軟組織受傷處理原則 PEACE & LOVE (by 陳彥志骨科醫師)
PEACE & LOVE 愛與和平？
最近很夯的運動傷害防護處理，相信很多人都可以把口訣朗朗上口了。從一開始的PRICE、到後面的POLICE、到現在的PEACE & LOVE。到底這中間演變了什麼？
1️⃣ 捨棄掉冰敷的建議 I for ICE
冰敷的確可以抑制疼痛反應、降低組織溫度跟發炎反應。但目前知道，過度壓抑發炎反應，反而會延緩組織清除壞死細胞的速率，影響到往下一步的重建癒合時期。
而當肌力進步後，我們下一步就要面對骨質疏鬆的問題了。運動科學研究已經證實，長期連續六個月以上的負重阻力訓練，能夠有效的增加骨質密度。身體為了要慢慢適應在訓練期間承受相對大的重量，骨質也會隨著壓力而增加。反過來講，太空人在太空中因為身體不需要承受壓力，骨質密度反而會變低。
所以說應該讓身體來適應我們，而不是我們去遷就他。
2️⃣不建議在急性期使用抗發炎藥物 Avoid anti-inflammatory medication
消炎藥是一般在急性期很常被給予的藥物，但在現在藥物可取得性提升到很方便的程度時。過度的抑制發炎反應也會如同第一點一樣，影響到癒合的速率。
那什麼藥物適合呢？解熱鎮痛但弱抗發炎的普拿疼是一個初步的選擇。
3️⃣加入適當承重、活動的觀念 Optimal loading
這個觀念代表了POLICE裡面的O，跟LOVE的Ｌ。傷害的過度保護反而會讓關節僵化，延長之後的復健恢復時間。在最新的PEACE & LOVE裡面，把適當活動負荷(Loading)放到亞急性期(LOVE階段)之外，更加入了心肺循環(Vascularization)跟運動(exercise)的觀念。這些都代表現在的觀念：在急性症狀過去後，要在能夠無痛活動的範圍內訓練。
4️⃣加入衛教跟心理層面 PEACE裡面的最後一個Education(教育)跟LOVE的Optimism(樂觀)。大家開始知道，情緒跟壓力其實都會影響運動表現跟恢復，傷害癒合更是如此。教育代表了讓傷者要開始對於自己的傷害更加了解，知道受傷部位、嚴重程度、所需的恢復時間以及其他可能的治療介入，因為了解而不會畏懼或是過度期待。進而以正面樂觀的態度去面對現階段的傷停時間。
我是陳彥志醫師，目前也擁有肌力體能、特殊族群訓練以及矯正運動等國際教練證照，定期會舉辦中高齡銀髮族訓練講座。 相關資訊歡迎到悍草訓練或個人粉絲專頁上查看喔！
合作撰寫：
好痛痛(粉絲頁)、陳彥志骨科醫師(專欄) (粉專) (悍草訓練粉絲頁) (悍草訓練網站)
好痛痛的運動傷害書籍，集結 2 位醫師、6 位物理治療師、2 位運動教練一起教你如何預防/處理運動傷害 (博客來連結) (誠品連結)
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