All we need is a little PEACE & LOVE

Soft tissue injuries are common among runners, both on the road and on trails. These injuries typically involve muscles, tendons, ligaments, or fascia, and they occur due to a combination of factors, including overuse, poor biomechanics, and environmental conditions.

Soft tissues play a vital role within our bodies, including surrounding, protecting, and supporting our organs, moving fluids between body parts, and offering shape and structure to our body.

We are well used to, and indeed conditioned to understand that if we sustain a joint or soft tissue injury, we should apply ice, or some form of cold therapy.

Until now we have had First Aid acronyms such as RICE (Rest, Ice, Compression, Elevation)

PRICE (Protect, Rest, Ice, Compression, Elevation) and P.O.L.I.C.E. (Protect, Optimal Loading, Ice, Compression, Elevation)

In summary, while all these methods focus on reducing swelling, pain, and protecting the injury, P.O.L.I.C.E. emphasizes a more proactive recovery approach with “optimal loading” promoting faster recovery through movement and load management.

Recent studies have now identified that the use of cold therapy for acute soft tissue injuries is no longer recommended, as the reduction of inflammation may delay healing. It is now recognised that inflammation is necessary to promote healing.

Swelling is desired for healing well!

The new acronym PEACE & LOVE provides a modern, comprehensive approach to acute injury management and rehabilitation. It integrates both the initial first aid steps and key recovery principles that focus not just on the physical, but also the mental aspects of healing.

PEACE (Immediate Care for Acute Injuries)

This part of the acronym focuses on the initial care after an acute injury, like a sprain, strain, or contusion.

P - Protect

Limit movement or activity to prevent further injury for the first 1-3 days. This helps shield the injured area from further damage.

E - Elevate

Elevate the injured limb above the level of the heart to reduce swelling and facilitate venous return.

A - Avoid Anti-Inflammatories

Anti-inflammatory medications (like ibuprofen) may hinder tissue healing. While pain control is essential, avoiding these medications early on supports the body’s natural inflammatory response, which is crucial for repair.

C - Compress

Use elastic bandages or compression garments to help manage swelling and support the injured area.

E - Educate

Patients should be educated about the importance of active recovery and avoiding excessive passive treatments. Understanding the injury and treatment empowers the patient and aids in long-term recovery.

LOVE (Long-Term Recovery and Rehabilitation)

This section focuses on the actions required to promote healing and full recovery over time, addressing both body and mind.

L - Load

Once pain permits, begin gentle loading of the injured area. Progressive loading helps regain strength, mobility, and function while promoting tissue repair. Gradual return to activity ensures the tissues heal properly without excessive stiffness or weakness.

O - Optimism

Positive thinking can significantly influence recovery. Addressing the mental and emotional aspects of injury can reduce stress and anxiety, which in turn can improve outcomes. Encouraging an optimistic outlook fosters motivation and adherence to rehabilitation.

V - Vascularization

Engage in pain-free cardiovascular exercises that promote blood flow and healing. Activities like swimming, cycling, or walking help maintain cardiovascular fitness without overloading the injured area.

E - Exercise

Tailored exercise programs focusing on mobility, strength, and balance are critical for full recovery. As healing progresses, specific exercises should be introduced to restore range of motion, muscle strength, and proprioception.

Why PEACE & LOVE is Effective:

Holistic Approach: It goes beyond just the physical treatment of the injury, incorporating psychological well-being and long-term recovery goals.

Promotes Active Healing: While initial rest and protection are vital, this protocol quickly shifts focus to progressive loading and exercise, avoiding the pitfalls of prolonged immobilization.

Empowers the Patient: Education and optimism play a key role in reducing fear and promoting a proactive, positive mindset during rehabilitation.

This modern acronym is a step up from older methods like RICE (Rest, Ice, Compression, Elevation) by addressing both the immediate and long-term needs of recovery and promoting a more active, mindful approach to healing.

There are a couple of exceptions to this advice:

In the absence of soft tissue injury, whole-body cold therapy can be useful for optimising recovery from sports training. So, we will still see sports teams and athletes using ice baths and cryo chambers after intense bouts of training or competition.

Cold therapy may still be useful for acute soft tissue injuries if there is excessive or prolonged swelling, which, conversely, can hinder the healing process. This may seem contradictory – an appropriately qualified professional can determine if cold therapy should be introduced as part of a recovery plan.

Medical Disclaimer

The advice and information provided in this article are based on general running and fitness principles and are intended for informational purposes only. They should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult with a physician or qualified healthcare provider before beginning any new exercise program, particularly if you have a medical condition or are taking medications.

As a running coach, I can provide guidance based on experience and training, but individual results may vary. You are responsible for understanding your own limits and abilities, and any use of the information provided in this article is done at your own risk. If you experience pain, discomfort, or any other symptoms while exercising, stop immediately and seek medical advice.

The information here is not intended to replace professional healthcare recommendations, and you should not delay seeking medical advice or ignore professional counsel based on content from this article.