Soft Tissue Injuries need Peace N Love!
Firstly, what is a soft-tissue injury?
A soft tissue injury is an injury which only involves the muscles, tendons or ligaments of the body. Common soft tissue injuries I see are muscle tears, strains, sprains, tendonitis, bursitis, and contusions ie. bruises or swelling.
A lot of people will be familiar with some of the following, outdated acronyms ICE, RICE, PRICE or even POLICE. These are all outdated acronyms.
The latest guidance is advising people to practice the PEACE N’ LOVE protocol when rehabbing a soft-tissue injury.
As a rule of thumb, in the acute stage or early stage of your injury (1-3 days roughly) use the PEACE N part of the protocol.
After the initial acute stage or in the sub-acute stage is when you begin the LOVE part of the protocol.
So, what do you mean by PEACE N’LOVE?
Protection: Avoid all aggravating activities/movements to the affected area for the initial few days to minimise bleeding, swelling etc. Keep in mind that prolonged rest can reduce strength in the tissue. Once pain levels are manageable, a small level of activity or exercise should resume.
Elevation: Elevate the injured limb, if possible, over heart level to promote movement of fluid out of the tissues.
Avoid NSAID’s: A controversial topic is the advice currently to avoid the use of anti-inflammatories or even ice! Although ice can be useful as an analgesic (Pain relief). This is because ice and anti-inflammatories potentially disrupt the inflammatory process and impair tissue repair.
Compression: Use a compression bandage on the injured area to reduce swelling and bleeding.
Education: Education on the injury and how to progress. A lot of people need to be educated on the huge benefits to an active approach to their own recovery. It’s important to establish realistic expectations and realistic timeframes for recovery.
Nutrition: The proper nutrition can make a difference with a soft tissue injury.
Load: Gradual, steady and progressively loading the tissue to slowly increase strength and endurance. Optimal loading without causing pain will promote repair, remodeling and build tolerance in the muscles, tendons or ligaments.
Optimism: Healthy levels of optimism are needed to overcome any injury. Catastrophizing, depression and fear can represent barriers to recovery.
Vascularisation: Pain free aerobic activity should be commenced soon after injury. This will increase blood flow. Increase blood flow in the body and injured area to flush toxins and provide fresh blood to the area.
Exercise: Exercise can help to restore strength, mobility and proprioception. Pain should still be avoided at this subacute phase of recovery to ensure optimal repair. Pain levels should be used as a guide for exercise progressions.