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Soft Tissue Injuries need Peace & Love

Dr J'aime Barry Osteopath

Updated: Jun 14, 2023

Managing soft tissue injuries can be complex. Over the years, these acronyms have been used

  • ICE - RICE [rest ice compression elevation]

  • PRICE [protection RICE]

  • POLICE [protection optimal loading ICE]

Some of these you may have heard of before, however, the evidence for management strategies is limited and only address the early injury phase, not addressing the later phases and ongoing/delayed recovery.

DAYS 1-3 PROTECTION

use tape or bandages to limit movement and minimise bleeding, and reduce the risk of causing further injury.

ELEVATE

above the heart, promoting interstitial fluid movement, there is weak evidence for this, however, the risk-to-benefit ratio is low.

AVOID ANTI-INFLAMMATORY modalities

that is ice and medications. Ice at best gives pain relief, however, it limits blood flow [aka healing!] Anti-inflammatory medications [at high levels] delay healing leading to more long-term conditions.

COMPRESSION

via tape or bandage to limit swelling and bruising.

EDUCATE

educate patients on the benefits of an active approach to recovery.


AFTER THE FIRST FEW DAYS

LOAD

return to mechanical load and regular activities to resume as soon as symptoms allow, benefits most soft tissue injuries.

OPTIMISE

Optimistic patient expectations are associated with better outcomes and prognoses.

VASCULARISATION

pain-free aerobic exercise should be started a few days after injury to increase blood flow to the injured structures and boost motivation toward recovery.

EXERCISE

assists in restoring mobility, strength, and proprioception. Pain should be avoided during the subacute phase (could be several weeks) of recovery, and be used to guide exercise progressions.

Referenced from the British Journal of Sports Medicine Dubois B, Esculier J-F, Br J Sports Med January 2020 Vol 54 No 2 https://bjsm.bmj.com/content/bjsports/54/2/72.full.pdf


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