Acute Injury Management Best Practice: Ice, RICE, PRICE, or POLICE?

Not sure how to best manage a new injury? Maybe you can't get in to see your doctor or physio until a few days later. This post outlines the current best practice guidelines for most acute soft tissue injuries.

*If you think you have a serious injury or are in a significant amount of pain. I recommend you see a doctor ASAP. The management strategies listed below are only for mild to moderate soft tissue injuries.

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1. Ice - The traditional approach

Anyone in the sporting world is probably familiar with ice. Ice is generally the go to after an initial injury. Ice helps to numb the pain and potentially reduce inflammation and the swelling that comes with it.

Recommended 15 min of ice max at a time

2. RICE - A more complete approach

R - Rest (doing nothing is not recommended for most minor/moderate injuries)

I - Ice

C - Compression (main purpose is to reduce swelling)

E - Elevation (above the heart, purpose is to reduce swelling)

3. PRICE - Adding Protect to RICE

P - Protect (avoid hurting the injury site, usually this means keeping the pain under a 3/10)

R - Rest

I - Ice

C - Compression

E - Elevation

4. POLICE - Widely accepted as the best overall approach (Replace Rest with Optimal Loading)

P - Protect

OL - Optimal Loading (early movement and usage of injured area within tolerance)

I - Ice

C - Compression

E - Elevation

5. PEACE & LOVE - a new and more comprehensive method - no more ice!!!

PEACE - basically the same as PRICE but without the ice

LOVE - pretty much Optimal Loading but more detailed

The key differences:

-There is finally a psychological component

-It recommends avoiding ice *GASP*

Avoiding ice doesn't mean you shouldn't use it at all. The advocates of PEACE and LOVE basically are saying that inflammation is part of the body's natural healing process and if you reduce it too much it could negatively impact how well you heal from an injury. Swelling still needs to be managed but try to avoid anything that gets rid of the inflammation at the same time.

Their recommendation for ice is to use it only for pain relief if necessary.

For more detail I recommend clicking on the picture and reading the original article from the guy who developed this.

Summary:

POLICE or PEACE & LOVE are the only ones i recommend to patients. Everything else is too outdated and while they work, they are sub-optimal. PEACE and LOVE will probably replace POLICE in the future as the best research supported recommendation (right now not enough people have heard of it)

Self management should always include these components:

1. Protection (keeping the pain to a minimum - usually a discomfort at most)

2. Swelling management - compression, elevation, blood flow and maybe ice?

3. Optimal loading - use the painful limb as much as you can comfortably tolerate

Again, I only recommend following this if you are sure your injury isn't serious.