Many acronyms have been thrown around over the years to assist with the management of soft tissue injuries. RICE (Rest, Ice, Compression, Elevation) became PRICE (Protection + RICE) which became PRICER (PRICE + Refer/Rehab) which it has stayed for many years. However, in 2012 Bleakley, Glasgow and MacAuley published in the British Journal of Sports Medicine a revision of this to become POLICE.
What does the POLICE acronym stand for?
Protection is part of optimal loading and involves the use of crutches, casts, braces etc to help protect the area as it heals. This helps to prevent excessive loading to the injured area in the early stages of healing but allows for as normal movement as possible and within pain limits.
Optimal Loading means replacing rest with a balanced and incremental rehabilitation programme where early activity encourages early recovery. The crucial factor is determining what the OPTIMAL load is for individual injuries. For severe injuries such as fractures, tendon or ligament ruptures etc this might mean complete rest of the injured area with the use of casting/bracing or surgery. But for most other injuries the right amount of loading will promote tissue healing and recovery. While rest may be helpful in the very short term, continued rest may lead to deconditioning of the tissues as all bones, tendons, ligaments and muscles require some loading (at the appropriate time) to stimulate healing. Here at Back in Motion we frequently use Hydrotherapy and Clinical Pilates to enable physiological movement under decreased load.
Ice - Apply ice wrapped in a damp towel for 10-20 minutes 2-3 times per day for the first 5-7 days post injury.
Stop applying ice if there are any negative effects such as increase in pain or swelling or skin soreness.
Compression - Simple tubigrip bandage can be used, usually doubled over, to help with swelling. The area should feel compressed but not uncomfortable or painful. Monitor circulation distal to the bandage and remove it for sleeping.
Elevation - Elevation can be very useful for reducing swelling and pain. Ensure all joints are supported (eg ankle and knee) and elevate regularly throughout the day.
The first few days following an injury are CRITICAL in minimising your recovery time, and OPTIMISING your outcome.
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