R.I.C.E. or P.R.I.C.E. principles are well known ways to help treat an acute soft tissue injury, such as a sprain, strain or bruise, in the early days. The acronym stands for rest, ice, compression, elevation.
However, what’s not so widely known is that in recent years, the R. (Rest) element has been replaced with O.L. (Optimal Loading).
Why the change?
Some rest initially can be beneficial, immediately after suffering an injury, but only for a very short period of time. What research shows is that early mobilisation (loading) stresses tissues in the correct manner for full recovery, whereas rest can actually impair optimal recovery of soft tissue injuries. Too much rest and you’ll quickly develop joint stiffness and muscle weakness.
Some injuries may require some ‘Protection’ such as using crutches for a few days, just to take the weight off a severe ankle injury, or a splint or brace for a wrist, ankle or knee. This will help to unload the injury enough to avoid further aggravation but still allow tissue stress to help with healing. But use of such protection should be minimised as inevitably you won’t be loading the area if it’s totally protected.
The hard part of this is correctly identify what exactly constitutes ‘Optimal Loading’, as it is different for different tissues and body parts. You can often use common sense, don’t be afraid to move and use the injured area within your own limits of pain. A mild pain is to be expected but anything more and you’re probably doing too much. You need to make sure that you keep progressing what you are doing, as this will help your injury heal better and longer term help prevent re-injury.
This is where seeking help from a Physio is great. A physiotherapist will combine their knowledge of the stages of healing with what you should and shouldn’t be doing to ‘load’ your healing tissues. They will give you a tailored and progressive exercise programme to make sure the healing tissues are given the optimal chance of long term recovery.
As with any injury, always seek medical advice if you are worried or concerned or want to get it checked out before starting any self directed management.
Some of the research:
PRICE needs updating, shall we call the POLICE?
What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?