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PT Rebels Podcast | Dr. Gina Fick, PT, ScD

Is RICE Still the Best Method to Treat Soft Tissue Injuries?

What is one of the most common phrases that we hear when someone suffers an injury? “Put some ice on it” is one of the first phrases that comes to our minds. It continues to be a point of emphasis from many health care providers to utilize the acronym, RICE: Rest, Ice, Compression and Elevation. The most recent literature suggests that we use and implement the new acronym, PEACE and LOVE. Notice the one letter missing? I. Ice is the missing ingredient in this acronym

In the first 72 hours, we recommend implementing the PEACE strategy for acute injuries:

  • P: Protect  

We want to start by unloading the tissues in a pain free manner in the first 24-72 hours after any initial soft tissue injury to help reduce the risk of causing more local tissue damage. Does this mean we stop moving altogether?  No, unless the pain is so severe that you physically cannot move. We want to have as much pain free motion as possible. 

  • E: Elevate 

We recommend elevating the injured limb above the level of your heart to help decrease the amount of swelling that may occur at the site of the injured tissue. For example, keeping your leg raised up on a pillow after an ankle sprain will help to decrease swelling.

  • A: Avoid 

You should avoid anti-Inflammatories. Seems counter-intuitive, doesn’t it? Quite the opposite. It is crucial to allow a healthy amount of inflammation to occur at the site of the injured tissue in the first 24-72 hours after injury. Taking anti-inflammatory medications can disrupt our normal healthy response to injury, and they do the opposite of what our tissues need. 

  • C: Compress 

External compression of injured tissue creates an environment that helps to limit swelling or edema at the site of injury. Various compression methods include ace bandage wraps, compression sleeves, or intermittent compression devices like NormaTec compression boots. 

  • E: Educate  

Education is one of the most important pieces of your recovery process.  It is important for us as physical therapists to provide our patients with education regarding tissue healing timelines, reasons behind our plan of care, and what you can expect as a patient regarding your return from injury. 

After the first 72 hours, we move onto the second half of the acronym, which is LOVE:

  • L: Load  

Injuries respond very well to loading with exercise and general movement. The cells within the body’s soft tissue prefer loading for optimal healing. We can load tissues in a safe manner with optimal exercise prescription based on the severity of the injury and tissue healing timelines. 

  • O: Optimism

Injuries can take a toll, not only on our physical health, but also on our mental health. Our brain plays a powerful roll in how we perceive pain and how we catastrophize threats to our bodies. A positive and optimistic mindset can play a big role in your recovery from your injury.

  • V: Vascularization  

We need adequate blood flow to our injured tissues to heal the way we all want. There are times we are unable to move our injured limb due to too much pain, but incorporating modified cardiovascular exercise is a great way to increase blood flow throughout the body and to our injured tissues even if that limb isn’t directly involved. 

  • E: Exercise  

EXERCISE IS KEY! Simply resting your soft tissue injury for multiple days/weeks will likely be disadvantageous to your body in the long run. We need properly dosed exercise to safely return to activity and to recover from injury as quickly and safely as possible.

Our Physical Therapists at Fick PT & Performance have the knowledge and experience to help you safely recover from injury, return to sport, help you reduce future injury risk. If you have already experienced an injury and are looking for pain relief, contact us for more information on how we can help you out.

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Gina Fick

Fick PT & Performance

"We Empower You To Recover From Injury As Quickly And Safely As Possible In Order To Optimize Your Function And Maximize Your Athletic Potential."


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