RICE is out, PEACE & LOVE is in
Dr. Elyse Harrop PT, DPT, OCS on the blog today
2.5 weeks before the Boston Marathon, I had a little mishap. After a strong training block where I was feeling good and strong and READY, I sprained my ankle (at run club of all places!). During a warm-up high skip I landed awkwardly, heard a loud crunch, and hit the ground. Uh oh.
Step 1: Freak out.
Step 2: Play it cool and get off the ground
Step 3: Turn on PT brain, and get going
Needless to say, I did not complete the workout. Once I confirmed my ankle wasn’t broken (I could walk, no pain in the malleolar zone), I tapped into my knowledge base.
If you’ve ever twisted an ankle, you’ve probably been told to follow “RICE” — Rest, Ice, Compression, Elevation. It was the gold standard for years. But science has evolved, and now we follow a new approach: PEACE & LOVE. It’s a smarter, more complete way to heal and get moving again.
PEACE (for the first few days):
Protect: Avoid activities that cause pain.
Elevate: Keep the injury above heart level.
Avoid anti-inflammatories: They can actually slow healing early on.
Compress: Use a brace or wrap to compress the joint
Educate: Trust the healing process
LOVE (for longer-term healing):
Load: Load and use the area as soon as you can with minimal pain
Optimism: A positive mindset really does help recovery!
Vascularization: Get blood flowing with pain-free cardio like biking or swimming.
Exercise: Rebuild strength, balance, and flexibility.
Luckily for me, my ankle sprain ended up being a grade 1 - no bruising but a hefty amount of swelling and soreness. By following PEACE & LOVE, I was walking right away. I was back to running within several days by taking shorter, slower, easier runs. I kept up with rehab exercises and compression when needed. Now, I’ll toe the starting line of the Boston Marathon relatively pain-free!
If you’re dealing with an injury, working with a physical therapist can help you heal smarter and faster. We’ll guide you through PEACE & LOVE and get you back to doing what you love — whether it’s finishing a marathon or just taking a walk without pain.
