Whether it’s a Sunday football match, a gym session or a slip on the stairs, sprains and strains are some of the most common injuries nurses and first aiders see. For years, the standard advice was RICE. Many physiotherapists now recommend a newer approach called PEACE and LOVE. Here’s what each means and how to use them.
Sprain or strain?
- Sprain: injury to a ligament (connecting bone to bone), often the ankle, knee or wrist.
- Strain: injury to a muscle or tendon, often the hamstring, calf or back.
Both cause pain, swelling, bruising and reduced movement.
RICE: the classic approach
- Rest: avoid putting weight on the injury for the first 1–2 days.
- Ice: wrapped ice pack for up to 20 minutes every 2–3 hours. Never put ice directly on the skin.
- Compression: a supportive bandage, not too tight.
- Elevation: raise the injured part above heart level.
RICE is still widely recommended by health services for the first few days.
PEACE and LOVE: the newer approach
Published in the British Journal of Sports Medicine in 2019, PEACE and LOVE covers both immediate care and recovery.
Immediately after injury: PEACE
- Protect: limit movement for 1–3 days.
- Elevate: raise the limb.
- Avoid anti-inflammatories: the authors suggest avoiding NSAIDs and too much ice early on, as inflammation is part of healing. (Your doctor may still recommend pain relief.)
- Compress: bandage or taping to reduce swelling.
- Educate: understand recovery and avoid unnecessary treatments.
After the first days: LOVE
- Load: gradually return to normal activity as pain allows.
- Optimism: a positive mindset is linked to better recovery.
- Vascularisation: pain-free cardio exercise boosts blood flow.
- Exercise: restore strength, flexibility and balance.
Which should you use?
Both approaches agree on early protection, elevation and compression. The main differences are the use of ice and anti-inflammatory medicines, and PEACE and LOVE’s emphasis on early gradual movement. Follow your local health service and physiotherapist’s advice.
Red flags: go to hospital or urgent care
- You can’t bear weight or take four steps
- Obvious deformity or a bone sticking out
- Severe pain, numbness, pins and needles or a cold, pale limb
- Pain directly over the bone (for ankles, the back of the ankle bones or the base of the fifth toe)
- A popping sound with immediate knee swelling
- Head injury with confusion, vomiting or loss of consciousness
Emergency departments often use the Ottawa ankle rules to decide whether an X-ray is needed.
Avoid HARM in the first 72 hours
Many guides add: avoid Heat, Alcohol, Running and Massage early on, as these can increase bleeding and swelling.
How long does recovery take?
- Mild sprain: around 1–2 weeks
- Moderate: several weeks
- Severe or ligament rupture: months, sometimes with surgery
Returning to sport too early is a common cause of re-injury.
Related guides
- Prometric nursing sample questions (including compartment syndrome)
- Common medical and nursing abbreviations