Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play it's role.
Getting people that "traditional" techniques like anti-inflammatories, icing and resting for ages are actually a bad idea requires educating people that it's okay to feel a little uncomfortable after an injury, and that a bit of swelling or inflammation is okay. Over time, we've come to believe that any kind of pain or discomfort means we should stop moving and take lots of tablets, but this really isn't the case.

 

After the first few days, when the injury isn't as painful, then you should look to use LOVE. Here's what LOVE stands for:

 

L: Load

 

Let pain guide your gradual return to normal activities.
Your body is pretty good at letting you know when things hurt, and movement and exercise benefit most people who have picked up an injury. Get back to moving as soon as you can - just don't push yourself into pain. It's important to get back to moving, because this helps healing happen faster and improves the quality of your recovery.

 

O: Optimism

 

Condition your brain for optimal recovery by being confident and positive.
If you've suffered an injury, it's understandable that you don't want to be in pain again, and that you might worry about that happening. You might feel down that you got injured and or even think that your injury is worse than it is. Studies show that people who trust that they will get better, and feel confident and optimism recover better than people who worry about their injury and stop moving.

 

V: Vascularisation

 

Choose pain free cardio-vascular activities to increase blood flow to repairing tissues.
This is a really complicated way of saying that your blood carries nutrients and stuff your injury needs to heal, so getting a good blood flow going and your heart pumping blood round is a good idea. As you might expect by now, don't push your level of activity into pain - be guided by what feels comfortable for you.

 

E: Exercise

 

Restore mobility, strength and balance by adopting an active approach to your recovery.
Exercise and movement are really important for both day to day health and healing. Don't do anything painful to begin with, and as your healing progress, allow discomfort to be your guide about when to stop.

 

The important thing to remember about exercise is that being strong, flexible and having a good sense of balance (all things that exercise helps with) means it's less likely that you'll get injured in the future. So get moving!

 

This information is taken from the wonderful British Journal of Sports Medicine.
Read about their advice for soft tissue injuries here: https://bjsm.bmj.com/content/bjsports/54/2/72.full.pdf