How We Actually Rehab Acute Injuries
In a recent blog post here, our RMT and Athletic Therapist Dan Marynowski discussed why ice isn’t necessarily the way to help acute injuries. Knowing what we now know about icing, acronyms guiding soft tissue management have
evolved from the traditional ICE/RICE/PRICE and POLICE protocols. The way we now
approach soft tissue management is taking all stages of healing into account rather than just the
acute phase. That being said, the new acronym that encompasses the rehabilitation continuum
from immediate care (PEACE) to subsequent management (LOVE) is PEACE & LOVE.
The purpose of this blog is to introduce this new acronym and shed some light on what is involved and how we currently approach working with acute injuries.
Protection
Protection means avoiding any particularly aggravating activities or motion in the first 1-3
days. However, it should be noted that rest should be minimized here as it can compromise
the strength and quality of the tissue. Even though this period is ‘protection’ this doesn’t mean there aren’t things that can and should be done from a movement perspective.
Elevation
Elevation involves placing the injured area above the level of the heart to promote a
lymphatic drainage and a decrease in swelling. At this stage gentle muscle contractions can
also assist with venous return.
Avoid anti-inflammatories
People OFTEN jump right to anti-inflammatories when they get hurt. However, current recommendations suggest you should avoid anti-inflammatories including medications (and even potentially ICE as discussed in the previous blog post)
because the body’s natural inflammatory response that is present to help heal after injuries
may be impeded and negatively affect long-term tissue healing.
Compression
Compression can involve bandages that help to limit swelling and tissue haemorrhage.
Provide healing by primary intent, meaning less scar formation.
Education
Education is rehab knowledge provided by the health care professional to the patient on the
importance of an active approach to recovery, along with appropriate loading, and realistic
expectations for rehab. Understanding the rehab process and getting active early on will be
much more beneficial for the client than any passive modalities and can leave you with long term beneficial knowledge.
Load
Load is encouraging the active over passive approach to recovery and to gradually load the
injured area as it tolerates without exacerbating symptoms. Optimal loading promotes repair, remodelling and builds tissue tolerance and the capacity of tendons, muscles and ligaments through mechano-transduction (the process of turning mechanical input into a physiological response). Ideally, normal activities should be resumed as soon as tolerated.
Optimism
Optimism addresses the mental side of injury and current research shows that an optimistic
outlook on recovery can improve recovery rate. Positive self talk and refraining from
catastrophizing can deliver a better outcome and prognosis towards recovery.
Vascularization
Vascularization refers to initiating cardiovascular activity to promote blood flow to the
injured area as increased blood flow will aid the healing process. Even when there is a lower
body injury, cardio exercises can still be performed such as using the ropes, an upper body
ergometer, or a rowing machine.
Exercise
Exercise helps to restore mobility, strength and proprioception early after injury. Throughout this process of resuming exercise certain signs should be monitored to ensure proper healing is occurring.
So the next time you have an acute injury (which hopefully doesn’t happen), forget RICE and get your tissues some PEACE and LOVE.
If you are interested in learning a bit more about soft tissue mobility and how to implement it into your recovery you can download our FREE PDF below!
