By Rob Clarke Driven Sports
Nothing sucks more life out of the eager trainee than an injury. If you’ve suffered some sort of setback you need to get yourself healthy again as soon as possible. The latest research in the field of injury treatment suggests how you can go about this.
Injuries ruin motivation, can depress your outlook on other aspects of life, and in pretty much all cases will cause you to look worse than you did. This is the exact opposite of what we want. If you aren’t healthy, you can’t train to the best of your ability, and that limits progress.
Being healthy pays, so it is in your best interests to take precautions with your training, like leaving your ego at the door and performing an adequate warm-up. This greatly reduces the chances of you sustaining an injury. But an unfortunate fact of life is that “**** happens”, so what should you do in the event of suffering a musculoskeletal injury?
Previously I’ve discussed other strategies for injury recovery, such as the platelet injections and stem cell treatment. A similar practice involves the supply of growth factors to the damaged area, such as IGF-1 injections. However these are semi-invasive treatments that are carried out after a consultation with a specialist You can take measures to maximise your recovery from injury as soon as it occurs, and this is where POLICE comes in.
Getting the R out of RICE
ICE is a classic mnemonic describing common first aid for injury. ICE involves icing the injured area (I), compressing it (C), and elevating it (E). These steps are aimed to minimize inflammation of the injured area, and minimize pain felt by the injured party. You may notice that I have omitted part of the mnemonic – rest. Including this gives us the phrase RICE which many of you may be more familiar with.
The reason for this omission is because the period of rest should be restricted to immediately following the trauma, but not thereafter. Prolonged periods of immobilisation can have negative repercussions, such as altered biomechanics of the tissue, and impaired strength recovery of the tendons. In other words, it can alter your normal range of motion and make you weaker over certain portions of a lift. Not good.
Minimizing rest is applicable at least for partial muscle or tendon damage. If the muscle or tendon is completely severed then the only course of action is surgery, but most cases of soft tissue injury from training are rarely this severe. A lot of the time it is a partial rupture or sprain, and in this event ICE typically comes first followed by active recovery.
Sports therapy researchers from the University of Ulster and Queens University Belfast, both in Northern Ireland, have recently collaborated for an editorial aimed at stimulating further research in the field of soft tissue healing. This was published recently in the British Journal of Sports Medicine. In it they describe the concept of functional treatment for injury, and introduce the mnemonic POLICE.
POLICE maintains the classic ICE aspect for immediate aid following trauma, but they introduce two new additions – Protection (P), and Optimal Loading (OL).
Protection is used over rest because it describes the action of avoiding future injury to the area, but does not suggest a concept of long-term restriction or immobilization. Soft tissue healing is improved by actually exercising as it induces a cellular response, causing the release of healing hormones and proteins. The trick is to find the correct balance of intensity for the exercise so that you can induce this healing protein expression while not causing further damage to the injured area. This is optimal loading.
ICE is skating on thin ice
The authors of the editorial suggest that rehabilitation strategies should be researched in order to optimize methodologies for recovery based on the nature and severity of the injury. Interestingly, they maintain the inclusion of ICE in the mnemonic mostly due to the often-reported pain-relieving effect and supportive nature it confers. As it happens there are very few studies supporting the idea of elevation following trauma. Strangely, the idea of compression stems from the recommended management of lymphatic swelling and deep vein thrombosis (DVT). These are two separate medical issues that are completely unrelated soft tissue damage, and the swelling noticed in response to injury is of a very different sort.
The practice of icing an injury isn’t untouchable either. In fact, a recent study - considered the first of its kind - actually investigated the effect that regular icing had on the recovery of a calf muscle tear. Well, technically it was looking at how feasible a larger study would be with this focus. They would need 396 participants with very similar muscle tears in order to conduct a proper analysis, and this study only used nineteen. But the fundamental finding of the small-scale study was that icing the tear did not help speed up the recovery. Interestingly it also didn’t appear to help with any pain relief either.
Today they refer to the latest mnemonic as POLICE, but if their intention of further research is carried out, this time next year it may simply be POL. Unfortunately that is much less catchy, but if it eliminates unnecessary practice that takes up time that could be spent doing productive active recovery then it can only be a good thing.