The P.O.L.I.C.E. principle may be the new way to ice and otherwise treat a musculoskeletal injury, such as a sprain or strain. The acronym stands for the five steps involved: protection, optimal loading, ice, compression, and elevation.

One thing it’s missing? Rest, a component of the long-usedR.I.C.E.method (rest, ice, compression, and elevation). Some healthcare practitioners now consider P.O.L.I.C.E. an advanced and favored approach.

This article describes how each approach differs and why the P.O.L.I.C.E. method may be the better option if you’re faced with an acute injury.

Under the R.I.C.E. method, for an injury such as asprained ankle, your healthcare provider would tell you to rest your leg and apply ice to the ankle while elevating your leg and using some form of compression (like anelastic bandage).

The thought process is that in the initial days following injury, your body brings a lot of blood and fluid to the injured site. While this aids with healing, it also causes swelling and pain while reducing therange of motion (ROM)of the joint.

1:18How to Treat a Sports Injury with R.I.C.E. Technique

1:18

How to Treat a Sports Injury with R.I.C.E. Technique

The Problem With R.I.C.E.

While the R.I.C.E. technique makes sense, it has a few shortcomings. According to some researchers, it hasn’t really been proven to work as well as many people think it does.

One study published in theJournal of Athletic Trainingfound a lack of solid evidence that the R.I.C.E. treatment for ankle sprains leads to better outcomes. In fact, some experts believe that applying ice right after an injury impedes the normal healing process.

Another problem with the R.I.C.E. technique is that many people take the “rest” phase too far when they would benefit from gentle exercises and movement.

Resting too long can lead to a loss of musclestrengthand flexibility and end up delaying healing.

Why P.O.L.I.C.E. May Be Better

Today, some healthcare providers are recommending the P.O.L.I.C.E. method instead of R.I.C.E. The P.O.L.I.C.E. method is broken down as follows:

Protection

During the first few days after an injury, you should certainly rest the injured joint,ligament,tendon, or muscle. But, after that, you should start gentle motions while maintaining the protection of the injured area.

For leg injuries, for example, 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, you should be able to progress from a few days of rest to passive ROM movements,active ROMmovements, and, finally,rotator cuff strengthening exercises.

Progressive Loading vs. Resting

Ice Application

Ice can help to reduce the swelling around an injured muscle or joint while decreasing some of the acute pain you may be feeling.

Your healthcare provider can help demonstrate thebest ways to apply ice to an injury. They can also teach you how to make your own ice pack.

Compression

In addition to ice application, you can add compression to the injured joint or muscle with an elastic bandage.

You can also use a product like Ice Tape to cool and compress the injury at the same time.

Elevation

An injury to your elbow or wrist requires you to elevate your entire arm.

When to Skip At-Home TreatmentIt is important to see a healthcare provider if there is any chance of a broken bone, dislocated joint, or other severe injuries. Signs of a severe injury include rapid swelling, a misshapen bone or joint, a loss of feeling at the injury site, or the inability to move or bear weight on a limb without extreme pain.

When to Skip At-Home Treatment

It is important to see a healthcare provider if there is any chance of a broken bone, dislocated joint, or other severe injuries. Signs of a severe injury include rapid swelling, a misshapen bone or joint, a loss of feeling at the injury site, or the inability to move or bear weight on a limb without extreme pain.

How Physical Therapy Can Help

The P.O.L.I.C.E. principle is a simple method to try on your own, although you may benefit from injury-specific instructions from anorthopedistor physical therapist (PT). This is especially true if an injured joint or limb needs extra protection.

For example, a shoulder injury may require the use of asling, while a knee ligament injury may require abraceduring the initial healing phases.

Your PT can advise you on exactly how much protection your injury requires as well as when it’s time to start using the limb again.

With the optimal rehabilitation plan, you should be able to return to normal activity without having to worry about stiffness or the loss of strength that can occur following a prolonged period of rest.

What to Expect From Physical Therapy

Summary

The P.O.L.I.C.E. method of treating an acute injury deviates slightly from the traditional R.I.C.E. method of rest, ice application, compression, and elevation.

3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wangt ZR, Ni GX.Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?World J Clin Cases.2021 Jun 16;9(17):4116–22. doi:10.12998/wjcc.v9.i17.4116American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Van den Bekerom MPJ, Sruijs PAA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GMMJ.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?J Athl Train. 2012 Jul-Aug;47(4):435-43. doi:10.4085/1062-6050-47.4.14Additional ReadingBleakley CM,Glasgow P, MacAuley DC.PRICE needs updating, should we call the POLICE?Br J Sports Med.2012 Mar;46(4):220-1. doi:10.1136/bjsports-2011-090297

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wangt ZR, Ni GX.Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?World J Clin Cases.2021 Jun 16;9(17):4116–22. doi:10.12998/wjcc.v9.i17.4116American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Van den Bekerom MPJ, Sruijs PAA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GMMJ.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?J Athl Train. 2012 Jul-Aug;47(4):435-43. doi:10.4085/1062-6050-47.4.14Additional ReadingBleakley CM,Glasgow P, MacAuley DC.PRICE needs updating, should we call the POLICE?Br J Sports Med.2012 Mar;46(4):220-1. doi:10.1136/bjsports-2011-090297

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wangt ZR, Ni GX.Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?World J Clin Cases.2021 Jun 16;9(17):4116–22. doi:10.12998/wjcc.v9.i17.4116American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Van den Bekerom MPJ, Sruijs PAA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GMMJ.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?J Athl Train. 2012 Jul-Aug;47(4):435-43. doi:10.4085/1062-6050-47.4.14

Wangt ZR, Ni GX.Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?World J Clin Cases.2021 Jun 16;9(17):4116–22. doi:10.12998/wjcc.v9.i17.4116

American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.

Van den Bekerom MPJ, Sruijs PAA, Blankevoort L, Welling L, van Dijk CN, Kerkhoffs GMMJ.What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?J Athl Train. 2012 Jul-Aug;47(4):435-43. doi:10.4085/1062-6050-47.4.14

Bleakley CM,Glasgow P, MacAuley DC.PRICE needs updating, should we call the POLICE?Br J Sports Med.2012 Mar;46(4):220-1. doi:10.1136/bjsports-2011-090297

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