If you’re an athlete, I’m almost positive you’ve pulled a muscle or sprained something at some point in your journey. Maybe you twisted an ankle, pulled a hammy, or just over did it during a workout and were abnormally sore for a several days or even a couple weeks.
Pretty much everyone has experienced a soft-tissue injury at least once. Soft tissue refers to muscle, tendon, or ligament. This blog article is meant to clarify how to best manage these injuries and navigate all of the information you can find online – much of it being misleading.
Most people, especially those who are active in sport learned that after an injury it’s best to use the acronym RICE to help recover – Rest, Ice, Compression, Elevation. I think this still holds true in certain circumstances and by no means is it wrong…
But recent research shows that this advice may too general and not the best way to approach every single injury.
A newer acronym seen in the literature today is PEACE & LOVE to manage acute soft-tissue injuries more appropriately.
Immediately after injury, PEACE: PROTECT
Try to avoid movements or exercises that are going to provoke the injury. This may seem like common sense, but so many athletes tend to push themselves too soon. At the same time, you want to minimize your time in this phase as too much “protection” can lead to deconditioning of the injured area as well as the body as a whole.
ELEVATE
This is one still holds true – elevate the injured tissue above the level of the heart to reduce fluid retention and manage swelling
AVOID ANTI-INFLAMMATORIES (when possible)
While NSAIDs are commonly used post-injury to manage pain, but they can actually impair our body’s natural healing process to some extent. Same goes for ice. If you can manage the pain, try to reduce anti-inflammatories and use of ice. If it is costing you the ability to sleep due to the pain, then don’t be a tough guy. Quality sleep is just as vital to appropriately healing, therefore, it’s all about the happy mediums with this one.
COMPRESSION
Applying pressure to the injured area allows for decreased swelling/edema and tissue hemorrhaging.
EDUCATION
As an athlete it’s important to educate yourself on proper ways to manage minor injuries and prevent injuries all together. Understanding the expectations of the healing process and being realistic about tissue healing times is hugely important. Below, I have included some great infographics on the science behind the stage of tissue repair and tissue healing timelines.
Three Stages of Tissue Healing
Once the initial few days have passes, we have to give our bodies and injured tissues LOVE! LOAD
Utilizing an active approach is key here – use pain as your guide to allow appropriate loading and movement of the specific tissues. Early loading has been shown to be very beneficial to get back to normal activity and life for a soft tissue injury and also improves the risk of a future reinjury.
OPTIMISM
Perception is everything. We know that the mind is very powerful in how injuries impact us. There’s plenty of research that shows us an individual with a negative expectation is more likely to have worse outcomes. The goal here is to stay positive and know that mother nature will take its course. You will heal and your pain will go away.
VASCULARIZATION
Blood flow helps drive the healing process. Move early and move often, but within reason. Try to push your heart and lungs with other areas that are not injured (i.e. shoulder injury – ride a stationary bike or go for a walk). Swimming may also be a great option depending on your injury. This plays into the healing process of getting new blood flow into the area and mitigating pain, ultimately, speeding up the recovery process.
EXERCISE
The research is strong with this area. We know that exercise is what’s going to bring us back to level ground after an injury, and most importantly, prevent it from happening again. This exercise should be progressive and should incorporate range of motion, mobility, flexibility, strength, power, proprioception. This will make you the most bulletproof following an acute injury.
The thought to keep in mind is to try to play the long game. I see athletes often who come in and get out of pain then go right back to high-level activity without taking appropriate measures to progressively build it back up. “Feeling better” may not mean you’re ready to return to high level activity. Hence why the “education” portion of PEACE and understanding tissue healing times is vital in order to not reinjure yourself. Take the time to put in the work and I promise it’ll be worth it in the long run. If you’re dealing with an injury and want more guidance and help, reach out with any questions. We design and implement rehab and performance programs to help our athletes, whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience. It is our goal for the people we work with to return to their sport or activity performing better than they did before.
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