P.E.A.C.E and L.O.V.E for Ankle Sprains and more!
Did you just suffer an ankle sprain or another soft-tissue injury and don’t know what to do next? With the acronym PEACE and LOVE, you’ll know what to do to promote healing and recovery!
First, “soft tissue” is commonly used to refer to muscles, tendons, ligaments, and/or fascia. There are several other types of soft tissue but four our purposes, we’ll be focusing on the ones mentioned above.
Second, it’s important to have an understanding of what happens at each stage of tissue repair. Below is a picture that provides a simple explanation of what occurs at each stage from initial injury to the final phase of repair. Acute phase (0-4 days), subacute phase (4-14 days), chronic phase (14 days-up to 2 years).
You just sprained your ankle, it’s time to listen to your body and allow PEACE to guide your approach.
P=Protect For the first few days (1-3) we want to minimize any further damage by resting and restricting movement. Use pain signals to help monitor when you can stop protecting the injury site with the goal of avoiding prolonged rest, as this can be counterproductive to tissue healing.
E = Elevation We’ve all heard of elevating above heart level, do this to help promote fluid “swelling” to move out of the injured limb.
A= Avoid anti-inflammatories I know we live in a culture where we visit our doctors and we are prescribed medication. In the case of soft-tissue injuries, we want to avoid taking anti-inflammatories and instead allow the body to go through the natural phases of healing, as the various stages of inflammation help to repair damaged soft tissues.
C= Compression Use taping or bandages to further help promote decreased swelling, this is especially effecting when dealing with an ankle sprain.
E= Education This step is mostly referring to your therapist educating you on the benefits of an active approach to recovery. Yes, there’s a time and place for manual therapy, dry needling, taping, etc. BUT we don’t want you to become dependent on these passive approaches. Long term, what’s going to make the most significant difference is loading the area through exercise and movement.
After a few days following injury, it’s time to give the injury site some LOVE!
L= Load We want to get you up and moving as quickly as possible. Allow pain levels to guide how much daily activities you can tolerate. We want to find the right balance between how much movement you can tolerate without aggravating symptoms and delaying healing.
O= Optimism Fear or avoidance of movement are valid, but they have also been shown to hinder repair. “Once you replace negative thoughts with positive ones, you’ll start having positive results” Willie Nelson.
V= Vascularisation Runners tend to only want to run, and I get that because I’m the same. However, you’ll need to temporarily find a pain-free aerobic activity that you enjoy to promote blood flow to the injured area to help with tissue repair. It'll also help to maintain your fitness in preparation for your return to running!
E= Exercise The benefits of exercise are are countless! They are even more important after injury to help restore mobility, strength, and proprioception. This is one of the situations where I will say, “pain-free” exercise because again, we don’t want to delay tissue healing in the subacute phase of recovery.
Whether you are dealing with an ankle sprain or another soft-tissue injury, these are the guiding principles behind treating a soft-tissue injury. The specifics of treatment will vary depending on what structure is involved, but this is a good starting point. In the next blog, I’ll share some exercises and drills you can do to recover from an ankle sprain!
If you’re dealing with a recent injury and don’t know what to do next, I’d love to help. Schedule a complimentary call and start your journey back to running!
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REFERENCES
Dubois B, Esculier J-F, Br J Sports Med January 2020 Vol 54 No 2
Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med 2009;43:247–52.
Knight KL. More precise classification of orthopaedic injury types and treatment will improve patient care. J Athl Train. 2008 Apr-Jun;43(2):117-8. doi: 10.4085/1062-6050-43.2.117. PMID: 18345334; PMCID: PMC2267322.