Immediately after a soft tissue injury, do no harm and let PEACE guide your approach
After the first days have passed, soft tissues need LOVE

By Blaise Dubois @blaisedubois and Jean-Francois Esculier @JFEsculier

PEACE refers to the days immediately following an injury, while LOVE is required for the ongoing recovery phase.

Principles of PEACE
P for Protection: Restrict movements that increase pain for 1-3 days to minimise bleeding, prevent distension of injured fibres and reduce risk of aggravating the injury.

E for Elevation: Raise the limb higher than the heart to promote interstitial fluid flow out of tissue. This has weak evidence, but is still recommended given its low risk-benefit ratio.

A for Avoid anti-inflammatory modalities: Medications to inhibit inflammation are not recommended as this could impair tissue healing. Also avoid icing the injured limb.

C for Compression: Use elastic bandage or taping to reduce swelling to help limit intra-articular oedema and tissue haemorrhage.

E for Educate: Therapists should educate patients on the benefits of an active approach to recovery.

After the first days have passed, soft tissues need LOVE, the physiotherapists write.
Principles of LOVE
L for Load: Add mechanical stress and resume normal activities as soon as symptoms allow. Optimal loading without exacerbating pain promotes repair and remodelling.

O for Optimism: Catastrophising, depression and fear can represent barriers to recovery. Practitioners should encourage optimism, while remaining realistic.

V for Vascularisation: Start pain-free cardiovascular activity a few days after injury to increase blood flow to the injured area.

E for Exercise: Strong evidence supports exercise for treatment of ankle sprains and for reducing the prevalence of recurring injuries.
“Whether they are dealing with an ankle sprain or a hamstring strain, we hope this blog post will encourage clinicians to give PEACE a chance, because perhaps all soft tissue injuries need is LOVE,” the conclude.

Soft tissue injuries simply need PEACE & LOVE
Posted on April 26, 2019 by BJSM