How do I take care of myself after an injury?
Immediately after a new injury, the acronym RICE for self-care may come to mind: Rest, Ice, Compression, and Elevation. The use of RICE treatment dates back to the late 1970’s, and for most people the goal of this protocol is to reduce inflammation, reduce pain, and perhaps improve the rate of healing.
But like much of our world, things have evolved since the seventies and as new evidence becomes available, our RICE protocol after an acute injury has been updated. Step aside RICE, make way for POLICE: Protection, Optimal Loading, Ice, Compression, and Elevation.
There are two key differences when comparing RICE and POLICE. The first difference is the addition of ‘protection’, and the second is the removal of ‘rest’, which has been replaced by ‘optimal loading.’ It was originally thought that once you experienced pain in a limb or a body region, we needed to rest and avoid all pain-provoking activities to ensure we didn’t cause more damage. However, thanks to modern pain science, we now know that pain with movement after an acute injury is normal and it is not always associated with tissue damage. In fact, pain is more a measure of perceived threat or danger by the nervous system.
When recovering from an injury, you want to find activities that are comfortable and well tolerated... we call this 'optimal loading'. As a rule of thumb, try to find a way to do activities that cause no more than 5 out of 10 on the pain scale to describe your optimal loading. If there is an activity that is causing more pain than 5 out of 10 on the pain scale, see if you can find a new way to get the task done temporarily, then re-attempt in a few days to check for improvement. Usually it’s beneficial to speak to a physiotherapist to learn where your optimal loading strategy should start.
Think ‘rest is rust, motion is lotion’ and POLICE your injury.
After a very short period of protection or reduced use of the injured body part, it is important to start to find the optimal loading strategies. Studies show that moving quickly after an injury is important and accelerates recovery. Gradually get back to your activities of daily living for optimal recovery.
To assist with pain and recovery, you may decide to use ice which will help reduce the pain temporarily. When using ice, always ensure there is a towel between your skin and the ice, and remove the ice after 10 minutes. If there is visible swelling in the area, you could add compression with a bandage wrap and elevate the limb. If you are ever unsure, speak with your physiotherapist to discover how to get your injury on the road to recovery.
By Sean Overin, Physiotherapist