We all get soft tissue injuries from time to time, whether you’ve gone over on your ankle while out walking, fallen on ice or ran too hard at the kids sports day! The end result usually is the same – bruising, swelling and plenty of pain.
R.I.C.E. or P.R.I.C.E. principles are well known ways to help treat an acute soft tissue injury, such as a sprain, strain or bruise, in the early days. The acronym stands for rest, ice, compression, elevation.
However, what you may not know is that the R (Rest) element has been replaced with O.L. (Optimal Loading).
Some rest initially can be beneficial, immediately after an injury, but only for a very short period of time. Research shows that early mobilisation (loading) stresses tissues in the correct manner and stimulates healing, whereas rest can actually impair optimal recovery of soft tissue injuries. Too much rest and you’ll quickly develop joint stiffness and muscle weakness.
Some injuries may require some ‘Protection’ such as using crutches for a few days, or a splint or brace for a wrist, ankle or knee. This will help to unload the injury enough to avoid further aggravation but still allow tissue stress to help with healing. But use of such protection should be minimised as you won’t be loading the area if it’s totally protected.
Use common sense when thinking about ‘optimal loading’, don’t be afraid to move and use the injured area within your own limits of pain. A mild pain or discomfort is to be expected but anything more and you’re probably doing too much. Make sure that you keep progressing what you are doing, as this will help your injury heal better and longer term help prevent re-injury.
Using the knowledge of a physiotherapist can guide you on the stages of healing and what you should and shouldn’t be doing to ‘load’ your healing tissues. At The Physiotherapy Place our physios can provide a tailored and progressive exercise programme to make sure the healing tissues are given the optimal chance of long term recovery.
Forget RICE – you now need POLICE
Protection: During the first few days after an injury, you should certainly rest the injured joint, ligament, or muscle. After that, you can start gentle motion while still maintaining some protection of the injured area. During this time, you may require some sort of assistive device, like crutches, to walk.
Optimum Loading: This describes the gentle motion you can start while in the Protection phase. For example, after a shoulder injury or shoulder surgery, you should be able to progress from a few days of rest to passive range-of-motion (ROM) movement, active ROM, and finally, rotator cuff strengthening exercises. This progressive loading of your injury can help promote optimal healing, and it can prevent delays in returning to normal due to joint and muscle tightness or muscle atrophy.
Ice: Applying ice may help to manage the swelling around your injured muscle or joint, and ice can help decrease some of the acute pain that you may be experiencing. Your physical therapist (PT) can help you determine the best method of applying an ice to your injury. He or she can also teach you how to make your own ice pack.
Compression: While applying ice, you can add compression with an ACE bandage. You can also use a product like Ice Tape to cool and compress the injury at the same time.
Elevation: Elevation is simple for some body parts. An injured ankle or knee can be placed on a stack of pillows while you are lying down. An injury to your elbow or wrist requires that you elevate your entire arm on something. Your PT can help advise you on the best way to elevate your injury.
Treatment of soft tissue injuries is one of our specialties at The Physiotherapy Place. If you want to learn more or speak with an expert physiotherapist about your specific case, get in touch to arrange a FREE 15 minute telephone consultation.