Since sports have returned after the Covid-19 restrictions have been lifted we have seen an influx or soft tissue injuries in the clinic. Given these types of injuries we are going to talk about the new way of approaching soft tissue management. Most people are aware of the RICE (rest, ice, compression and elevation) principal for soft tissue injury management, however this has recently been changed to POLICE (protection, optimal loading, ice, compression and elevation). The main difference being the optimal loading versus rest. The acronym will be explained below:
- PROTECTION – Depend on the injury and severity, protection of the injured area may be required. For example, with a lateral ankle sprain (LAS), either a brace or boot may be required in the early stages to protect the ligament to allow for healing to commence and pain/swelling to reduce.
- OPTIMAL LOADING – Load soft tissue injuries actually helps with the remodelling of the tissues and adequate healing. However, the load should not exceed the amount of load the injured tissue can currently tolerate as this can cause more pain and swelling. For example, with a minor LAS gentle walking early in the injury can be commence and is favourable for recovery. In more severe cases where they might be in a boot for protection, the person can still start gentle range of movement exercises out of the boot. This is always best to check with your physiotherapist the adequate amount of load for the injured area.
- ICE – Applying ice for 20 minutes every 2 in the first 2 to 3 days helps to reduce pain and swelling of the injured area. This can continue after the initial 2 to 3 days but doesn’t have to be as often.
- COMPRESSION – Applying a light compression sock or bandage around the injured area also helps to reduce swelling of the injured area. For example, with a LAS a compression sock should be used in the initial stages of the injury. Once swelling has resolved it is no longer needed.
- ELEVATION – Elevating the injured limb above the heart of the body will help to reduce swelling. For example, with a LAS laying on your back with your leg on 2 to 3 pillows to have the ankle above the heart. This can be done several times a day.
While the P.O.L.I.C.E. Principle is recommended immediately following an acute injury, it is ideal to visit a physiotherapist who can determine the best management for your injury. You will be guided as to how to perform optimal loading, with simple exercises and motions that would allow your injured muscle or ligament to heal properly. And as your injury heals, your physio can prescribe other exercises that would further help in your recovery.
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