Management and rehabilitation of soft tissue injuries can be a complex task. Whether you have rolled your ankle while playing soccer, pulled a hamstring when sprinting or hut your shoulder when swinging too hard playing tennis, there are some simple things you can do immediately to ensure the best possible outcome for yourself! Acronyms such as RICE and POLICE are well known and effective for the acute stage of an injury. But what about past the initial shock, how do you manage an injury in the sub-acute and chronic stages? More recently, a new acronym called PEACE and LOVE has been established. This guideline provides a more comprehensive approach to soft tissue injuries and highlights the importance of a biopsychosocial approach in order to aid recovery.
Initially, your body needs PEACE.
P = Protect.
Immediately following and injury, it is important to avoid activities and movements that increase the pain during the first few days (1-3). The purpose of this is to reduce bleeding, reduce the risk of aggravating the injury further and prevents more serious damage to potentially injured fibres. However, it is important to note this does not mean resting completely! Still keep other areas of your body active throughout the day, as prolonged rest compromises tissue strength and healing.
E = Elevate.
Try elevating the injured limb higher than the heart as often as possible. For leg injuries, try lying down with your feet elevated on a few pillows. For an upper limb injury, sit down comfortably and stack a few pillows on your lap to prop your arm up across your body. This will encourage any fluid to flow out of the injured tissue and reduce swelling.
A = Avoid anti-inflammatories.
Our bodies have an array of inflammatory processes which are automatically started from the point of injury. Our body regulates and works through this process to support soft tissue regeneration and recovery. If you are taking anti-inflammatories for an injury long term, these medications may inhibit the ability of our body systems to facilitate healing. Additionally, while ice has long been to ‘go to’ for most injuries, there is very little high quality evidence to support the use of ice. Ice is used mainly as a short term pain reliever but is limited in benefits past that. Alternatively, it could impair inflammation, angiogenesis and revascularisation (important processes for tissue healing).
C = Compression.
To help reduce swelling, external pressure using taping or bandages can be used. It is important to apply any tape or bandage firmly, but not too tight. It is advised to consult your local physiotherapist to show you how to correctly apply these (as to ensure no further damage).
E = Education.
By visiting a physiotherapist, they will provide vital education on the benefits of an active instead of passive approach to recovery. More passive approaches such as manual therapy, acupuncture or electrotherapy have little effect on pain and long term outcomes as compared to an active approach by you. Education surrounding correct load management, expectations and exercise will provide you with the ability to effectively manage your injury long term.
After a few days, you need to give your body some LOVE.
L = Load.
For everyone with a musculoskeletal injury, appropriate load management is the key to avoiding flare ups and encourage healing. Movement and exercise should be incorporated early in the rehabilitation and normal day to day activities should resume as soon as symptoms allow. To know if you are doing too much or too little, think about keeping your pain below a 4/10. If its higher, you need to take a break. If its lower, you can challenge yourself with more! Optimal mechanical loading promotes repair, tissue tolerance and remodelling and strength of muscles, tendons and ligaments.
O = Optimism.
The brain plays a huge role in rehabilitation. Psychological factors such as fear, depression, catastrophisation and negative expectations can adversely influence prognosis and outcomes of an injury. It is important to condition your brain and stay optimistic and realistic about the journey ahead!
V = Vascularisation.
An important component of injury management is the inclusion of pain free cardiovascular activity. Benefits of a cardiovascular component include boosting mood and motivation and increasing blood flow to the injured area (which now circulates healing properties and removes waste products from the damaged tissue).
E = Exercise.
Once again, pain levels should guide you on what and how much exercise to do. However, exercise is the most important component in order to prevent the injury recurring in the future. Exercise aims to restore mobility, strength, proprioception and endurance of the affected body part.
If you or a family member would like to learn more about how physiotherapy can help with your soft tissue injury, the physiotherapists at Back In Motion Como would love to help!
Website: https://www.backinmotion.com.au/como
Phone Number: 9313 3414