Is POLICE Better Than RICE for Sprains and Strains?

For so many years now, therapy for ankle strains or sprains, at least as first-aid in many cases, has always been Rest, Ice, Compression, and Elevation or more known in the sport medicine world as RICE. But lately there have been strong moves from various sectors, such as the editorial in the British Journal of Sports Medicine, to replace this traditional therapy with another one known as POLICE or Protection, Optimal Loading, Ice, Compression, and Elevation.

Alarming Rate of Injuries and Recovery

Triggering the unexpected attention to these conditions are the alarming statistics associated with ankle injuries and their unsatisfactory rates of recovery. In a recent issue published by the American Journal of Medicine, it was reported that 28,000 ankle injuries occur every day and that only 35 to 85 percent of sprained ankles are healed in three years.

Loading and Protection Instead of Rest

One aspect of RICE therapy that was highlighted by physical therapist was in the area of rest. It was their position that longer periods of rest may be harmful and may produce changes to tissue biomechanics and morphology. They believed that the period for rest should be limited and should only be done immediately after the injury.

According to Eric Robertson, the spokesperson for the American Physical Therapy Association and a professor at the Regis University in Denver, Colorado, injured patients should start moving the sprained or strained parts soon after the injury. He added that the old method of giving it rest is not supported by medical science but largely on educated guessing.

Referring to the 2013 guidelines set by the National Athletic Trainers Association (NATA), grades 1 (stretching and damage to ligament fibers) and 2 (partial tearing of the ligaments) of ankle sprains should involve functional rehabilitation or treatment that involves movement of the affected ankle soon after an injury. This does not mean compelling injured patients to make movements with their ankles immediately. This simply means starting range-of-motion routines after a number of days and followed by gradual loading. Manipulation by trained therapists of the affected joints may also be very beneficial.

For the more serious sprains that may be manifested by a complete tearing of the ligament (grade III), the affected joint may have to be immobilized for at most 10 days. Immediately thereafter, the patient should start moving the affected joint.

RICE May Still Have Its Place

Even with these developments, there are still medical experts who support the traditional RICE. It was pointed out that RICE is not meant to be the regular treatment but only as a first-aid guideline in situations such as waiting to be taken to the doctor or the emergency room, especially when the injury happens on a weekend.

It has been acknowledged that while these injuries may seem minor, they can have a huge impact on the daily life of the patient. That is why the attention of the proper health care providers who have the experience and competence is vital in these cases.