Running injury recovery used to be focused on RICE: Rest, Ice, Compression and Elevation. RICE has been shown to actually slow recovery from injury and healing. After a running injury there is a natural and beneficial inflammatory process around the injured tissues that we want to allow to happen. Inflammation around the injured area creates a natural brace that limits movement (think sprained ankle) to allow injured tissues to heal. The inflammatory fluid also contains many substances that help with the pain and healing including neutrophils, macrophages, and satellite cells. If we ice, compress, or elevate the injured area we are decreasing this natural and helpful inflammation which will slow healing.
PRICE is another common acronym where the P which stands for Protect was added to RICE. Protecting the injured area to prevent further injury in a good idea for a limited period of time, but the body will naturally do this with pain messages and natural inflammation. We want to use braces, wraps, tapes, orthotics, etc. as little as possible because they all weaken the body and allow movement before the body is ready which can lead to re-injury.
PEACE is third acronym used for running injuries. PEACE stands for Protect, Elevate, Avoid anti-inflammatories, Compress, and Educate. Protect, Elevation, and Compression I already talked about above. Avoiding anti-inflammatories is a good idea because as I stated above, we want to allow the neutrophils, macrophages, and satellite cells to surround the injured tissues to help it heal faster. We also don't want to take any drugs that decrease the feelings of pain because pain signals are there to tell us whether or not we are ready to start loading the injured tissues. If it hurts, it's not healed and too early to start running again. When the area is naturally pain free, then it's our body telling us we can slowly are carefully start running. Education is always a good thing (you’re educating yourself right now!).
LOVE is the newest acronym used when talking about running injuries and stands for Load, Optimism, Vascularization, and Exercise. The acronym LOVE is great: we want to slowly start Loading the injured joint in most cases (as long as the pain is not increased by loading). Optimism creates both physical and mental/emotional changes associated with faster healing and better health. Pessimism creates physical and mental/emotional changes associated with slower healing and worse health. The choice seems clear. Vascularization means getting pain free cardiovascular exercise because it boosts blood flow, keeps muscles and joints moving, and boosts motivation and mindset. Exercise is referencing specific therapeutic exercises to restore strength, mobility, and proprioception to the injured joint and other affected joints.
Let's summarize what slows recovery from running injuries and what helps healing happen faster:
Bad: Ice, Compression, Elevation, Anti-inflammatories, prolonged external Protection and anything that reduces your body's natural inflammation or numbs your pain.
Good: Load, Optimism, Vascularization, Exercise, limited Protection and anything that allows your body to heal itself naturally and any pain free movement and therapeutic exercise to restore function.