04/07/2026
Did you know? RICE is out. PEACE & LOVE are in. โ๏ธ
Just published ๐ฅ
๐ฃ๐ฅ๐๐๐ (๐ฃ๐ฟ๐ผ๐๐ฒ๐ฐ๐๐ถ๐ผ๐ป, ๐ฅ๐ฒ๐๐, ๐๐ฐ๐ฒ, ๐๐ผ๐บ๐ฝ๐ฟ๐ฒ๐๐๐ถ๐ผ๐ป, ๐๐น๐ฒ๐๐ฎ๐๐ถ๐ผ๐ป) ๐๐ ๐ฃ๐๐๐๐ ๐ฎ๐ป๐ฑ ๐๐ข๐ฉ๐ (๐ฃ๐ฟ๐ผ๐๐ฒ๐ฐ๐๐ถ๐ผ๐ป, ๐๐น๐ฒ๐๐ฎ๐๐ถ๐ผ๐ป, ๐๐๐ผ๐ถ๐ฑ ๐ฎ๐ป๐๐ถ-๐ถ๐ป๐ณ๐น๐ฎ๐บ๐บ๐ฎ๐๐ผ๐ฟ๐ถ๐ฒ๐, ๐๐ผ๐บ๐ฝ๐ฟ๐ฒ๐๐๐ถ๐ผ๐ป, ๐๐ฑ๐๐ฐ๐ฎ๐๐ถ๐ผ๐ป ๐ฎ๐ป๐ฑ ๐๐ผ๐ฎ๐ฑ, ๐ข๐ฝ๐๐ถ๐บ๐ถ๐๐บ, ๐ฉ๐ฎ๐๐ฐ๐๐น๐ฎ๐ฟ๐ถ๐๐ฎ๐๐ถ๐ผ๐ป, ๐๐
๐ฒ๐ฟ๐ฐ๐ถ๐๐ฒ) ๐ถ๐ป ๐ฎ๐ฑ๐ผ๐น๐ฒ๐๐ฐ๐ฒ๐ป๐ ๐น๐ฎ๐๐ฒ๐ฟ๐ฎ๐น ๐ฎ๐ป๐ธ๐น๐ฒ ๐๐ฝ๐ฟ๐ฎ๐ถ๐ป ๐ฟ๐ฒ๐ต๐ฎ๐ฏ๐ถ๐น๐ถ๐๐ฎ๐๐ถ๐ผ๐ป: ๐ฎ ๐ฟ๐ฎ๐ป๐ฑ๐ผ๐บ๐ถ๐๐ฒ๐ฑ ๐ฝ๐ฟ๐ผ๐๐ฝ๐ฒ๐ฐ๐๐ถ๐๐ฒ ๐ฐ๐ผ๐บ๐ฝ๐ฎ๐ฟ๐ฎ๐๐ถ๐๐ฒ ๐๐๐๐ฑ๐ ๐ผ๐ณ ๐บ๐๐๐ฐ๐น๐ฒ ๐๐๐ฟ๐ฒ๐ป๐ด๐๐ต ๐ฎ๐ป๐ฑ ๐ฑ๐๐ป๐ฎ๐บ๐ถ๐ฐ ๐ฏ๐ฎ๐น๐ฎ๐ป๐ฐ๐ฒ
๐ฆถ Lateral ankle sprain (LAS) is one of the most frequent musculoskeletal injuries in active adolescents, yet wide variability persists in diagnostic methods and treatment pathways (https://pubmed.ncbi.nlm.nih.gov/29514819/, https://pubmed.ncbi.nlm.nih.gov/29886432/).
๐ For more than 20 years, acute care has relied on the PRICE (Protection, Rest, Ice, Compression, Elevation) approach, combined with non-steroidal anti-inflammatory drugs (NSAIDs). However, guideline authors note a lack of high-quality evidence supporting PRICE as a universal strategy and warn that excessive rest and prolonged NSAID use may impair optimal tissue repair (https://pubmed.ncbi.nlm.nih.gov/29514819/). On the contrary, contemporary rehabilitation enhances early loading, progressive exercise, and patient education. A 2019 systematic review and meta-analysis reported that exercise-based rehabilitation reduces recurrent sprains risk compared with usual care, though optimal content and dosage remain unclear (https://pubmed.ncbi.nlm.nih.gov/30612980/).
In order to avoid drawbacks of traditional treatment algorithm, PEACE and LOVE was suggested as a two-phase protocol covering immediate care (Protection, Elevation, Avoid anti-inflammatories, Compression, Education) and subacute recovery (Load, Optimism, Vascularization, Exercise), paying attention to education, early optimal loading, and graded activity (https://pubmed.ncbi.nlm.nih.gov/31377722/).
โค๏ธ โฎ๏ธ Traditional PRICE + NSAIDs and the PEACE and LOVE frameworks differ not only in clinical management but also in underlying physiological basis. PRICE concentrates primarily on early symptom control by reducing pain and swelling; however, prolonged rest and routine use of anti-inflammatory strategies may impair beneficial inflammatory cascades, macrophage activation, angiogenesis, and collagen remodeling required for optimal tissue healing (https://pubmed.ncbi.nlm.nih.gov/22889660/).
Conversely, PEACE and LOVE supports early, gradual mechanical loading and patient education to stimulate mechanotransduction, maintain neuromuscular function, and support collagen fiber alignment. This protocol aims to optimize tissue regeneration and functional recovery rather than simply controlling symptoms (https://pubmed.ncbi.nlm.nih.gov/31377722/).
๐ In a brand-new randomized prospective comparative study, Meลกkauskas and colleagues (https://pubmed.ncbi.nlm.nih.gov/41840451/) enrolled 76 adolescents (12โ17 years) with first-time LAS, allocated to PRICE + NSAIDs or PEACE and LOVE treatment group (s. comments). Functional performance was assessed at 1โ2, 5โ7, and 12โ15 weeks using Biodex isokinetic dynamometry and the Y-Balance Test composite score (YBT-CS).
๐ Significant improvements over time were observed for strength, range of motion, and dynamic balance in both groups. However, no statistically significant group effects or Group ร Time interactions were detected, indicating similar recovery trajectories between rehabilitation approaches during the 12โ15-week follow-up period.
๐กClinical relevance
The PEACE and LOVE framework may represent a biologically informed and patient-friendly approach to LAS management in adolescents, emphasizing education, early optimal loading, and functional rehabilitation. Despite being a more recently proposed rehabilitation framework, PEACE and LOVE demonstrated short-term functional outcomes comparable to those observed with the traditional PRICE + NSAIDs approach. In the present study, both rehabilitation protocols were associated with comparable short-term improvements in strength, ROM, and dynamic balance. No statistically significant between-group differences were detected.
โญThe magnitude of these changes was modest, and their clinical relevance should be interpreted cautiously. Future studies incorporating minimal clinically important difference thresholds, patient-reported outcomes, and longer follow-up are needed to determine practical impact. Given the single-center design, application of these findings should be considered in the context of local clinical resources and expertise
Infographic: https://pubmed.ncbi.nlm.nih.gov/31377722/
