Immediate injury management has moved from RICE (rest, ice, compression, elevation) to PEACE, do no HARM!….and then LOVE
This does not mean RICE is wrong, just that current evidence adds more…
PROTECT
Off-load and restrict movement of the area for up to 3 days. This might mean crutches or a sling. This will minimise further injury to the area. Pain signals will help guide you.
ELEVATE
Elevate the injury above your heart to help reduce swelling.
AVOID ANTI-INFLAMMATORIES
As these can inhibit tissue repair in the early stages of healing. Use other medication such as Paracetamol for pain relief, for the first week or so after injury.
COMPRESS
External compression such as bandaging or tape can reduce further swelling or bleeding and rest the area. This must be professionally applied to prevent further damage.
EDUCATION
Speak with your Physiotherapist on advice for RELATIVE rest (resting by avoiding activities that could aggravate the injury) and which exercises will speed recovery. Ask about exercises to help maintain the rest of your body whilst recovering, and progressive exercises and stretches for the injured area. Find out about set goals for recovery time and progressive loading of injured tissues.
IN THE IMMEDIATE POST INJURY PERIOD (2-3 DAYS) DO NO HARM! YOU SHOULD AVOID DOING THE THINGS BELOW FOR 72 HOURS AFTER INJURY.
HEAT
Applying heat to the injury could increase bleeding and swelling
AVOID ALCOHOL
This can increase bleeding and swelling. This will delay your healing
RUNNING OR RE-INJURY
You can cause further injury that isn’t strong enough to take the impact of running or exercise.
MASSAGE
Massaging increases blood flow and massaging the injured area directly could increase bleeding and swelling.
After the first few days have passed, your injured tissues need LOVE!
Loading
Loading the injury within the limits of pain, early on in recovery has been shown to promote healing and tissue repair. Ask for Physiotherapist for guidance on what this looks like for your specific injury.
Optimism
Depression and fear about an injury have been shown to predict a poorer recovery and outcome of an injury, than being realistic, informed and positive, working actively towards a full recovery.
Vascularisation
Improved blood flow through the tissues, carries nutrients and oxygen to promote healing. Gently moving the joint and working the muscles around the joint will improve the blood flow and encourage healing. A Physiotherapist will show you what exercises are appropriate for your injury at each stage.
Exercises
Controlled and progressive exercises, within pain limits are a key to recovery. Restoring mobility, strength and proprioception will help speed your recovery and prevent further injury.
