We are all likely familiar with that acronym, PRICE, (Protection, Rest, Ice, Compression, Elevation) that we use to manage acute injuries. However, this has become a bit of a controversial subject today and research indicates that perhaps modifications to our old methods just may be in order. A new acronym POLICE, which includes the traditional components of PRICE, adds Optimal Loading, which may just be a better method of managing your acute injury.
Although there have been many studies done on PRICE as a therapeutic intervention, the problem is that there is a lack of high-quality research and evidence in the literature.
Optimal loading and rest
We do know that protection and modified rest after injury are supported by the research and are necessary to unload and/or prevent joint movement for a period after an injury.
However, it appears that SHORT periods of unloading/rest are best after acute soft tissue injury and needs to be combined with modified activity to promote proper healing.
Rest should be of limited duration and restricted to immediately after trauma. Longer periods of rest are harmful and produce adverse changes to the tissue biomechanics, while gradual early loading of the joint or tissue with controlled activity and exercise is more likely to restore the strength of the tissue.
It is important to stress controlled activity. Excessive movement, lack of protection or aggressive movement will obviously cause further damage or re-injury so it is important to protect the tissues while still find that optimal or “sweet spot” of optimal loading. The challenge is in determining what is ‘optimal’ in terms of the dosage, nature and timing. A good rehabilitation plan is what you need! Check with your physiotherapist to ensure you are on the right track.
To ice or not to ice
Sometimes the pain from an acute injury is hard to take and icing WILL help to manage that pain.
However, when there is an injury to an area in your body, our immune system jumps into action and responds by producing inflammatory cells which head over to the injured tissue. These cells release a hormone that helps to repair the structure of injured tissue.
Some studies have indicated that if ice is applied to the area with the intent of removing the swelling it interferes with proper blood flow due to vessel constriction and also removes inflammation which prevents the release of this repairing hormone and then the inflammatory cells can’t reach their target.
The best icing technique appears to be 5 minutes maximum of cooling followed by 20 minutes of no ice for the first 12 hours after the injury.
We obviously need more study on this but the evidence we have today suggests we move cautiously away from prolonged icing to more moderate icing, at the most appropriate time in an injury’s timeline.
Need advice on your acute injury? We can help….
Services Offered:
Acupuncture
Dry Needling
Intramuscular Stimulation (IMS)
Physiotherapy
Virtual Physiotherapy
