Acute injury management – POLICE vrs RICE

Most of us have heard than the way best way to manage an acute injury is by PRICE. That’s Protect, Rest, Ice, Compression and Elevation. However there is recent evidence to suggest that Rest should be replaced with Optimal Loading.


So why replace rest with “optimal loading”?cartoon-police

  1. While rest may be helpful in the very short term, continued rest may lead to deconditioning of the tissues – joint stiffness, muscle weakness and tightness and reduced proprioception (control and balance)
  2. Optimal loading will stimulate the healing process as bone, tendon, ligament and muscle all require some loading to stimulate healing.
  3. The right amount of activity can help manage swelling. For example in the ankle, contraction of the calf muscles helps to move swelling up the body against gravity. Complete rest would the prevent this.

The key word here is optimal.

In some cases optimal loading may be no loading. Unstable fractures, complete tendon ruptures etc are unlikely to benefit from loading and may require casting, bracing or surgical repair. There is no recipe for this, each situation needs to be managed based on the person and their injury and usually under the guidance of a health professional.


Bleakly CM, Glascow P, Mac Auley DC Price needs updating, should we call the POLICE? Br J Sports Med 2012.


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