RICE is outdated. What to do for injuries instead

For decades, the standard advice for a new injury was simple: RICE

• Rest

• Compression

• Ice

• Elevation

If you grew up playing sports or spending time in a gym, you probably heard this from a coach, trainer, or healthcare provider. For a long time, it was the go to approach for sprains, strains, and other soft tissue injuries.

But our understanding of how the body heals has changed over the years. Many clinicians now follow a different framework called PEACE and LOVE, which better reflects what actually helps tissues recover.

A quick refresher: What RICE stands for

The RICE protocol was popularized in 1978 by sports physician Gabe Mirkin.

The idea was straightforward: reduce swelling and protect the injured area while it heals.

• Rest to avoid further irritation.

• Ice to help reduce pain and swelling.

• Compression to limit fluid buildup.

• Elevation to help swelling move out of the area.

  
  

This approach was widely adopted because it was simple and easy to remember. But over time, research and clinical experience have shown that focusing only on reducing swelling and resting the area may not lead to the best recovery.

Moving beyond RICE

RICE focused mostly on calming symptoms. What we have learned since then is that recovery is not just about reducing swelling or pain. Healing tissues also need circulation, movement, and gradual loading to rebuild.

A newer framework called PEACE and LOVE was developed to reflect that more complete approach to recovery. It was introduced in 2019 in the British Journal of Sports Medicine.

The framework separates injury management into two phases: the early stage and the rebuilding stage.

PEACE: What to focus on early

The first phase focuses on protecting the injured tissue and allowing the body’s natural healing process to begin.

Protect: Reduce activities that significantly increase pain for the first few days after an injury. This helps prevent further tissue damage.

Elevate: Keeping the injured area elevated above the heart when possible can help manage swelling.

Avoid anti inflammatory strategies: This recommendation often surprises people. The goal is not to eliminate inflammation right away, because inflammation is part of how the body starts repairing damaged tissue. Instead of trying to completely shut it down, the focus is on supporting the natural healing process.

Compress: Light compression, such as with an elastic wrap, can help manage swelling.

Educate: Understanding what is happening and what to expect during recovery helps people make better decisions and avoid unnecessary fear about movement.

What about ice?

Ice has been part of injury advice for decades, and it can still have a place. Cooling an injured area can temporarily reduce pain, which may make the first couple of days after an injury more manageable.

Where the conversation has shifted is around using ice to aggressively stop inflammation.

Inflammation is one of the first steps in the body’s repair process. It brings blood flow and specialized cells to the injured tissue so healing can begin. When we try to completely shut that process down, we may also slow parts of recovery.

That does not mean ice is harmful or should never be used. It is simply better viewed as a short term pain management tool, not the primary treatment for healing the tissue.

For those who still like to ice the injured area, we recommend doing an ice massage to the area for 2-5 minutes. Take a paper cup, fill with water & freeze. Once frozen, you can peel back the top layer of the paper cup, to expose the ice. Once the ice is exposed, you can then gently rub this over the painful area in circular motions- not over any open wounds!

LOVE: What helps the tissue rebuild

Once the initial irritation settles down, recovery shifts toward gradually restoring movement and strength.

Load: Reintroducing movement and load as pain allows helps the tissue adapt and regain strength.

Optimism: Mindset plays a role in recovery. Positive expectations and confidence in the process are associated with better outcomes.

Vascularisation: Light aerobic activity increases blood flow, which helps nourish healing tissues.

Exercise: Progressive strengthening and mobility work help restore normal function and reduce the risk of reinjury.

The bottom line:

Injuries do not just heal by resting long enough. Tissues recover best when they are protected early on and then gradually reintroduced to movement and load.

Frameworks like PEACE and LOVE reflect a shift toward active recovery.

Instead of trying to completely shut down inflammation or immobilize the area for long periods, the focus is on guiding the healing process so the tissue can rebuild and regain function.

For many people, this is the missing step. The pain settles down, but the tissue was never properly strengthened or reintroduced to normal movement. That is often why the same injuries tend to return.

A good recovery plan usually includes a combination of managing symptoms early on, restoring mobility, and progressively strengthening the injured area so it can tolerate the demands you place on it.

If you are dealing with an injury that is not improving, or one that keeps coming back, a structured rehab plan can help guide the recovery process and get you back to the activities you enjoy.