Why "PEACE & LOVE" Is Better Than "R.I.C.E"-- A Movement Based Protocol for Recovery
- Dr. Gerry Robles PT, DPT
- Jul 17, 2025
- 3 min read
When you twist an ankle or experience any soft tissue trauma, your first instinct might still be the classic "R.I.C.E." method. This is Rest, Ice, Compression, and Elevation. For decades, this was considered best practice. But science evolves, and so has physical therapy. I get asked these questions constantly in my practice. Should I ice? Elevate? What do I do?
Enter the modern, evidence-based framework: PEACE & LOVE. This holistic method addresses not just the physical, but also the emotional and behavioral aspects of healing. This is something especially relevant for my active people and athletes of all sports.
What Is PEACE & LOVE?
The acronym PEACE & LOVE was introduced in the British Journal of Sports Medicine in 2019 by physiotherapists Blaise Dubois and Jean-François Esculier to guide both acute and long-term injury management. It stands for:
P- Protect
Avoid activities and movements that increase pain during the first 1–3 days post-injury.
E- Elevate
Raise the injured limb higher than the heart to promote fluid drainage.
A - Avoid Anti-inflammatories
NSAIDs (like ibuprofen) may impair the healing process in the early stages. Inflammation is a natural part of tissue repair.
C- Compress
Use elastic bandages or taping to limit swelling and support the area.
E- Educate
Your physical therapist should guide you with clear, evidence-based information about your condition and prognosis.
Once the acute phase is over, the LOVE part begins:
L- Load
Progressively and safely load the injured tissue to promote remodeling and return to function.
O- Optimism
Psychological factors, such as fear or catastrophizing, can delay healing. Positive expectations matter (this is backed by science).
V- Vascularization
Encourage pain-free aerobic activity to boost blood flow and recovery.
E- Exercise
Tailored exercises help restore strength, mobility, and function while preventing reinjury.
Why R.I.C.E. Is Outdated
Originally coined in 1978 (cmon this is a long time ago!) by Dr. Gabe Mirkin, the R.I.C.E. protocol was widely accepted for decades. However, even Dr. Mirkin has since recanted his earlier recommendations, stating:
“Coaches have used my 'RICE' guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.”
— Dr. Gabe Mirkin, 2015 1
The primary limitation of R.I.C.E. is that it ignores the active recovery process. It focuses on symptom suppression rather than promoting tissue regeneration, psychological readiness, or long-term function.
Why PEACE & LOVE Aligns with Modern Physical Therapy
As a sports physical therapist, I often see athletes and active adults who are told to "just rest and ice it." This not only prolongs healing but often creates fear-avoidant behavior and unnecessary dependence on passive treatments.
The PEACE & LOVE approach fits perfectly within the biopsychosocial model of care. It addresses not only the physical injury but also the person behind the injury. It encourages patients to become active participants in their healing journey, with the guidance of their physical therapist. And as I always say in my practice, communication is key in healthcare (a lost art).
Final Thoughts
Your body doesn’t need just ice and rest... it needs PEACE and LOVE.
Whether you’re a weekend warrior or a professional athlete, a modern approach to injury recovery empowers you to heal smarter, move better, and return to the activities you love.
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Questions or concerns? Drop them in the comments.
Dr. G
Sources:
Dubois, B., & Esculier, J.F. (2019). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), 72–73.
Mirkin, G. (2015). Why Ice Delays Recovery. DrMirkin.com.
Bleakley, C., Glasgow, P., & MacAuley, D. (2012). PRICE needs updating, should we call the POLICE? British Journal of Sports Medicine, 46(4), 220–221.
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