Sprains and strains? All you need is PEACE and LOVE

If you’ve ever had a twist-and-shout moment with an ankle or knee, you may have employed the RICE protocol, a popular method for managing post-injury pain and swelling.  

But research suggests PEACE and LOVE, a newer model of physical therapy, could be more beneficial in the long term – and that RICE may actually be counterproductive. 

What is RICE? 

This approach to managing soft-tissue injury, easily remembered by the helpful acronym RICE, advises: 

• Rest: Let your injury heal for a day or two. 
• Ice: Reduce inflammation and pain by icing the injury. 
• Compression: Wrap the injury to reduce swelling, which helps manage pain and loss of function. 
• Elevation: Prop up the injured appendage to lessen fluid buildup and therefore pain and swelling. 

“RICE has been the standard recommendation for soft tissue injuries, such as ligament sprains and muscle strains,” says Matthew Ferlindes, a physical therapist at Aurora Health Care. “It focuses on immediate pain relief but not so much on long-term healing.” 

What is PEACE and LOVE? 

This revised acronym – coined in 2019 by Blaise Dubois and Jean-Francois Esculier – instead promotes immediate comfort while optimizing recovery.  

Right after an injury, try PEACE: 

• Protection: Restrict movement for a few days to minimize aggravation to the injury. 
• Elevation: Prop up the injured appendage to lessen fluid buildup. 
• Avoid anti-inflammatory treatment: Refrain from using ice and anti-inflammatory pain medication like ibuprofen, which can delay healing by making it difficult for blood cells to travel to damaged tissue. 
• Compression: Wrap the injury to reduce swelling, which helps manage pain and loss of function. 
• Education: Discuss your treatment with a physical therapist or primary care provider who can help you determine the right combination of passive treatment, such as acupuncture, and active recovery using the injured appendage. 

After a few days, engage in LOVE: 

• Load: Try bearing weight or using the injured appendage appropriately and comfortably. Movement helps heal injured tendons, ligaments and muscles. 
• Optimism: Focus on a successful recovery. A positive attitude results in better outcomes. 
• Vascularization: Engage in light aerobics to promote blood flow to the injured area, which speeds up healing and can reduce the need for pain medication. 
• Exercise: Develop a plan for rehabilitative movement with your care team, as restoring strength and balance after an injury can help reduce future injury to the appendage. 

“PEACE and LOVE gives control to the injured person as it offers active ways to help recover from an injury – and active approaches to rehabilitation outweigh passive approaches,” Ferlindes says. “Working with a physical therapist can give you the tools and exercises you need to safely heal.” 

Are you trying to find a physical therapist or an orthopedic specialist? Find one in Illinois or Wisconsin.