Most physical therapists are no longer recommending the long-standing RICE acronym (Rest, Ice, Compress, Elevate) as a standard treatment for injuries, like rolled or sprained ankles.

Brooks Rehabilitation, a leading provider of comprehensive rehabilitation services, worked with James Maggert, PT, DPT, OCS, CSCS, a physical therapist at one of Brooks’ outpatient clinics, to shine a light on the new recommendations for injury treatment.

“This a trend that’s pretty old that we’re trying to reverse a little bit,” says Maggert. “Previously, we used to tell people that if you ever have an acute injury or an acute ankle sprain, you want to do RICE, which is rest, ice, compress and elevate. Now, we tell people instead of RICE, we use the acronym PEACE and LOVE.”

Maggert said that the new acronym came out around 2020, and the transition has been slowly gaining popularity in the field over the last three to four years.

Leaving RICE in the Past

“We’ve moved past [RICE] for a few reasons. There are theorized benefits to cold, such as decreasing swelling and inflammation, but it’s kind of a mixed bag when you look at the research on it. If it does do that, it’s very little. But even if it has a small impact on inflammation, after an acute injury, you actually want inflammation because that’s what heals your body.”

Maggert says that inflammation is a natural response of the body to acute injuries, and when an injury occurs, the increase in blood flow to the affected area is what helps initiate the repair process, not the ice in RICE.

Maggert says current recommendations use the new acronym PEACE & LOVE:

PEACE

  • Protect: Protect the injured area from further damage by avoiding activities that cause pain or may worsen the injury.
  • Elevate: Elevate the injured area above the heart to help reduce swelling.
  • Avoid anti-inflammatory medications: Avoid using anti-inflammatory drugs (NSAIDs) as they may potentially delay the healing process.
  • Compression: Applying compression to the injured area can help control swelling and provide support.
  • Education: Learn about the injury, its causes, and how to prevent it in the future.

LOVE

  • Load: Gradually reintroduce movement and light weight-bearing activities to promote healing.
  • Optimism: Stay positive and maintain a good mindset during the recovery process.
  • Vascularization: Perform gentle exercises like cycling or swimming to promote blood flow to the injured area.
  • Exercise: Gradually progress to more challenging exercises to restore strength, flexibility, and function to the injured area.
  • “PEACE and LOVE is definitely something that I’ve noticed a difference in, and more clinicians are starting to adopt the new recommendations,” says Maggert.

For more information on Brooks Rehabilitation and their innovative approach to injury treatment and recovery, visit brooksrehab.org.

About Brooks Rehabilitation

For more than 50 years, the nonprofit Brooks Rehabilitation, headquartered in Jacksonville, Fla., has been a comprehensive system of care for physical rehabilitation. Ranked as the No. 1 rehabilitation hospital in Florida and one of the top 20 in the nation on U.S. News & World Report, Brooks operates two inpatient rehabilitation hospitals in Jacksonville, Fla., and a Center for Inpatient Rehabilitation in partnership with Halifax Health (Daytona Beach). Brooks also offers one of the region’s largest home healthcare agencies; more than 50 outpatient therapy clinics; the Brooks Rehabilitation Medical Group; two skilled nursing facilities; assisted living; memory care; and the Clinical Research Center, which specializes in advanced research to further the science of rehabilitation. In addition, Brooks provides many low- or no-cost community programs and services to improve the quality of life for people living with physical disabilities. For more information, visit BrooksRehab.org.

About James Maggert, PT, DPT, OCS, CSCS

James Maggert holds a doctorate in physical therapy from the University of Central Florida, Orlando, Fla. After graduation, he received an orthopedic specialist certification through a residency at Brooks Rehabilitation’s Institute for Higher Learning. Currently, Maggert is completing a fellowship with the American Academy of Orthopedic and Manual Physical Therapy to further advanced his specialization while he oversees the care and treatment of patients at Brooks’ outpatient clinic in the Nocatee area of Ponte Vedra Beach, Fla.

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