Police: The New Rice
Remember the old acronym RICE for first aid to minor injuries of joints, muscles, and tendons? It stands for Rest, Ice, Compression, and Elevation and is useful knowledge for self-management of minor injuries. However, as we’ve advanced our knowledge of tissue damage and repair, there has been a pivot toward a new acronym called POLICE. This stands for Protect, Optimal Loading, Ice, Compression and Elevation. Essentially, R has been replaced with POL to be more comprehensive.
Protect: the injured area. This should be the first order of business! The injured part should be protected from further disruption during this time with the use of braces, wraps, or walking aids.
Optimal Load: This could mean anything from no weight bearing to full weight bearing to gentle isometric exercise and anything in between depending on the injury.
Ice: The use of ice has been debated recently, but most agree that nothing feels better on a hot, inflamed joint than a cold pack, especially in the first 48 hours. After this time period, it’s acceptable to use heat or alternate hot and cold packs.
Compression: Wrap up that joint or strained muscle for extra support and to control any excess swelling. The right amount of compression and ice together really help control the pain.
Elevation: When there is a significant amount of swelling, raise the injured limb above the level of the heart to decrease swelling.
Initially, in muscle and tendon injuries, there will be an inflammatory phase which, depending on the extent of injury, could last from several days to several weeks. The next two phases of healing are called regeneration and remodeling. Regeneration starts about four days after injury and can last up to 4 weeks. The remodeling phase can last for many more weeks and sometimes months. It is important to talk to your doctor or physical therapist and discuss timely and safe exercise to enhance your recovery. Research has proved that optimal loading of a tendon, as in resistance exercise, promotes remodeling and leads to long-term structural and functional improvements. There is sufficient evidence that correlates exercise and the release of cellular factors that promote muscle regeneration and healing. So talk to your doctor or physical therapist about the right time and dosing of exercise for your injury.