Acronyms have been used as memory tricks for a long time to provide advice on the early stages of healing from acute injury (eg. knee sprain, strained shoulder muscle, etc). One of the first used for healing was RICE: Rest, Ice, Compression, and Elevation. PRICE was later introduced, adding ‘Protect’ to the list.

More recently, POLICE and PEACE & LOVE have been adopted as more research has come out regarding best practice for healing.

In this blog post, we will discuss how acronyms can guide the management of acute injuries and provide examples.

POLICE

Protection, Optimal Loading, Ice, Compression, and Elevation

The first step in managing an acute injury is Protection. This involves protecting the injured area from further damage or injury. For example, if you have sprained your ankle, you may need to wear a brace or tensor wrap, or use crutches to protect the ankle from further damage.

Next on the list is Optimal Loading. This involves applying the appropriate amount of pressure/stress to the injured area to promote healing without causing further damage. For example, in the case of a muscle strain, you may need to gradually increase your activity level to promote circulation to the affected area.

The third step is Ice. Applying ice to the injured area can help reduce inflammation, swelling, and pain. Ice can be applied for the first 7-14 days after an injury (or longer if the region still feels warm and swollen) for up to 20 minutes at a time, several times a day, until the swelling and pain subside. My top tip is to use a damp towel between the ice and skin to get the cold sensation into the body the fastest. Once the region feels numb you can remove the ice and let the area warm back to body temperature before applying ice again.

Compression is the fourth step. This involves applying pressure to the injured area to reduce excessive swelling. Compression can be achieved through the use of a tensor wrap, compressor sock/sleeve, or submerging the affected region in warm (ie. hydrostatic pressure). Note: the compression should not limit your circulation below the affected region (ie. avoid numbness/tingling).

The fifth and final step is Elevation. Elevating the injured area above the heart can help reduce swelling by promoting the drainage of excess fluids. For example, if you have injured your knee, you may need to prop your leg up on a pillow/stool to elevate it.

Now let's look at two examples of acute injuries and how the POLICE method can be used to manage them.

Example 1: Ankle Sprain

An ankle sprain is a common acute injury that occurs when the ligaments that support the ankle are stretched or torn. The POLICE method can be used to manage an ankle sprain as follows (note: this list is not a substitute for a proper assessment with a trained professional, such as a Physiotherapist):

• Protection: Use crutches or wear a brace to protect the ankle and prevent further injury.

• Optimal Loading: Gradually increase activity level as the ankle heals. Start with simple range-of-motion exercises and progress to more strenuous activities as tolerated.

• Ice: Apply ice to the ankle for 20 minutes at a time, several times a day, until the swelling and pain subside.

• Compression: Apply a compression bandage or sleeve to the ankle to reduce swelling and promote healing.

• Elevation: Prop the ankle up on a pillow to elevate it and reduce swelling.

Example 2: Hamstring Strain

A hamstring strain is an acute injury that occurs when the muscles at the back of the thigh are stretched or torn. The POLICE method can be used to manage a hamstring strain as follows (note: this list is not a substitute for a proper assessment with a trained professional, such as a Physiotherapist):

• Protection: Avoid activities that may further strain the hamstring. Use crutches if necessary to avoid putting weight on the affected leg.

• Optimal Loading: Gradually increase activity level as the hamstring heals. Start with gentle range-of-motion exercises and progress to light stretching and strengthening exercises as tolerated.

• Ice: Apply ice to the affected area for 20 minutes at a time, several times a day, until the swelling and pain subside.

• Compression: Apply a compression bandage or sleeve to the affected area to reduce swelling and promote healing.

• Elevation: Prop the affected leg up on a pillow to reduce swelling.

PEACE & LOVE

Extending on POLICE, Blaise Dubois and Jean-Francois Esculier (2020) introduced the acronym "Peace & Love" to guide the management of acute sports injuries from initial onset through to later healing stages. It provides another meaningful advancement in how I, as a Health professional, approach injury management.

The "Peace" component stands for Protection, Elevation, Avoid anti-inflammatory modalities, Compression, and Education. Immediate protection of the injured area is recommended to prevent further damage. Elevation and compression can help reduce excessive swelling. It suggests anti-inflammatory medication should be avoided during the first few days of injury (note: this is not a substitute for professional advice from your prescribing healthcare professional), as should icing. Education regarding the nature of the injury and its expected course is essential to ensure a safe and effective recovery.

The "Love" component emphasizes the importance of optimal loading, optimism, vascularization, and exercise. It suggests that early mobilization and gradual loading of the injured area can promote healing and reduce the risk of further injury. Optimism and positive thinking can also have a significant impact on the recovery process as it promotes a engagement in the recovery program and reduces catastrophizing thoughts about how severe the injury is and your potential for healing. Adequate blood flow to the injured area can be facilitated by light exercise and movement, which can also help to maintain joint range of motion.

Not sure what acronym to use or how to approach healing your injury? Get in touch and I would be happy to help you recover to your fullest potential!

References:

1. Dubois, B., & Esculier, J. F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British journal of sports medicine, 54(2), 72-73.

- Thanks for reading and keep looking for more posts in the future on other ‘hot topics’ in the world of Physiotherapy and Physical Rehabilitation!