The P.O.L.I.C.E. Principle is a new way to approach an acute injury.

In the past, physiotherapists, doctors and specialists have recommended the R.I.C.E. principle following an acute injury.  This acronym stands for Rest, Ice, Compression, and Elevation. However research has shown that this isn’t necessarily the best way to optimise recovery. Often after an acute injury, a little bit of rest is necessary.  But one problem is that many people may rest for far longer than is actually needed.  A long period of rest can actual delay recovery by leading to stiffness and weakness. Therefore the P.O.L.I.C.E. (Protect, Optimal Loading, Ice, Compression and Elevation) is now the best way of managing acute injuries.

The P.O.L.I.C.E. principle is now recommended to help promote healing and recovery.


Following injury, a short period of rest or immobilisation can help. During this time a splint or brace may be used (or crutches for lower limb injuries). The length of the rest period will depend on the severity of the injury. For most injuries 2 to 3 days rest is sufficient. For severe ligaments sprains up to 10 days rest may be required.

Optimal Loading

While protecting the injured body part, gentle movement should be started early. For example, in acute lateral ankle sprains introducing gentle walking early, has been shown to reduce swelling and improve early return to work and sports. Optimal loading can help promote healing of the injury and reduce joint stiffness and muscle weakness. The optimal loading for each injury will depend on the specific injury.


Applying ice can help to reduce swelling and reduce pain around the injured muscle or joint. After an acute injury ice can be applied every 2 hours for 20 minutes for the first 2-3 days. A plastic bag containing crushed ice or a commercial ice pack can be used. A wet towel should always be used between the ice pack and the skin to prevent ice burn.


A standard elastic bandage is a cheap effective tool to help control swelling. Bandaging should start distal (down) from the injured part and extend above the site of injury. Overlap each layer overlapping by 50% and use light to moderate pressure.


This is useful to reduce swelling and pain. An injured ankle or knee can be rested on pillows, however it is important that the leg is above the level of the pelvis. To elevate an elbow or wrist a sling can be used.

Physiotherapy will ensure that optimal loading and proper healing occurs. If you have suffered an acute musculoskeletal injury like a sprain or muscle strain, booking an appointment at Better Health is a good first step in your care. I can advise you on exactly how much protection your specific injury needs and when you can start using it again. Performing exercises will allow your injured muscle or ligament to heal properly.  Physiotherapy will ensure that optimal loading and proper healing occurs by progressing your exercises as your injury heals.

Janette O’Toole

Janette O’Toole

Principle Physiotherapist
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