With the beautiful fall colours in Muskoka, many of us are turning to hiking as a way to enjoy the scenery.
Hiking has many benefits—it is great for our cardiovascular health, lower body strength, proprioception (awareness of body position in space), balance, and improving our mood. The uneven terrain on trails does pose risk for injury, specifically, an ankle sprain. An ankle sprain occurs when the ankle is forcefully turned (“rolled”) inwards or outwards .
The most common ankle sprain is a lateral (outside) ankle sprain. (Note: it is possible to sprain the medial (inside) of your ankle, but far less commonly seen in practice.)
There are three major ligaments that may be affected depending on the position of your foot and ankle when it was rolled. These ligaments include the anterior talofibular ligament (ATFL), calcaneofibular (CFL), and posterior talofibular (PTFL). An ankle sprain results in pain, swelling, and bruising around the ankle. Furthermore, it makes it difficult to walk, let alone hike!
If you’ve had any first aid course, you’ve probably heard of the acronym “RICE” when it comes to acute injuries—Rest, Ice, Compression, and Elevation. However, as research has evolved this isn’t necessarily considered best practice today. The British Journal of Sports Medicine recommends “PEACE & LOVE” for soft tissue injuries, such as an ankle sprain. Meaning, it’s time to ditch the “RICE” principles!
So what exactly does “PEACE & LOVE” mean?
“PEACE” stands for Protection, Elevation, Avoid anti-inflammatories, Compression, and Education. The “PEACE” principles applied during the initial stages after an ankle sprain looks something along the lines of:
P: protection: avoid painful movements initially during the acute stage
E: elevation: put the affected foot up above heart level;
A: avoid anti-inflammatories: no need for NSAIDs at this stage;
C: compression: wrap the ankle in a tensor bandage to help reduce or prevent further swelling; and
E: education: seek the advice of a health care provider.
After the acute stage, the “LOVE” principles apply—Load, Optimism, Vascularization, and Exercise. Applying the LOVE principle in the case of an ankle sprain may look like this:
L: load: continue to do your normal activities like walking (as long as you are cleared by your health care provider). A health care provider, such as a physiotherapist, can also teach you appropriate loading exercises to optimize your recovery;
O: optimism: have positive thoughts, it’s going to get better!;
V: vascularization: engage in cardiovascular activities that increase blood flow without causing pain; and
E: exercise: strength and proprioception exercises can prevent future injuries.
That’s right—rest is no longer indicated when it comes to acute injuries, such as ankle sprains. Instead, an active approach can help your recovery by regenerating cells and improving blood flow to the injured area.
A physiotherapist can help educate you on the principles of “PEACE & LOVE” and can prescribe exercises in the early stages of recovery following an ankle sprain. As your pain and swelling come down, a physiotherapist can then guide you on the right path towards returning to your beloved activities, such as hiking, by prescribing appropriate strength, proprioception, and balance exercises so you can get back on the trails!
Please note, this article is for general educational purposes only, you should always have your injuries assessed by a health care provider.
Dubois, B. & Esculier, J-F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine. 54, 72-73.
For more information or to book an appointment call 705-380-3312 or visit the website. Surge Physiotherapy is located at 33 King William Street, Suite 204, in Huntsville. Office hours are flexible with evening appointments available (three times per week). Email: firstname.lastname@example.org.
Andi is passionate about helping you achieve your goals and get back to doing the things you love. Whether it is returning to running, lifting your grandkids, or recovering from surgery, Andi combines her multifaceted background in manual therapy, education kinesiology and exercise rehabilitation to provide individualized treatment. She believes that movement is medicine and enjoys sharing this philosophy with her clients.
Andi is a Muskoka native who completed her Master of Science in Physical Therapy at the University of Toronto in 2017. She received her Bachelor of Science in Exercise Science in 2010 and her Master of Education in 2012 from Auburn University Montgomery in Alabama where she was a member of the varsity soccer team.
When she is not working in the clinic, Andi enjoys giving back to her community through volunteering and also enjoys running, playing soccer, snowboarding, and baking.