Rethinking Injury Recovery: Why PEACE & LOVE Has Replaced RICE

For years, most of us were taught the same thing after an injury: Rest, Ice, Compression and Elevation (RICE). While this approach was once considered best practice, our understanding of how the body heals has evolved.

Today, the evidence supports a different approach—PEACE & LOVE—which works with your body's natural healing response rather than trying to suppress it. At Mountside Physio, in Mount Maunganui, we take a balanced approach to ensure we manage each injury and consider the patients preferences as well.  

Why We've Moved Away from RICE

The RICE protocol was introduced in 1978 by Dr Gabe Mirkin and became the go-to advice for treating sprains, strains and other soft tissue injuries. The goal was simple: minimise pain and swelling to encourage recovery.

Since then, research has shown that inflammation plays an essential role in tissue healing. Rather than being something to eliminate immediately, it's part of the body's repair system, bringing blood flow, immune cells and nutrients to the injured area.

Using ice immediately after injury reduces blood flow by constricting blood vessels, while early use of anti-inflammatory medications (NSAIDs) may interfere with the body's normal healing processes. Although these strategies can temporarily reduce pain, they may also slow tissue repair when used too early.

Even the Creator of RICE Changed His View

In 2015, Dr Mirkin publicly acknowledged that the evidence no longer supported routine icing and prolonged rest as methods to speed recovery. He noted that while ice may provide short-term pain relief, it can also reduce blood flow and potentially delay healing.

The emphasis has since shifted towards protecting the injury initially, followed by gradual movement and rehabilitation.

The PEACE & LOVE Framework

Current best practice, outlined by Dubois and Esculier in the British Journal of Sports Medicine (2020), recommends the PEACE & LOVE approach.

PEACE: Immediate Management

• Protect – Reduce unnecessary movement for the first couple of days to avoid aggravating the injury.
• Elevate – Raise the injured area above heart level where practical to help manage swelling.
• Avoid Anti-inflammatories – Allow the body's natural inflammatory response to support tissue repair.
• Compression – Apply appropriate compression to help manage swelling and provide support.
• Education – Understand that healing takes time, and that excessive rest can actually delay recovery.

LOVE: Ongoing Rehabilitation

• Load – Gradually reintroduce movement and weight-bearing as symptoms allow to encourage tissue healing.
• Optimism – A positive mindset can influence pain, confidence and recovery outcomes.
• Vascularisation – Gentle cardiovascular exercise helps improve circulation and supports healing.
• Exercise – A progressive rehabilitation programme restores strength, flexibility and function while reducing the risk of re-injury.

Does Ice Still Have a Place?

Absolutely—but its role has changed.

Ice can still be useful for reducing pain in the short term, particularly if comfort is your immediate priority after an injury or sporting event. However, if the goal is to optimise tissue healing, routine icing immediately after injury is no longer considered essential.

The same applies to anti-inflammatory medications. They can be appropriate in certain situations, particularly later in the recovery process, but using them immediately after injury may interfere with the body's normal repair mechanisms.

The Take-Home Message

Our understanding of injury management has come a long way. Rather than trying to eliminate every sign of inflammation, we now recognise that it's a critical part of recovery.

The PEACE & LOVE approach encourages us to respect the body's natural healing process while introducing movement and rehabilitation at the right time. This evidence-based strategy not only supports healing but also helps people return to activity with greater confidence and resilience.