P.O.L.I.C.E – Acute Injury Management
For years, people have been advised to complete rest following injury. The most well-known acronym for managing acute injuries is the R.I.C.E principle. This stands for Rest, Ice, Compression, and Elevation. However, in 2012, a new study indicated the best care for an acute injury is now P.O.L.I.C.E.
Let’s explain what this means:
Look after the injury site, and be more vigilant and conscious not to twist, turn or roll the joint. It may be helpful in this period to use crutches, braces, casts, etc, to allow the area to heal. Taping joints such as the ankle and wrist can be helpful to minimise excess movement.
This is the key difference. While rest may be beneficial in the short term, it can lead to increased joint stiffness, muscular tightness, weakness and decreased balance and stability. Optimal loading will facilitate a healing response from your body and stimulate tissue repair. It is important to remember that this is not the case for all injuries. For example, a fractured bone will need to be cast alone.
However, with a simple ankle sprain, you can immediately begin mobility, balance and strengthening exercises. We recommend that our patients begin loading as pain allows in the clinic. Avoid living in fear of pain. You need not be 100% pain-free before beginning your rehabilitation journey.
This is always a popular topic. Unfortunately, there is no conclusive evidence that the application of ice reduces swelling post-injury. We do know that it can certainly provide local pain relief by numbing the area.
Please be careful with this, as over-application can cause a skin burn. We recommend a 10-minute application with a cloth between the ice and your skin. If this isn’t a viable option, keep moving the ice to cause some friction.
Another topic where there is inconclusive evidence. However, compression is very important in conditions such as lymphoedema for reducing swelling and therefore from clinical experience, we do recommend its use. Remember not to apply your compression bandage too tightly as it can restrict circulation.
It is a simple but very effective method of managing swelling. The aim is to keep the injured area above the level of your heart.
Remember, complete rest isn’t always the answer. The next time you get an injury, think about the P.O.L.I.C.E principle. As always, P.O.L.I.C.E is not applicable for all injuries and we recommend seeing a professional for advice.