✌️PEACE & ❤️LOVE > 🍚RICE

Happy Hump Day, folks!

As promised, a (slightly, lol) shorter newsletter this week. Let’s learn about ✌️ & ❤️!

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We recently covered our mental frameworks around injury, having “bad” body parts, and not being afraid to use movement to heal us. That covered the long-term recovery processes. But what about right after an injury?

Think back to the last time you twisted an ankle, jammed your thumb, or suffered some other minor to moderate musculoskeletal injury. What did you do in the immediate minutes, hours, and days that followed?

My bet is that you jumped to a familiar acronym: RICE. This stands for Rest, Ice, Compression, and Elevation. These were deemed the appropriate strategies for an acute bodily injury to help modulate pain and promote healing.

I’d bet you also jumped for the ibuprofen or acetaminophen. And I can’t blame you! Injuries hurt.

But more recent science and guidance from rehab professionals suggest that RICE may not be the best solution to promote pain relief and recovery after an injury. 

Move over, RICE, there’s a new acronym in town: PEACE & LOVE.

But first, a little background on what actually happens when we injure ourselves.

(Like that I’m making you wait to reveal the acronym? Keep reading, eager beaver. If you’re extra impatient, skip down to the infographics. I won’t know.)

When we talk about musculoskeletal injuries, we typically think of a sprain to a ligament or a strain to a muscle/tendon. This could include contusions (blunt force—think getting punched or smacking your shin on a table) or fractures, but those are somewhat different injuries that may require different treatment. For purposes of this post, think about sprains and strains to our ligaments, muscles, and joints.

When our body sustains an acute injury like this, we first feel pain. Sensory neurons in that area of our body send messages to our brain that something is wrong. Pain has a purpose: it tells our brain to protect the injured area to prevent further damage. Pain is simply a signal in our body—like hunger, anxiety, or butterflies when your crush walks by—that we should listen to.

But like most things in life, too much of a good thing is a bad thing. Injuries lead to what we call an “inflammatory cascade.” Red and swollen = inflammation. Depending on the type of injury, the body sends all sorts of cells and chemicals to the site. The sequence of events typically looks something like this:

Why does all this matter? Because in order to understand how we can best act to respond to an injury, we need to understand what our body is already doing, and what the goal behind our automatic processes are.

“Inflammation” in a short-term sense is necessary. The first few steps above would be considered inflammatory. The body needs to bring in nutrients and specialized cells to an injured area to start the healing process. But, again, too much for too long is not good for us. Many of today’s chronic diseases are diseases of chronic inflammation gone unchecked.

But if we can give an injury proper time to be inflamed, our body is more quickly able to move from Step 1 through Step 4.

That’s why immediate icing and popping four ibuprofen may not be ideal. Ibuprofen and other anti-inflammatory drugs are literally that—they act in our body to reduce processes of inflammation. But if inflammation is a necessary first step in healing, we may actually be hampering our bodies’ innate healing systems.

Allowing inflammation to run its course early on may require enduring a bit more pain initially for the sake of better long-term healing. However, it’s important to note that if the pain is too much to handle or function, you shouldn’t feel bad for using ice/medicine. Again, try to find the “just right” of weighing how much you can tolerate with trying to let your body heal. Taking a balanced, nuanced approach is often better than any extreme.

(Tylenol/acetaminophen, on the other hand, is just a pain-reliever, not an anti-inflammatory drug, so it won’t have the same inflammation-blunting effects.)

Alright, alright, I’ll tell you what PEACE & LOVE stands for now. Protect, Elevate, Avoid Anti-Inflammatories and Ice, Compress, Educate. Then, Load, Optimism, Vascularization, and Exercise.

Read the graphics from PhysioNetwork below for brief explanations.

Protect, Elevate, Avoid anti-inflammatories & ice, Compress, Educate. In the first days following an injury, take care to protect the area. To manage pain and swelling, gently but firmly wrap the area and elevate it often. These are better options than drugs and ice.

In the next phase of healing, it’s important to use that body part again! Move to Improve, after all 😉. And remember this post about how optimism and the beliefs we hold about ourselves often come true? Still applies here.

Why not RICE?

You’ll notice that the C and E of RICE remain in this newly recommended acronym. Compression and Elevation are still effective strategies for pain management that don’t impair healing. However, Rest and Ice got the boot. And this acronym wasn’t comprehensive enough to give guidance on what we should do to return to function after the initial painful stages.

Historically, people hear the word “rest” and think bedrest. Do nothing. Don’t move. But this isn’t the best strategy. If we completely immobilize for long periods of time, we will quickly begin to lose muscle, range of motion, and function at that joint—and even at other parts of our body. Instead, Protect the injured area, but continue to incorporate movement into your everyday life to stay healthy, preserve muscle, and promote blood flow.

No Ice? Or anti-inflammatory drugs? These aggressive strategies can put a real damper on our bodies’ natural healing processes. If you can use other pain management strategies like compression and elevation, it’s best to avoid these two.

The LOVE part of the acronym is my favorite. If you want to return to normal function, you can’t baby your injured body part forever. It is essential to gradually work back up to full function. Let pain be your guide, and listen to your body as you reintroduce Load (bodyweight or weighted activities), Vascularization (regular, repetitive movement that elevates your heart rate), and Exercise (in the form of mobility, strength, and balance/sensory training).

Next time you injure yourself, think twice before using RICE. Instead, remember PEACE & LOVE.

Your sprained ankle needs them just as much as the world and everyone around you.

✅ Take Action

Every newsletter's Take Action section will invite you to take small steps to improve your health. Recognizing that we all have different capabilities, I'll offer three different levels of action you can choose to take.

Level 1: Next time you face an injury, don’t immediately jump for the ice and pills. Try compressing and elevating the injured body part instead.

Level 2: Even when part of your body is injured, you still need movement. This may mean temporarily focusing more on upper or lower body exercises, depending on the injury, but get creative and find ways to stay active!

Level 3: Reintroducing load and exercise to the injured body part is essential after the inflammatory cascade has calmed down and you don’t risk re-injury. Be patient with yourself and gradually build back your strength and mobility.

This newsletter is brought to you by… me!

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✍️ Drew's Picks:

• Podcast: The Science of Eating for Longevity. Another great one from Dr. Hyman, with guest (and his inspiration) Dr. Jeffrey Bland.

• Article: Is chocolate milk on its final act in school lunches? What’s more important: decreasing kids’ added sugar consumption, or getting them the protein and nutrients and milk provides? Good arguments on either side!

Spread peace & love to everyone around you this week, injured or not ✌️❤️

Keep moving,

Drew

The content in Move to Improve is meant to be informative in nature, but it should not be taken as medical advice. It is always a good idea to consult with a trusted health professional before making any major lifestyle changes that could have a significant impact on your health. This is not a medical resource, and any opinions and articles are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional. Please think critically and take what I say with a grain of salt (aka don’t sue me).