An ankle sprain is something all of us have probably experience at one time or another, and in some cases, really struggled to get back to feeling 100% after. Well, there is a new acronym that is being utilized to help people recover from this type of injury quicker, and more effectively. That acronym is P.O.L.I.C.E. (protection, optimal loading, ice, compression, and elevation) and it helps correct the element of “rest” that the previous acronym, RICE (rest, ice, compression, and elevation) was based on. Don’t get me wrong, rest is an important part of any healing process, but is often misunderstood by patients. P.O.L.I.C.E. adds different components to the rest side of healing in that it states protection and optimal loading are better adjectives to describe this part of the process. I will explain each letter and how it helps the healing process. A reminder is needed here: your body has to repair itself but these steps will help put it in the optimal environment for recovery.
P: Protection: a brace, tape job, or splint that will limit the amount of additional injury you cause to the injured body part. Examples: crutches, walking boot, ankle brace, knee brace, etc.
OL: Optimal Loading: this is a crucial element that needs to be utilized and is often overlooked because of fear of causing further injury. Optimal loading is a fancy way of saying moving the injured body part as soon as possible without pain. It has been proven that the sooner a person can regain normal range of motion and strength around the injury, the quicker the body is able to heal. By doing exercises as simple as ankle pumps to gain movement back after an ankle sprain, or flexion and extension exercises at the knee after a knee injury, helps make sure that inflammation isn’t allowed to settle in the joint space and really lowers the time it takes for the joint to regain movement and strength.
I: Ice: ice is a vasoconstrictor along with having analgesic effects on the nerves that it comes into contact with. By constricting the blood vessels around the injury, it helps limit the amount of fluid that will travel to the injury site which in turn, lowers the amount of inflammation the joint will experience. The analgesic effects help limit the pain experienced around the injury because it lowers the nerves ability to conduct signals back to the spinal cord. A general rule for duration of treatment is 20 mins. on: 1 hr. off.
C: Compression: by applying compression to the injured limb, it helps stops edema, which is the pooling of fluid around the injury site. Compression should be applied to the injured limb quickly after an injury to keep the blood and bodily fluids moving away from the injury site. When applying a compression wrap, one rule must be followed: always start wrapping distal (below/farthest from the heart) the injury and move proximal (above/closest to the heart) the injury loosening as you move up. For example, with an ankle sprain, start wrapping at the toes and move up the leg towards the knee.
E: Elevation: let gravity be your friend and utilize it to help keep edema from forming. Get the injured limb above your heart so that the blood and fluid is forced to move back to the core of the body.
For the best results, all of the components of P.O.L.I.C.E. need to be utilized simultaneously and in conjunction with one another.
Kyle Johnson, MS, ATC
Augustana College Assistant Athletic Trainer