Updated: Feb 7
Ever heard of RICE? Or maybe PRICE? Well there's a newer theory of acute injury management.... POLICE! This stands for Protection, Optimal Loading, Ice, Compression and Elevation.
Protection is pretty self explanatory.. protect the injury from getting worse! This is the first step of any rehabilitation process! If the injury turns from a small tear to a complete rupture, that little slip road to recovery is going to turn into the M11! Depending on your injury type and severity, this could include anything from simple 24hrs of rest, to immobilisation with crutches and a support. This changed from the R in RICE protocol to be a little more specific. Not all injuries need complete rest. Some still do however... EVERY injury is different.
The first time I heard this I thought the lecturer had been reading some wacky books. But thinking about the healing process and doing some reading, it is well known that the sooner an injured body part can become active to some extent, the better in terms of recover. To give you an example... An ACL rupture (knee ligament) would need immobilising to allow the structure to repair etc. However the surrounding muscles can still be stimulated to prevent some of the muscle loss associated with complete stop of activity. Without getting too technical... simply contracting your quadriceps muscles can provide them with enough muscular activity to prevent any muscular atrophy. Thinking about it with a quad strain and crutches... if you felt a twinge in your quad towards the end of a run and it was sore the following day, would you use crutches for a week? Course not! You may adapt your training levels but you would still walk on it. In fact, the blood "pump" caused by the muscular contractions of walking would actually help blood flow to the injury and remove toxins caused by the muscle damage.
Probably the most well known method of acute injury management. Applying cryotherapy (more commonly known as ice) to an injury can assist in reducing pain by decreasing inflammation. Ice can be applied through direct ice packs, a "Cryocuff" (image left), ice baths amongst others The cooling of the body tissues is able to produce an analgesic effect via a variety of mechanisms. Including; reduced nerve conduction velocity, inhibition of nociceptors via the gate control theory, reduction in muscle spasm, vasoconstriction and reduction in enzyme activity / cellular metabolism. To put it simply, ice stops the nervous system sending pain signals to the body. Imagine getting really drunk and writing a cringey love letter to your colleague... Ice freezes the postman's van so that he can't deliver the letter! And yes... that is the first time postmen and love letters and ever been used to describe the Pain Gate Theory...
The research behind compression is sketchy to say the least.. and I'm not sure I agree with it... You'll probably have been chucked a tubigrip bandage by your doctor if you've ever been to see him (which is why most NHS GP's are useless when it comes to sports injuries, but that's a post for another day...). From personal experience the compressed feeling of support around an injured joint can have some good psychological benefits, especially at the acute stage of an injury when you're nervous about weight bearing. The theory behind compression bandages is that it helps to manage swelling by reducing blood flow.
Again, as with the common theme of this process, the reasons behind elevating an injury are to reduce bleeding and inflammation. There's not really much more to explain with elevation!
**Consult your therapist before applying any treatments as not everyone can use the same treatment modalities!
I hope this post helps understand the immediate process of injury treatment. Give my common injuries and conditions section a read for other issues you might have! Or get in touch for a more detailed assessment and/or treatments.