Peace and Love: The New Soft Tissue Management

Modern research is telling us ‘PEACE & LOVE’ ✌️❤️ is the new soft tissue management protocol and RICER may soon be a saying of the past. 

This new acronym has been developed to address not only the acute, but also the subacute and chronic stages of tissue healing. Additionally, it aims to highlight the importance of patient education and addresses the psychosocial factors involved that may enhance recovery. 

In this blog we will break down each component of the acronym so that you know how to best manage soft-tissue injuries. 

PEACE is required in the first few days following a soft tissue injury 

P – Protect

• Unload or restrict movement for the first 1-3 days. This reduces bleeding and the risk of aggravating the injury. 
• In saying this, you don’t want to completely avoid movement as this compromises tissue strength and quality. 
• Use pain as a guide for movement and removal of protection e.g. the removal of crutches for an ankle sprain to encourage weight bearing 

E – Elevate

• Elevate the injured limb, ideally above the level of the heart. This promotes fluid flow out of the injured tissue. 

 A – Avoid anti-inflammatories

• The body’s natural inflammatory process in the early stages of an acute soft tissue injury is an important part of the healing process and the use of anti-inflammatory medication can hinder this process, therefore affecting the quality of recovery. 
• It is also now recommended to avoid ice. Although effective in reducing pain, there is little evidence to support its use in management of acute soft-tissue injuries as it also may disrupt the natural healing process.  

C – Compress

• Taping, bandages and compression garments are recommended to reduce swelling and tissue bleeding. 
• The above should still allow for full range of motion at the affected joints. 

E – Educate

• Education is key! It’s important for practitioners to ensure that you, the patient, have a clear understanding of what is happening to your bodies and set realistic expectations about recovery times.
• An active treatment approach is recommended. 

 

After the first few days have passed, soft-tissues need LOVE

 

L – Load

• Soft tissue injuries benefit best from an active approach with movement and exercise. 
• Normal activities should resume as soon as symptoms allow for it. 
• Early mechanical stress with optimal loading without increasing pain promotes repair and recovery of soft-tissues.  

O – Optimism

• The brain plays a significant part in rehabilitation and therefore being optimistic can improve the chances of an optimal recovery. 
• A negative mentality that includes catastrophisation, depression and fear can disrupt optimal recovery. 

V – Vascularisation

• Pain free cardiovascular exercise is encouraged as it is a motivation booster and increases blood flow to injured structures, therefore aiding in recovery. 
• Early mobilisation and aerobic exercises improve physical function, supporting return to work and reduce the need for pain medication. 

E – Exercise

• Personally, I believe this is the most important. Specific exercises help restore mobility, strength, proprioception and reduce the risk of recurring injuries. 
• Pain should be avoided to promote optimal recovery in the subacute phase. 
• Gradual exercise progression should be based on pain levels and preferably under the guidance of your health practitioner for optimal results and safety. 

Infographic below of Peace & Love (from British Journal of Sports Medicine)

For the visual learners, here is a video outlining the above. 

The team at Williamstown Health and Lifestyle are here to help you with all your injuries. If you want more information or require some assistance with management of your injury please don’t hesitate to contact us on (03) 9397 8877 or book online here !

Peter Vlahos

Osteopath