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P.O.L.I.C.E

By Aaron Thomas



Who has had an injury before? A muscle strain? An ankle sprain? Or maybe just sore after a hard workout? We have traditionally been told that we should use RICE, or Rest, Ice, Compression, and Elevation to treat these types of soft tissue injuries. In theory, Rest reduces metabolic demands on the injured structures and prevents re-injury. Ice is thought to also reduce metabolic demands but also limit bleeding and reduce pain through some changes at the microscopic level. Compression and Elevation

reduce swelling and bleeding.


But does this really improve the outcome? Well, it totally depends on your outcome. Do you want earlier recovery or quicker return to physical activity? Are you training for an event or a race and want to be back to 100% by your day? Or maybe you just want to stop hurting immediately after the injury?



Let’s think about a new acronym for acute injuries, termed POLICE : Protection, Optimal Loading, Ice, Compression, Elevation.

More and more studies are showing that early rehabilitation with range of motion, strength, and prevention of re-injury is the way to go when compared to RICE alone. This can lead to quicker return to sport specific activity and less time missed from work or even just life. So, should we abandon the RICE thinking? Well, not entirely….Very brief periods of Rest prevent re-injury, but limiting immobility is the key with emphasis on Optimal Loading. Ice has mixed evidence on the improvement of swelling and pain, but probably doesn’t hurt and can have positive impact on return to function. Compression and elevation, similarly do not have a lot of good evidence either way, but might provide comfort. They key is to prevent too much immobilization.


Bottom line: Keep moving. And more importantly maintain your core and stabilizer muscles around your joints to prevent injury in the first place.


Hope you guys enjoyed this, feel free to comment and ask questions. Let us know what else you want to learn about. It’s always OK to work SMARTER and HARDER!



Below are some examples of protection and optimal loading when it comes to the P.O.L.I.C.E method. Be sure to proceed with proper guidance or advisement.


Step up with applied ankle dorsiflexion

Banded ankle eversion



References:

Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, should we call the POLICE? British Journal

of Sports Medicine 2012;46:220-221.

Van den Bekerom MP, Struijs PA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GM. What is the

evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?

Journal of Athletic Training. 2012;47:435-443.



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