Why You Shouldn’t Use Ice (PEACE and LOVE Acronym)
For years, the go-to method for treating acute soft tissue injuries was RICE — Rest, Ice, Compression, Elevation. But as our understanding of tissue healing evolves, so too must our treatment strategies. At Holland Landing Health Centre, a leading East Gwillimbury and Newmarket wellness center, we’re committed to evidence-based care — and the research is clear: icing might do more harm than good.
From RICE to PEACE & LOVE
In 2019, Dr. Blaise Dubois and Jean-François Esculier published a landmark editorial in the British Journal of Sports Medicine, proposing the PEACE & LOVE approach as a more comprehensive, science-backed alternative to RICE. This acronym acknowledges both the immediate and longer-term stages of recovery.
PEACE – for the initial (acute) phase:
P – Protect: Limit movement for the first 1–3 days to prevent further damage. Avoid complete rest.
E – Elevate: Elevate the injured limb above the heart to reduce swelling.
A – Avoid anti-inflammatories: Medications like NSAIDs may inhibit tissue healing by reducing the natural inflammatory response. It’s important to note – that you should always discuss your medical options with your medical doctor or pharmacist.
C – Compress: Use elastic bandages or taping to help limit swelling and support the area.
E – Educate: Empower patients to understand their condition and avoid over-reliance on passive treatments.
LOVE – for the subacute/chronic phase:
L – Load: Gradually reintroduce movement and resistance to promote tissue repair and capacity.
O – Optimism: Positive expectations can influence outcomes — mindset matters.
V – Vascularization: Engage in pain-free cardiovascular activity to increase blood flow and promote healing.
E – Exercise: Restore mobility, strength, and proprioception through targeted exercise, tailored to the injury and individual.
Why Ice Might Be Counterproductive
Although icing may temporarily reduce pain, it could delay the body’s natural healing process. Inflammation, often viewed negatively, is a critical part of tissue repair. One animal study (Takagi et al., 2011) showed that icing post-injury reduced macrophage infiltration — the immune cells responsible for clearing damaged tissue and initiating healing.
Another review (van den Bekerom et al., 2012) found limited evidence supporting ice for improving long-term outcomes in soft tissue injuries. Additionally, vasoconstriction caused by cold exposure can limit blood flow, reducing oxygen and nutrient delivery to healing tissues.
What We Recommend Instead
At Holland Landing Health Centre, a trusted East Gwillimbury and Newmarket wellness center, we take a proactive, integrated approach to injury care. Our services — chiropractic, physiotherapy, massage therapy, osteopathy, and naturopathic medicine — are tailored to support all phases of recovery.
We also educate clients to stay active within pain limits, develop recovery plans that build tissue resilience, and foster a healing mindset grounded in optimism and agency.
References:
Dubois B, Esculier J-F. (2019). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), 72–73. https://doi.org/10.1136/bjsports-2019-101253
Takagi R, Fujita N, Arakawa T, et al. (2011). Influence of icing on muscle regeneration after crush injury to skeletal muscles in rats. The American Journal of Sports Medicine, 39(11), 2115–2123. https://doi.org/10.1177/0363546511413379
van den Bekerom MPJ, Struijs PAA, Blankevoort L, et al. (2012). What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? Journal of Athletic Training, 47(4), 435–443. https://doi.org/10.4085/1062-6050-47.4.14
