In the past physios often advised RICE and PRICE – and some of this advice is still relevant, for example
P – Protect – let’s stop testing and stressing the area when it is painful. Minimise movement to prevent excess bleeding and further tissue damage.
R – Rest – we will delve deeper into this below.
I – Ice – evidence remains limited as to whether ice is best – but if it feels good it can help alleviate the heat and pressure. Please don’t burn the skin!
C – Compress – by using bandages or tape, to reduce excessive bleeding- but take advice form your physio so that blood flow is not restricted. This can also provide mechanical support to protect the injury
E – Elevate – to allow the swelling to naturally drain towards your lymph glands and towards your heart.
This has now been updated to POLICE with Optimal Loading replacing Rest.
P – Protect is still there – so stop Testing and stressing it if it is painful
OL– Optimal Loading – This emphasises the need to incrementally load the injury to ensure optimal healing and recovery. This is where injuries can become chronic- loading too much too soon or equally fear setting in and avoidance of movement delaying recovery.
I– Ice
C-Compression
E -Elevation – Remember this means elevation above the heart.
In 2019, PEACE and LOVE acronym was proposed.
This includes immediate acute care as well as medium to long term management and encompasses a fully rounded approach to soft tissue injury management:
So for immediate action Give your soft tissues PEACE
P– Protection
E– Elevation
A– Avoid Anti-Inflammatories – we want your brilliant body to do what it was designed to do – which is to create inflammation. So don’t go stopping it in the first 24-48 hours.
C– Compression
E– Education – talk with your physio team so you are ready for the next phase for optimal loading.
& then after 3 days, with your physios advice, let’s show it some LOVE
L– Load
O– Optimism – taking a positive attitude towards your injury, catastrophising can create fear of movement and stop you listening to your body’s needs. Talking to your physio can keep you realistic with set time frame and goals.
V– Vascularisation – Raising the heart rate through pain free cardiovascular exercise will ensure good circulation to the injury site which can assist healing. This is also a good way to maintain overall health and motivation and to transition back to full function more easily. This can help reelase your natural endorphins- your natural pain killers and moed enhancers
E– Exercise – Follow the advice from your physio – there is strong evidence to help your recovery with a graded exposure to exercise.
Research:
PRICE needs updating, should we call the POLICE? C M Bleakley, P Glasgow,D C MacAuley Br J Sports Med 2012;46 :220–221. doi:10.1136/bjsports-2011-090297
Soft-tissue injuries simply need PEACE and LOVE Dubois B, Esculier J-F. Br J Sports Med 2020;54:72–73. Accepted 16 July 2019 Published Online First 3 August 2019.
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