Are outdated injury advice and myths delaying your recovery? In this video, Dr. Gerry (Doctor of Physical Therapy) breaks down the top 3 injury myths that need to die…icing, resting, and rushing to get an unnecessary MRI.
Learn why the R.I.C.E. protocol is officially dead, how icing stalls tissue healing, why “waiting” is a terrible rehab strategy, and how the modern P.E.A.C.E. & L.O.V.E. protocol uses movement to rebuild physical capacity and futureproof your body against future injuries.
TOPICS & TIMESTAMPS:
0:00 – The Outdated Injury Advice That Needs to Die
1:40 – We Are Organisms, Not Robots: Why Loading Tissues Matters
2:37 – Myth #1: Why Icing Delays Healing & The Flaw of R.I.C.E.
4:51 – Myth #2: Why Resting Until Pain Goes Away Destroys Capacity
6:15 – The Traffic Light System for Movement & Pain Thresholds
8:03 – Art of PT (1-on-1 Sports PT in Naperville, IL)
8:52 – The P.E.A.C.E. & L.O.V.E. Protocol Breakdown
13:35 – Myth #3: Why You Don’t Need an MRI Right Away
14:53 – What MRIs Actually Show: Normal Age Changes vs. True Tears
17:37 – Rebuilding Physical Capacity & Long-Term Resilience
19:02 – How We Work With Athletes & Active Adults (In-Person & Remote)
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And for decades, the standard was the rice protocol, right? Just rest, ice, compression, and elevation. And even the doctor who came up with it, Dr. Mkin, I believe his name is, the creator of the rice protocol, said it’s outdated. So why are we still using it? Why is this still a thing in rehab or injury? And what he said was was he retracted the recommendation and even said that it delays healing, which makes sense if you think about it. Inflammation isn’t an error. Inflammation is supposed to happen. It’s a necessary part of tissue repair and tissue healing. And if you think about it, ice constricts blood vessels, right? It freezes everything. So when you freeze it, it helps numb the pain like we talked about earlier. At the same time, you’re just leaving those cells in there. Those that inflammatory soup is not going anywhere. It’s stuck because you’re freezing it. You essentially want to be flushing those things out, right, for better healing. So, icing doesn’t really help the inflammation process. If anything, it stalls it. So, instead of icing, what we now recommend as physical therapists is an active approach, right? lightweight, pain-free movement. It acts as a natural pump muscle contractions to flush out the inflammation as opposed to just icing it and freezing it and keeping it in there longer. And again, all this muscle contractions, natural movement acts as a natural pump for the lymphatic system, which is the the fluid that travels throughout your body collecting waste, flushing things out. And again, light movement, muscles contracting is much better than just icing it and freezing the inflammation process. And again, if you think about it, it kind of makes sense. Um, so we shift from the rice protocol to something we’ll talk about later, which is called the peace and love protocol, but we’ll come back to that in a second. But, so that’s the first myth is just some hurts. Well, let me ice it. Let’s stop doing that.
The second myth is resting until the pain just goes away. Just waiting just, you know, my back hurts, let me just lay down and do nothing. Or my knee hurts, let me just not walk. Uh, not good rehab plan. That’s not a good rehab plan at all. So, how do you keep your physical capacity when you do have pain or injury? Again, you need an active approach to rehab. Meaning, you need to be moving and exercising, but of course, in a safe manner. And that’s where the physical therapist comes in. That’s our job to show you these things to build capacity, not lose um that physical capacity that you need to further futureproof yourself for injury. When you stop moving because of pain, when you stop doing everything and just wait the pain out, tendons lose stiffness, muscles atrophy or get smaller, your nervous system, your CNS turns up the sensitivity signals because it sees all movement as dangerous. And that’s not a good thing. You don’t want your body to be afraid of like when you have back pain of bending over again. I see it every day. People are super afraid of bending over again. and that becomes a threat to their system and it’s not a good thing. So you want to be actively avoiding and not doing anything. And what you need to do instead instead is find find good gentle feel-good movements. And again, that’s kind of our job as physical therapists to show you these things. But good rule of thumb is if the pain on your subjective pain scale, you know, the the usual zero out of 10 pain. If the pain is less or around a three out of 10, that’s usually a green light. You can move. It’s safe. It hurts a little bit, but it’s safe. It’s not going to cause any further damage, which people are so afraid of. It was going to hurt me again or it’s going to damage myself even more, which is not true. Or so that’s more green light or yellow light. It’s more three to three to six out of 10 pain, which we probably have to modify it a little bit and that’s okay. Usually around a five, we can modify it. Anything above a five or a six, we just scrap it. We try something else. We come back to that movement or exercise. And again, that takes communication with your your PT. You have to find these things with your physical therapist. But generally speaking, if the pain is around, you know, less than a 5 out of 10, less than a four out of 10, you’re safe. Above a five or a 6 out of 10, we probably have to ditch it, modify it, try something else. So, a little bit of pain is okay. Too much pain is is a red light. Don’t do it. Controlled movement reassures your nervous system that the tissue is safe, that the movement is safe, and it also dampens the alarm signals, which is what you want. Maintaining again tissue health, joint health, as opposed to doing nothing where that doesn’t give you the the tissue health or the joint health that you want because nothing’s happening. There’s no fluid movement, there’s no circulation, there’s no adaptation, which is what the human body requires.
Quick pause. This video is brought to you by Art of PT. It’s my physical therapy practice here in Neapville, Illinois. It’s all personalized. It’s all individualized. It’s all one-on-one physical therapy. So, if you are an athlete or someone who does the high rocks or plays a lot of pickle ball or jiu-jitsu person or combat sports, you go to the gym all the time, you’re around Neapville and something hurts, I’m here to help. Come check us out. Again, it’s all personalized. It’s not the like the usual corporate physical therapy place where the PT see three patients at once. It’s all individualized to you. So check us out. It’s artf.com. The link is in the description. It’ll go right to us. Tell us your story. We’ll get you back to 100%. I promise.
Back to the episode. Let me circle back to the peace and love protocol which we have an infographic here. So if you look at it, it’s quite literally peace and love, right? Instead of the whole rice protocol. So I feel like us as physical therapists or people in the rehab department of healthcare, the rehab section of healthcare, we hopefully we know this by now and we’re telling our patients this, but I don’t think it’s something that the mainstream, you know, YouTube space or the mainstream social media space talks about a lot. they still kind of they’re stuck in that rice protocol just resting it, icing it, waiting for the pain to go away. So, let’s kind of walk through this a little bit. So, going back to the protocol, the P is protect, right? Which means again protection. That doesn’t mean stop everything. Continue moving, but focus on light movements, gentle movements, elevate, self-explanatory. The A is one where I is where people kind of are shocked by. But the A is stands for avoid any anti-inflammatories, which again we’ve been taught or we’ve been hurt, we’ve heard so many years that anti-inflammatories are good for any type of pain, right? And there’s again there’s some good research showing that NSAIDs and again icing don’t help the inflammatory process. it actually delays tissue healing. So, we want to avoid those things. C in the piece part of the protocol is compression. Again, pretty self-explanatory. E is for education, which means trust your body and the healing process. Focus on again light active treatment and avoid passive treatment. Passive treatment, meaning again, doing nothing or going to your physical therapist and just wanting a massage and doing nothing and having the rehab provider do everything for you. That’s a passive approach to your injury rehab. That’s something you want to avoid because eventually you want to get back to your sport, to the gym, to walking again, to to moving again. Passive treatment will not help that. The L stands for load, meaning you have to load those tissues that are healing. I know it’s it sounds not good. It sounds like you’re going to be hurting yourself more, but again, your tissues need load at the appropriate dosage, and that’s key. O stands for optimism. Again, sounds kind of woowoo. It sounds like, oh, well, I should be feeling I should feel good, positive outlook, but again, there’s good research showing that a positive outlook on your health helps pretty much everything. So that’s something that should definitely be in your back pocket when recovering from an injury or pain. So that’s optimism. That’s O. V. V is vascularization. Meaning you want more blood flow to the area, right? Tissues repair and get better and heal and desensitize with more blood flow, not by sitting and doing nothing. And pain-free. The the V here stands for like pain-free cardiovascular activities. I mean, you could throw anything in there, like even just light walking, light elliptical, light bike, light movements that your PT has taught you, and ease, of course, exercise, which, you know, again, I get it. I work with people every day, and when I tell them we have to move and they’re in pain, they don’t want to do it. And I get it. It sucks. It at first it might hurt a little bit, but again, every time we go through the whole physical therapy process, the treatment session, they walk out feeling better. They’re like, “Oh, Jerry, that feels a lot better. My back pain feels a lot looser. My neck feels a lot better.” And again, that builds their confidence. And we we build from treatment session to treatment session and we go from there. So, that’s the whole peace and love protocol. And this is something that should be out there more. And maybe I haven’t seen it, but again, this is something where people, especially people who are avid gymgoers, you know, people who do the high rock stuff now, crossfitters, you know, my jiu-jitsu guys, my my boxers, my kickboxers, my Muay Thai athletes. Um, I tell this to people every day and the look on their face is like, “What what do you mean?” Like, “I don’t know. I haven’t heard of this before.” So again, this should be more out there. And I’m glad to again shed some more light on this.
So we have icing, the first myth. Second myth is just resting. The third myth is one of my favorites. It’s you don’t need an MRI to know what’s going on. And this is of course, you know, with the caveat of everything else is medically screened out. There’s no red flags and it’s a true muscularkeeletal issue. You’d be surprised how often I get people who come in with back pain or shoulder pain and knee pain. I tell them, “You don’t need an MRI. It’s just going to waste your time because you’re going to get an MRI. They’re going to send you right back to PT anyway. As long as I see that there’s no red flag signs, mean there’s no numbness and tingling. there’s no and again I’ll probably post like a a little link in the description of this YouTube video showing red flag signs but it’s our job to screen those out and if I don’t see anything it’s a it’s a true muscular skeletal issue and that’s something that can be rehabbed and you don’t need an image for it. You don’t need an X-ray. You don’t need an MRI and and I get it. People have had pain for a while and just they just want to know what’s going on. Like why is this not getting better and I don’t know what this is? and again MRI and then the specialist says well you still need PT anyway so you don’t really need it and again I’m not saying never do this and it’s a horrible idea but modern rehab science shows that again MRIs often show just normal age changes meaning yeah there’s probably a bulging disc in your back yeah there’s probably some fraying in your labum in your hip labum and your shoulder labum yeah your rotator cuff is probably partially torn a little They’re not going to do a crazy surgery for that. Nor should they. Um, most of the surgeons that I know want to do rehab first anyway. So, they’ll just send you right back to PT with me. And again, it it requires a lot of patience and hard work on the patients end to actually rehab their pain and and injury and get better. And, you know, patience is is tough for a lot of people. I see it every day. But also when we go through the process, I see them becoming a different person and their pain gets better and they never needed surgery. And I’ve seen countless people over the years in my man, how long have I been doing PT for? In my nine, eight, nine years of being a physical therapist of them not getting surgery, of them avoiding a meniscus surgery that they they didn’t need or a back surgery that they didn’t need or a shoulder surgery that maybe one surgeon told them to get a a repair on this and then, you know, they didn’t really need that and we avoided it. And as as PTs, you know, we treat the person the person and their movement function. And again, studies, modern rehab science shows that studies show that a massive percentage of people are completely pain-free with, again, like I said, these normal age changes, these disc bulges, these laboral tears, these rotator cuff tears. Now, if it’s completely torn, we have something, you know, a different issue. But like partial tears, some fraying in the labum, a disc bulge, they sound scary, but again, they’re not as scary as you think and they can be rehabbed. And again, if that’s all screened out and it’s a true muscularkeeletal issue and it just hurts a little bit and there’s some fraying, there’s a bulge, a biomechanical movement evaluation from your physical therapist will tell us everything we need to know. And again, it’s a process. We walk you through it. It takes some patience and but again at the other side of it, you come out a better person and you get stronger and you never needed an un unnecessary surgery or an unnecessary MRI that’ll just waste your time.
Most of the time with these general pains, again, you don’t need this MRI. And what you do need is to rebuild your physical capacity again, which is done through physical therapy. And again, icing is old school. Resting it is old school. And again, even getting an MRI right away is old school. Um, and again, I keep preaching patience. But, um, if it’s just aches and pains and muscularkeeletal things and again, it’s a whole process. That’s why I love physical therapy. It’s called therapy for a reason. Therapy is up and down. It takes time. It It builds you back up. And that’s what we do in PT. We build you back up. Your knee pain, we get it stronger. We bulletproof it so it won’t get injured again. Same thing with your back pain. I don’t care what joint it is. If it’s your shoulder, if it’s your hand, your wrist, your neck, we rebuild it. We get you painfree. We get you stronger. We futureproof it for any other injuries that you hopefully won’t have in the future. Um, and it’s not impossible. I know maybe some of you watching this, you’ve had pain for a while, chronic pain. Um, it takes time, but again, it’s not something you can’t overcome. And I see it every day. And it’s again, when they’re done with physical therapy or they get better, they come become a different person and they become stronger both physically and mentally. And it’s something I love to see.
So, if you’re tired of outdated advice of someone telling you just to rest it and ice it and do nothing, at Art of PT, my physical therapy practice, we do all individualized, all private, all personalized physical therapy. It’s all one-on-one with the physical therapist. We assess everything. We’re not doing the old school giving you an ice pack for 15 20 minutes or a heat pack or god forbid ultrasound on something that no PT should be doing anymore. Um it’s it’s modern rehab and it’s all individualized to you the patient. And we’re in Aprville. The link is in the description to my practice. It’s artf.com. The contact us link is in the description. Again, I work with all athletes, pickle ball players, I’ve got a huge influx of them just spraining their ankle. If you play pickle ball around Neapville, um my high rocks people, everybody’s training for a high rocks these days. I know it’s very uh it’s fun. I’ve done some training for it. It’s super fun. But a lot of people sometimes go too hard and they sprain their knee or they they hurt their back. And I I see it every day. So, I work with all them. And again, my people I the usual people I work with, my jiu-jitsu athletes, my Muay Thai athletes, my, you know, baseball players, basketball players, the average gym person, um, I’m here to help as well. So, the link is in the description, like I said, or if you want to work with me completely online, I have a ton of online clients now, which is great. It’s the same link that goes right to us at Art of PT. So, you could hit the contact us link, fill it out, tell us your story, and we could work together completely online where I do a whole movement analysis through video. We work together. I give you a whole customized rehab plan. We check in periodically. I keep updating a rehab plan and you get better that way. And it’s also a great way to get an individualized rehab plan if you’re not in the state where I practice in.
Newsletter that I have is also linked in the description. It’s all free. It’s a ton of PT stuff, modern rehab science stuff, sports PT stuff, exercise science stuff on there. So, it’s completely free. Like I said, sign up in the description as well. And then my Instagram is also on there. You can DM me on Instagram at aptd g on there. I’m a little bit more active nowadays. So you could definitely just message me on there. So lots of avenues to reach me and hopefully you got some some good advice from this from this video and not the old school advice of just resting icing and doing nothing uh or rushing to get an MRI because again that’s outdated. Stop doing that. It’s again, it amazes me that people still preach these things. But that’s this video. Hope you got some value out of it and I’ll see you guys next time. Peace.

