Why I Stopped Advising Ice for Injuries: Embracing PEACE & LOVE
Introduction: A Skeptic’s Journey
For as long as I can remember, ice has been a staple in injury management. As an athlete, it was second nature—roll an ankle? Ice it. Sore knee? Ice it. Strained muscle? Ice, elevate, compress, and rest. It was ingrained in the sports world, medical community, and public consciousness. It wasn’t just recommended; it was expected. I have been an athlete for many years – in my spare time! Running, swimming cycling. I love the cold and used ice for years. My trainers told me to do it. I attribute it in part to my love of cold water swimming. That however is a different blog. This is in relation to injury management.
But ….
So, in 2013, when one of my osteopathic students casually mentioned that research was shifting away from icing injuries, I was skeptical. He claimed the science was moving on, that ice was no longer the go-to solution for recovery. My gut reaction? No way. Ice had been used for generations—how could something so universally accepted be wrong? It sounded like one of those fitness trends that come and go, another overblown controversy.
But something about his conviction stuck with me. I also had a lot of respect for his experience in the professional sports trainer world. I wasn’t ready to dismiss it outright, so I started looking into it. I read the articles, listened to the debates, and explored the research. And what I found surprised me. The more I dug, the more I realised that what I had always accepted as fact was, in reality, slowing down healing rather than aiding it.
By 2015, I had seen enough evidence to change my approach. Since then, I have not advised the use of ice for injuries. Instead, I have encouraged my patients to support their body’s natural healing mechanisms rather than suppress them. And that’s where PEACE & LOVE comes in—a smarter, science-backed way to manage injuries that prioritises healing over numbing.
Let’s break it down.
What’s Wrong with Ice?
The idea behind icing an injury is simple: it numbs pain and reduces swelling. But here’s the problem—swelling is not the enemy. Inflammation is the body’s natural response to injury, kickstarting the repair process. Ice may temporarily dull pain, but it also slows down the immune response, restricts blood flow, and delays tissue healing.
Research has shown that applying ice after an injury can:
- Constrict blood vessels, reducing oxygen and nutrients reaching the damaged tissue.
- Slow down the removal of waste products, preventing the body from clearing out damaged cells efficiently.
- Suppress the inflammatory response, which is crucial for tissue repair.
Instead of accelerating recovery, ice actually prolongs it. And yet, for decades, we’ve been conditioned to reach for an ice pack at the first sign of an injury. It’s time to rethink this outdated approach.
The PEACE & LOVE Approach: Let the Body Heal Naturally
Rather than focusing on numbing pain and reducing swelling at all costs, the PEACE & LOVE method embraces the body’s natural healing process. This acronym provides a comprehensive, evidence-based approach to injury management, ensuring that tissues recover properly while maintaining function.
PEACE – The Immediate Response to Injury
- P – Protect: In the initial stages of an injury, it’s important to avoid movements or activities that cause pain. This doesn’t mean complete immobilisation, but rather modifying activity to prevent further damage.
- E – Elevate: Raising the injured limb above heart level can help promote fluid drainage and reduce excessive swelling—without cutting off the inflammatory response completely.
- A – Avoid anti-inflammatory medication and ice: This is a crucial shift in injury management. Non-steroidal anti-inflammatory drugs (NSAIDs) and ice both hinder the body’s natural healing response. The inflammation that occurs after an injury is a necessary part of tissue repair, and suppressing it can delay healing.
- C – Compression: Applying light compression with a bandage or sleeve can help manage swelling and provide support without cutting off circulation.
- E – Educate: Patients need to understand their injury and recovery process. Too often, we’re told to rest excessively, rely on painkillers, or fear movement. Education empowers people to take an active role in their healing journey.
LOVE – What Comes Next?
Once the initial injury phase has passed, we move to the LOVE phase—focused on promoting long-term recovery and restoring function.
- L – Load: Movement is medicine. Gentle loading and weight-bearing activities (as tolerated) stimulate tissue repair, improve circulation, and help prevent stiffness or weakness.
- O – Optimism: Mindset matters. Studies show that positive expectations and confidence in recovery lead to better outcomes. Chronic pain and disability are often influenced by fear-avoidance behaviours, so maintaining an optimistic outlook is key.
- V – Vascularisation: Blood flow is essential for healing. Low-impact cardiovascular activities like walking, swimming, or cycling can increase circulation, helping tissues repair more effectively.
- E – Exercise: Rehabilitation exercises restore strength, flexibility, and function. A structured rehab plan—gradually reintroducing movement and strength training—ensures a full recovery and prevents reinjury.
Where Does M.E.A.T. Fit In?
Another approach that aligns well with PEACE & LOVE is MEAT, which emphasises Movement, Exercise, Analgesia, and Treatment.
- Movement: Keeping the injured area mobile helps maintain circulation and reduces stiffness.
- Exercise: Progressive strength and stability training ensures that the body returns to full function.
- Analgesia: Pain relief can be managed without suppressing inflammation—manual therapy, heat, and natural pain management techniques can be beneficial.
- Treatment: Seeing an osteopath, physiotherapist, or healthcare provider can help ensure optimal recovery through manual therapy, rehabilitation strategies, and education.
Rather than immobilising and icing, MEAT encourages active recovery, keeping tissues engaged and promoting faster healing.
Rethinking Traditional Advice
So why has it taken so long for the “ditch the ice” message to catch on? The RICE (Rest, Ice, Compression, Elevation) method has been deeply ingrained in sports medicine and general practice for decades. It’s easy, it’s familiar, and it provides short-term pain relief. But we now know better, and as healthcare practitioners, we have a responsibility to evolve with the science.
The good news? More and more professionals are adopting PEACE & LOVE and MEAT as better alternatives to traditional injury management. By shifting the focus to movement, education, and active recovery, we’re empowering patients and athletes to heal in a way that respects the body’s natural processes rather than suppressing them.
Conclusion: Time to Embrace PEACE & LOVE with a little meat on the side!
If you’ve spent years reaching for an ice pack every time you get injured, this shift in thinking might feel uncomfortable. But the reality is, the body is incredibly intelligent—it knows how to heal when given the right conditions. Funnily enough, that’s what Andrew Taylor Still said (the founder of Osteopathy in 1874) when he mentioned that the body has it’s own medicine chest!
Instead of fighting against inflammation, we need to work with it. Instead of immobilising injuries, we need to nurture movement. Instead of focusing solely on pain relief, we need to prioritise tissue repair and function.
So next time you’re injured, take a deep breath and remember: PEACE & LOVE. Give your body the support it needs to heal naturally, and you’ll likely recover faster, stronger, and with a greater appreciation for how brilliantly it works.
Here’s one of the videos that influenced me. Dr. Kelly Starrett is one of the most influential specialists in my sports and professional life.
Reference: Dr. Kelly Starrett, The Ready State. ‘Stop Icing’. https://youtu.be/0JflPw5FQEY?si=oZWMTnGSmby1qyvL
I am currently training for the English Channel swim and working with a Physiotherapist for my shoulder conditioning who uses his method. He is the bomb!
Hope this challenges you to re think old ideas!