Have you heard of the RICE principle? Or maybe PRICE?
Dubois and Esculier (2019, 2020) dove into the evidence. There are numerous flaws in the RICE principle.
Rest is no longer advised. Yes, you should unload and restrict movement for 1–3 days to minimize aggravating the injury, but prolonged rest reduces tissue strength and healing. "Mechanical stress should be added early and normal activities resumed as soon as symptoms allow."
The authors also question the use of ice or cryotherapy. There are no high-quality studies to support the use of ice. They note that even if it's for analgesic (pain-reducing) use, it can reduce the natural course of inflammation — and inflammation is how we heal. It isn't a bad thing in a new injury situation.
They suggested the PEACE & LOVE principle instead.
PEACE is for the acute stage of the injury (around 3 days):
- Protect and Elevate are straightforward.
- A — Avoid Anti-Inflammatories: the various phases of inflammation help repair damaged soft tissues, so inhibiting inflammation with medication may negatively affect long-term tissue healing, especially at higher dosages. Standard of care for soft-tissue injuries should not include anti-inflammatory medications.
- C — Compression of the joint can help improve quality of life.
- E — Education that electrotherapy and modalities do not have significant effects. Movement is the key to improving pain and function.
After the initial days, the area needs LOVE:
- L — Load the area; let pain be your guide.
- O — Optimism. Recovery has a mental component. Tissues heal; the body is capable of amazing things.
- V — Vascularization. Start pain-free activities to increase blood flow.
- E — Exercise to return to full strength.
Check out the complete article here.