PEACE & LOVE: The RICE has expired for Injury Recovery

Whether you’ve ever rolled an ankle, tweaked a hamstring, or made an ill-advised attempt to set a new record under less-than-ideal scenarios, we’ve all suffered injuries. And when these, happen, you’ve probably been told to follow the RICE method: Rest, Ice, Compression, Elevation.

Well, I want to spend this episode updating our current thinking about injury recovery, and it turns out that RICE might not be the best approach anymore. Instead, I’d like to highlight the PEACE & LOVE method. And while this may sound like something from a corporate wellness retreat—it's actually a new evidence-based approach to injury recovery that prioritizes tissue healing without needlessly prolonging the process (1). 

A Brief History

While RICE was the prevailing acronym for quite some time, updates in our medical understanding of injury and recovery have challenged the focus on rest, ice, compression, and elevation. First, the idea of Protection updated the acronym and PRICE was born.

Despite this minor change, the issue with RICE wasn’t about what it was missing. Instead, it put misguided emphasis on the word ‘rest.’ Indeed, over the last several decades, medical guidelines have aimed to reduce the bedrest periods for almost all illness/recovery – including surgeries (particularly joint replacements), hospitalizations, and even athletic injuries.

This led to a new acronym (POLICE) being suggested as early as 2011. This replaced the ‘Rest’ guidance, with ‘optimal loading’ (2).

Now, ten years later we have a further shift in how to approach joint injuries, with more comprehensive instructions and guidance. Instead of policing our injuries, we can show them some PEACE and LOVE. So, let’s break it down.

Step 1: Give Your Injury Some PEACE 

Giving your injury some ‘peace’ is as close as we get to the ‘rest’ recommendation with this acronym. These suggestions are best immediately following an injury.

P – Protect: Briefly put, focus on reducing movement that could aggravate the injury in the first few days. If certain activities are worsening your pain, these are likely best avoided immediately after the injury.

E – Elevate: Some things haven’t changed—raising the injured limb above heart level can still help reduce swelling.

A – Avoid Anti-Inflammatory Therapies: This one might surprise you, but recent research has called common pain medications (NSAIDs) into question. In fact, some research suggests NSAIDs like ibuprofen may actually impair the body’s natural healing response (3). Inflammation is part of the repair process, so as long as the pain and inflammation isn’t excessive, you may just want to let your body do its thing (4). While ice is okay, it’s important to note that there isn’t a ton of high-quality evidence that it actually enhances injury recovery (5).

C – Compress: This one stays too. A bit of compression can help manage swelling, but don’t cut off circulation or you’ll make your foot change colors (which is not medically advised).

E – Educate: This is perhaps the most revolutionary part—understanding that passive treatments (like excessive rest and icing) aren’t as helpful as active recovery. The more you know, the better your decisions will be. Utilize high-quality resources for this, Google can only take you so far before it may try convincing you that your sprain is actually a rare tropical disease.

Step 2: Show It Some LOVE 

This isn’t love at first sight. After the first few days of PEACE, start to show your joints some LOVE.

L – Load: Get moving (gradually)! Early mechanical loading—like gentle movement and resistance training—actually helps tissues heal stronger (6). Keep in mind, though, that while I know we all like to go fast, you do not want to rush this part!

O – Optimism: Mindset matters. Studies show that negative expectations about recovery can actually worsen your injury course and affect recovery (7). So, believe in your body—because science does.

V – Vascularization: Get that blood flowing! Activities like cycling or swimming may be lower impact ways to increase circulation, which helps deliver oxygen and nutrients to healing tissues.

E – Exercise: Once pain allows, progressively reintroducing strength and mobility work is key. The goal is to restore function without fear of reinjury. Your tissues want to move, regardless of how attractive sitting on the couch binging Netflix or ‘doomscrolling’ TikTok may look.

The Verdict

Ultimately, while RICE isn’t entirely wrong, it is outdated. The new approach acknowledges that healing is an active process—one that benefits from movement, mindset, and gradual reloading. So next time you get a little too ambitious with your plyometrics, skip the don’t fret and show your injury some PEACE & LOVE.

Disclaimer: If you have any uncertainty about your injury, it’s severity, or the rate of improvement do not hesitate to get it checked out by a medical professional. Accurate diagnosis and informed physical therapy are crucial to efficient and effective recovery (the ‘E’ in PEACE)!

Sources and Further Readings:

1. Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med. 2020 Jan 1;54(2):72–3. 

2. Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, should we call the POLICE? Br J Sports Med. 2012 Mar 1;46(4):220–1. 

3. Paoloni JA, Milne C, Orchard J, Hamilton B. Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use. Br J Sports Med. 2009 Oct 1;43(11):863–5. 

4. Duchesne E, Dufresne SS, Dumont NA. Impact of Inflammation and Anti-inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic. Phys Ther. 2017 Aug 1;97(8):807–17. 

5. Vuurberg G, Hoorntje A, Wink LM, Doelen BFW van der, Bekerom MP van den, Dekker R, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018 Aug 1;52(15):956–956. 

6. Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med. 2009 Apr;43(4):247–52. 

7. Briet JP, Houwert RM, Hageman MGJS, Hietbrink F, Ring DC, Verleisdonk EJJM. Factors associated with pain intensity and physical limitations after lateral ankle sprains. Injury. 2016 Nov 1;47(11):2565–9.