We all know the acronym R.I.C.E - Rest, Ice, Compression, Elevation - often used after an acute soft tissue (muscle, tendon, ligament) injury such as an ankle sprain or pulled muscle. We know there is merit to each of these things individually with injury recovery, but as of recently, strict rest after a soft-tissue injury is being challenged in the sports medicine world. After an acute injury, brief periods of rest and unloading of the injured tissue are recommended for a limited duration to avoid further injury to the tissues and allow localized healing mechanisms to occur at the cellular level. However, studies are now showing that progressive loading of the injured tissues may be superior than R.I.C.E alone. Controlled, progressive loading of the acutely injured soft tissues can help restore tissue strength and has been shown to improve healing times when compared to strict immobilization and rest. Hence, this is where the updated acronym P.O.L.I.C.E comes into play! 

According to a recent editorial by the British Journal of Sports Medicine, P.O.L.I.C.E or Progressive Optimal Loading - Ice - Compression - Elevation, may be the best treatment guidelines to assist you in managing an acute soft tissue injury(1). Progressive optimal loading is a broad term referring to gentle, controlled forces applied to the tissues as tolerated. These forces can range from hands-on (manual) techniques applied to or near the injured tissue by your Physical Therapist to gentle range of motion or isometric muscle contractions. As the BJSM clinical commentary states, the word “optimal” will depend on multiple variables relating to the injury including nature, severity, and timing of the injury. These types of early interventions can promote recovery at the cellular levels of the injured tissues and allow them to remodel into stronger, healthier tissues. It is important to know what exercises are appropriate in the P.O.L.I.C.E model for the promotion of healing to the tissues, and that is where your Doctor of Physical Therapy at Colorado Sports Physical Therapy will guide you. Call today if you are healing from an injury and looking for ways to speed up your recovery to get back to the activities you love!

References:

1. Bleakley CM, Glasgow P, MacAuley DCPRICE needs updating, should we call the POLICE?British Journal of Sports Medicine 2012;46:220-221.