Soft Tissue Injury Management

Soft tissue injury management has evolved.  We had ICE then RICE then PRICE and POLICE.  These previous acronyms have focus on acute management and not considering subacute and chronic stages of soft tissue healing.  Updated injury management principles now cover immediate care with the acronym PEACE.  And the long-term management with the acronym LOVE.  So what does PEACE and LOVE mean for soft tissue injury management?

In the first few days after sustaining a soft tissue injury

P – Protect.  Avoid any movements that cause additional pain.  Keep movement to a minimum to avoid further tissue damage and bleeding.  Warning prolonged rest can compromise tissue strength and quality (1).

E – Elevate.  To promote and encourage draining of the swelling, raise the injurued area above your heart height.

A – Avoid Anti-Inflammatories. Inflammation helps to repair soft tissue injury damage.  Using medication, and/ or cryotherapy can stop this process and delay recovery.

C – Compress. Using appropriate compression, taping or bandages helps with the swelling and bleeding.  Make sure compression is not so tight tat blood flow is totally restricted.

E – Educate.  Receiving good education for injury management is invaluable.  This education should be about the condition and load management.  There are some benefits taking a passive approach with Physiotherapy or Osteopathy.  However, the impact of these therapies is nowhere as beneficial as an active approach.

After the initial few days, your injury needs LOVE

L- Load.  This means putting force through or using the joint or affected area.  Movement and exercise do benefit most patients with an injury.  When loading the area, this should be normal everyday movements.  Loading should not cause any additional pain or aggravate any symptoms.  Optimal loading without causing more pain promotes repair, remodelling and builds tissues tolerance and the capacity of tendons, muscles and ligaments through mechnotransduction (3)

O – Optimism.  Being optimistic about recovery and return to activity or sport are associated with better outcomes and prognosis.  Negative psychological factors can present barriers to recovery.  Beliefs and emotions are thought to explain more of the variation in symptoms following an ankle sprain than the degree of pathophysiology (4)

V – Vascularisation.  Resuming cardiovascular activity is crucial in the management of a soft tissue injury.  The exact amount or cardiovascular exercise will be specific to the individual and the injury, but it should be pain free.  This will help boost motivation and increase blood flow to the injured area.

E – Exercise.  When returning to exercise pain should be avoided to ensure best possible repair during recovery.  Pain can be used as a guide when looking to progress your exercises.  Using exercise as treatment can help reduce the likelihood and the injury reoccurring.  Performing the right exercises can help restore mobility, strength and proprioception early after a soft tissue injury. (2)

When it comes to soft tissue injury management, try giving PEACE and LOVE a chance.  If you are unsure about navigating your soft tissue injury recovery, please contact us as we would love to help you get back to your movement and exercise faster.