Ten thousand steps and more. And if this first chronicle of the year was placed under the sign of peace and love? Don’t worry, it’s not just a counterpoint to the general atmosphere but a health sport subject. “Peace and love” is an acronym invented by two physiotherapists Canadians, Blaise Dubois and Jean-François Esculier (Runner’s Clinic, Quebec), to guide the management of injuries: sprains, muscle damage, but also tendon damage, even cartilage or bone damage. This two-step strategy was exposed in a short article in the British Journal of Sports Medicine in January 2020.
Acute trauma related to violent stress (shock, contraction, torsion), but also more chronic damage, by repeated mechanical stress, musculoskeletal pathologies are very common in athletes. “In athletics, 70% of practitioners have at least one injury during the year, whatever their level, and this may be valid in other sports”, emphasizes Professor Pascal Edouard, sports doctor at the University Hospital of Saint-Etienne and researcher at the Jean-Monnet University of Saint-Etienne.
The acronym “Peace” corresponds to the immediate management of acute injuries. The “P” for “protection” is to first stop (usually two to three days) all activities that cause pain. The objective is to minimize bleeding, prevent the distension of damaged fibers and prevent the risk of aggravation of the lesions. The “elevation” (“E”) of the injured limb above the level of the heart aims to reduce fluid stagnation. “A” refers to the “abstention” of anti-inflammatories, these drugs can negatively affect the long-term healing of tissues, justify the two Canadians. They also advise against the application of ice, for lack of high-level evidence on its effectiveness. Although the effects are mainly analgesic, the ice could disrupt inflammation and revascularization, and ultimately impair tissue repair, they argue. To reduce the oedema, they recommend a “compression” (“C”) by elastic bands or tapping. Finally the “E” is the “education” of the patient to the benefits of an active approach, and preventing over-medicalization. “Passive modalities, such as electrotherapy, manual therapies, or acupuncture, performed early after injury, have insignificant effects on pain and function compared to an active approach, and may even be counterproductive to long term “, they write.
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