Did You Just Get Injured? Forget Rice, Call In The POLICE!

Man getting physical therapyIf you've had an injury in the past few decades, you have probably been told about the RICE method of recovery. That is Rest, Ice, Compression, and Elevation. This has been the standard treatment for years and years. I started to hear people saying that it wasn't as effective as it should be and they recommended MICE instead which replaces rest with movement. That has it's own problems as too much movement can cause more injuries. Let's take a look at some of the newer methods of treatment.

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Problems With RICE Treatment

In the orthopedic world, sprained ankles are like the common cold. Over 28,000 people sprain their ankles every day in the U.S., usually on the outside of the joint. It's an injury where the ankle turns inward on impact. And if they're not treated properly, 30-40% of patients can endure persistent problems.

Researchers are now blaming some of these persistent problems on the immobilization step of RICE. “The idea of complete rest used to dominate all of orthopedic medicine,” says certified orthopedic specialist Eric Robertson, PT, DPT, director of Kaiser Permanente Northern California Graduate Physical Therapy Education in Union City, California. “Whether it was back pain or an ACL tear, you’d be in a body or leg cast for 6 weeks.”

Current research now suggests that a long period of rest can affect your recovery in a negative way. When an injury occurs to the ligaments, the body lays down scar tissue in a cross-hatch pattern instead of the normal parallel pattern, and that can create weakness. Realignment of these fibers is achieved through the use of the tissue which is why those who immobilize an injury are more likely to reinjure the affected area.

Injuries the ligaments that support the ankle also contributes to problems with balance. And, if you stay off that foot, it can propagate that problem. The sooner you can get on the leg and move it in a carefully, controlled manner, the better it's going to do. Tissue normally responds positively to force so getting on the foot right away is the goal.

A 2012 review study gave early movement a green-light. It found that people who followed early mobilization, some during the first week after an ankle sprain, enjoyed a shorter recovery period and better range-of-motion than those sticking to the standard RICE protocol.

Let The POLICE step up

If you've sprained your ankle, knee, wrist, or other joint, the first step you need to do is to make sure it's not something more serious. If you can't bear any weight on it, it's extremely tender, there was rapid swelling or visible deformities, get it checked out. You may have to go to an ER or urgent care, but more and more orthopedic clinics take same day appointments.

If the problem isn't a fracture or tear, your best bet is a new treatment acronym called POLICE. This stands for:

  • Protection
  • Optimal loading
  • Ice
  • Compression
  • Elecation

A visit with a physical therapist can show you the right way to move your foot, leg, or arm, to improve healing and protect it from further injury.

A therapist may also suggest balance exercises to help build the supporting muscles and reduce the chance of future sprains. There are predictable patterns of weakness, and the exercises can help.

Manipulation of the affected area is another form of treatment the therapist may use. Moving the joint around just after a sprain can be really helpful in healing. The problem, is this part of therapy can be painful and you need to provide feedback so they don't move it too much.

Your doctor may also suggest taking an NSAID such as ibuprofen or naproxen sodium during the first day or two to help relieve pain. But these medications can also impede healing by suppressing inflammation and can hurt your GI tract. With that said, one of my doctors has suggested I continue to take one of these (my choice is Aleve which is naproxen sodium) daily to keep the level in my blood up and help with day-to-day pain.

So What Should You Do?

As with all injuries, seek the advice of a medical professional if you're not sure. If it is a sprain, try getting some weight and movement into the joint as soon as possible. If possible, you can help from a physical therapist to help in your recovery! I find mine PT to be invaluable in aiding not only my recovery but in helping prevent future injuries.

Do you have questions on RICE or POLICE? Let me know and I'll find an answer for you!

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