Tuesday, March 6, 2012

RICE or POLICE?

I came across this recent article in the British Journal of Sports Medicine (What? Doesn't everyone browse through that journal?!) and I'm always up for challenging old ways and old acronyms as these scientists do.

Many of us have learned to respond to a soft tissue injury with RICE (rest, ice, compression, elevation) or PRICE (protection+RICE). Researchers from the University of Ulster synthesized recent research and suggest that rehabilitation with a POLICE approach can result in a shortened and more thorough recovery.

POLICE stands for protection, optimal loading, ice compression and elevation. The key difference is the concept of optimal loading rather than rest. Animal models have shown that “mechanotherapy” or a progressive loading of the affected limb can stimulate and accelerate healing. They state, “rest should be of limited duration and restricted to immediately after trauma. Longer periods of unloading are harmful and produce adverse changes to tissue biomechanics and morphology.” The trick is finding that level of optimal loading. This doesn’t mean the end of braces and crutches, but rather they should be thought of as tools to help with the progressive loading in the return to full function. The article indicates that modalities such as massage can be thought of as a type of mechanotherapy and have a place in recovery.

I suspect most runners and triathletes would overshoot "optimum" levels of loading but it's reassuring to know that total rest is not ideal either.


Bleakley, C.M., Glasgow, P., MacAuley, D. C. (2012). PRICE needs updating, should we call the POLICE? British Journal of Sports Medicine, 46(4) 220-221.

1 comment:

  1. It's a well known concept in equine rehab. After the initial swelling is brought under control and the injury has begun to heal, horses will be hand walked, jogged, even dropped in a swimming pool. The theory, in layman's terms, is that light controlled work will cause the scar tissue to develop in a neat, functional, linear pattern. Without this loading, the scar tissue will develop a in a messy pattern that will compromise strength and mobility in the injured area. Use it or lose it... though I can say first hand how hard it is to be on a leash short enough to avoid re-injury. I'm glad I didn't have to live with me last summer!!

    (I totally read stuff like that.)

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