Resist ICE - Move to Peace and Love (political pun but this is about injuries)
I twisted my knee skiing a couple weeks ago. I'm fine — really — but in the moment I had that familiar reaction: Fear, anxiety, ice it, rest it, don't move.
Turns out, that reaction is a bit of cultural programming that doesn’t serve us well.
And the story of how we all came to believe it is fascinating
The RICE MYTH
The RICE acronym — standing for Rest, Ice, Compression, and Elevation — was coined by Dr. Gabe Mirkin in his 1978 book The Sportsmedicine Book as a simple guide for treating acute athletic injuries.
Interestingly, the story has a notable twist: in 2014, Mirkin publicly revised his views on routine icing and complete rest after reviewing research on inflammation and tissue healing. By 2015 he wrote that both ice and complete rest may actually delay healing rather than help.
It turns out that localized icing on an injury as well as resting – i.e.: not moving – actually slows down the healing process!
But it’s hard to change ideas in the culture - they get frozen like ICE into how we perceive the world.
So what does actually help?
In 2020, researchers Dubois and Esculier proposed a replacement: PEACE & LOVE. The shift in philosophy is significant — instead of suppressing the body's natural response to injury, we work with it.
This suggests a more nuanced and flexible approach to our healing which includes finding ways to continue moving.
THE METAPHOR
I think this shift maps beautifully onto life's other injuries:
The setbacks, disappointments, and emotional hits we take. When those happen, are we tempted to ice them — shut down, go still, avoid feeling? Or can we find a way to protect ourselves briefly, then keep moving?
Maybe we can understand how to keep moving through both physical injuries as well life’s injuries by looking at the newer protocols of PEACE & LOVE…
THE PROTOCOL
Here's the full breakdown of the acronyms, proposed by Dubois and Esculier in 2019 to cover the full range of soft tissue injury management from immediate care to subsequent management.
PEACE covers the first few days after injury:
P – Protect: Unload or restrict movement for 1–3 days to reduce the risk of aggravating the injury, reduce bleeding, and prevent swelling.
E – Elevate: Elevate the limb higher than the heart to promote fluid flow out of the injured tissue.
A – Avoid anti-inflammatories: Avoid any medications or modalities that work to reduce inflammation in the acute post-injury stage, including ice.
C – Compress: Early compression with a tensor bandage or tape can help decrease unnecessary swelling and help with pain.
E – Educate: Setting realistic expectations and understanding that an active approach, rather than relying solely on passive treatments, can help in the long term.
LOVE takes over after the first few days:
L – Load: Put more weight through the injured body part and start getting back to normal activities as soon as possible, without exacerbating pain.
O – Optimism: The brain plays a significant part in rehabilitation — staying realistic and encouraging optimism helps improve the chances of an optimal recovery.
V – Vascularization: Pain-free cardiovascular exercise is a motivation booster and increases blood flow to injured structures.
E – Exercise: Restore range of motion, strength, and proprioception of the injured area to get back to normal activities and decrease the chance of re-injury.
THE APPLICATION
What I notice is that this newer protocol is more nuanced and detailed. It acknowledges both the body as well as the mental implications of injury and then transitions to mind-body approaches to build movement back into life.
I also “love” that the acronym itself sets us up for a mindset of compassion toward ourselves.
I’m currently in the LOVE stage of my own knee recovery - walking, and building stable range of motion, staying optimistic, as well as moving other parts of my body for my own emotional and physical health.
In life, I can see using this as a way to keep up with my business tasks, my creative endeavors, as well as building healthy relationships.
Let’s change RICE to mean Resist ICE (political pun intended) and adopt PEACE & LOVE.
How do you apply this — to your body or your life? I'd genuinely love to hear. Reply to this email or leave a comment below.
All the best in moving with peace and love,
Patrick