Ankle Sprains and the P.E.A.C.E. and L.O.V.E. Acronym

 

An ankle sprain is a common injury that occurs when the ligaments in the ankle are stretched or torn. This can happen when the foot is twisted or turned in an awkward way, causing the ligaments to stretch beyond their normal range of motion. In the past, rehabilitation for an ankle sprain typically involved a combination of rest, ice, compression, and elevation (known as RICE) to reduce swelling and pain. Today, more and more rehabilitation specialists are using the acronym, PEACE and LOVE. PEACE is usually focused on immediately after the injury and LOVE is focused on in the few days following the injury.

  • P = Protect
    • Unload movement for 1-3 days
    • Minimize rest. Too much rest puts your strength and quality of movement at risk
    • Let pain guide you as you progressively begin to load
  • E = Elevate
    • Elevate the injured limb higher than the heart to prevent swelling
  • A = Avoid anti-inflammatory modalities
    • Anti-inflammatory medications may negatively affect long-term tissue healing
    • Avoid ice
      • Use of ice is mostly analgesic
      • Although it is widely accepted as an intervention there is very little high quality evidence that supports the use of ice in the treatment of soft tissue injuries
      • Ice may potentially disrupt inflammation, angiogenesis and revascularisation
      • Ice may potentially delay neutrophil and macrophage infiltration
      • Ice may potentially increase immature myofibers
        • This can result in impaired tissue regeneration and redundant collagen synthesis
  • C = Compress
    • Using an ace wrap or bandage can help prevent excess swelling, but it needs to allow for full range of motion
  • E = Educate
    • Patients with ankle sprains benefit greatly from being educated by a rehab specialist like a physical therapist
    • Athletes can be instructed on proper load management, the early phases of therapy and what that needs to look like, and to better understand their recovery time and when they should go back to playing sports.
  • L = Load
    • Early and optimal loading of the effected tissue can help promote repair and remodeling of the tissue.
    • Building tissue tolerance and increasing your capacity is needed to progress in your rehab. A physical therapist specializes in helping you understand when it is appropriate to progress or regress. Everyone is different so having a specialist monitor you can be helpful.
  • O = Optimism
    • Being optimistic in your rehab is very important
    • The brain is extremely powerful and can be used to improve your condition and prognosis
  • V = Vascularization
    • Getting cardiovascular exercise that doesn’t involve excess pain helps increase blood flow to the injured area and promotes healing
    • Cardio also helps boost mood which comes back to the topic of improving optimism to help with overall psychological health.
  • E = Exercise
    • Exercise prescription from a Doctor of Physical Therapy can help you get back to the activities you’re wanting to do faster and it can reduce the risk of a recurrence injury
    • After an ankle sprain, your risk doubles to have another ankle sprain for the next year. This is why it’s so important to get proper treatment from a Doctor of Physical Therapy

Treatments may include physical therapy exercises to improve range of motion and strength, as well as support devices such as braces or tape to provide additional stability to the ankle. The length of time it takes to recover from an ankle sprain can vary depending on the severity of the injury. In general, it is important to follow a doctor's recommendations and not return to physical activity until the ankle is fully healed to prevent re-injury.

Once the swelling and pain have subsided, the next step in the rehabilitation process is typically to begin physical therapy exercises to improve range of motion and strength in the ankle. These exercises may include stretching, strengthening, and balance activities, and may be performed in a therapy clinic and at home. After evaluation your Doctor of Physical Therapy will provide specific instructions for which exercises to do and how to do them properly. It is important to follow these instructions closely and not to push yourself too hard, as this can delay healing or lead to re-injury.

If you’ve sprained your ankle be sure to come in for a movement assessment and evaluation to see what you need to begin doing now to prevent future injury and to heal quickly from your current ankle sprain!

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