Tuesday, March 6, 2012
RICE or POLICE?
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.