Updated

Updated · The Washington Post · Jul 1

Esculier, DuBois Urge 9-Step PEACE and LOVE Protocol Over RICE for Soft-Tissue Injuries

Updated

Updated · The Washington Post · Jul 1

Esculier, DuBois Urge 9-Step PEACE and LOVE Protocol Over RICE for Soft-Tissue Injuries

Q: The new PEACE & LOVE protocol advises against anti-inflammatories, but when might they still be the right choice for managing severe injury pain?

Yes—anti-inflammatories can still make sense when pain is so severe that it prevents sleep, basic movement, or the early rehabilitation that now appears to speed recovery. The PEACE & LOVE approach argues that in the first days after a sprain or strain, inflammation is part of healing, so routinely suppressing it with ibuprofen or similar drugs may slow tissue repair. That is why the protocol prefers acetaminophen for pain and encourages early, gentle loading instead of complete rest. But experts also stress that pain control matters. If pain is intense enough that a patient cannot bear weight, cannot start gentle motion, or cannot participate in rehabilitation, a clinician may decide that short-term anti-inflammatory treatment is the better trade-off. The same applies when uncontrolled pain risks stiffness, muscle inhibition, or delayed recovery because the person avoids movement altogether. The key is that this should be selective, not automatic. Anti-inflammatories may be reasonable for severe symptoms, but ideally at the lowest effective dose, for the shortest necessary time, and with medical guidance—especially if the injury could be more serious than a routine sprain or strain. In practice, the newer consensus is not that anti-inflammatories are never appropriate. It is that they should not be the default in the acute phase, and they are most justified when severe pain is blocking function and recovery.

1 articles · Updated · The Washington Post · Jul 1

Jean-François Esculier and Blaise DuBois say common sprains, strains and slight tissue tears should be managed with PEACE and LOVE, a 9-step approach that discourages ice, anti-inflammatory drugs and prolonged rest.
Research cited in the report suggests RICE can slow healing because inflammation helps clear damaged cells and trigger repair; icing constricts blood flow, while ibuprofen blunts prostaglandins that help activate stem cells.
Rest is the biggest concern, experts said, because immobility quickly weakens muscle, tendons and ligaments and can lengthen recovery, while gentle early movement helps limit scarring and restore function.
The protocol calls for brief protection, compression and elevation, then early loading, aerobic activity and strengthening; for pain relief, Esculier recommends acetaminophen instead of anti-inflammatory drugs.
Even RICE originator Gabe Mirkin wrote in 2015 that ice and complete rest may delay healing, underscoring a broader shift toward movement-based recovery for minor soft-tissue injuries.

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The Washington Post8h ago

Esculier, DuBois Propose PEACE and LOVE Protocol for Soft-Tissue Injuries, Replacing RICE

The new PEACE & LOVE protocol advises against anti-inflammatories, but when might they still be the right choice for managing severe injury pain?

Is icing an injury now a thing of the past, and what gentle movements can you safely start immediately?

As weight-loss drugs surge in popularity, could they be silently increasing your risk of tendon injuries during exercise?

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The Washington Post8h ago

Esculier, DuBois Propose PEACE and LOVE Protocol for Soft-Tissue Injuries, Replacing RICE

Esculier, DuBois Urge 9-Step PEACE and LOVE Protocol Over RICE for Soft-Tissue Injuries

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