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Police: Protection, Optimal Loading, Ice, Compression & Elevation

A Physio’s Physio Journey: – The Importance of Ice! 

We all know that in that acute phase post soft tissue injury POLICE (protection, optimal loading, ice, compression and elevation) is our main go to treatment method. However, even though this acronym is a hugely helpful healing tip for controlling swelling I still find that I have to discuss and strongly advice its importance to clients. With the importance of regular icing being the main topic. 

Swelling is a normal reaction of the body to injury and is part of the inflammation process. Inflammation is the body’s first step of starting to heal. With inflammation there is increased redness, heat, swelling and pain to the injured area. Redness and heat are caused by increased blood flow to the place of injury. Swelling is caused by increased movement of fluid and white blood cells to this area. Pain is caused by the release of chemicals and the compression of nerves around the area. This swelling and pain prevents you from wanting to use this injured body part and thus protects you from causing further injury. It’s very clever but when this response continues and becomes excessive it can cause more damage than good. 

Using ice as a treatment method is call Cryotherapy and it is great for helping control this unwanted swelling. Cryotherapy helps swelling as it provides a local anaesthesia and decreases oedema, cellular metabolism, local blood flow and nerve conduction velocities. In this acute phase of injury (the first 72 hours) icing the area of injury for 20 minutes (no more than this!) every 2 hours can really help with swelling and pain. Following this (especially if you have an operation like me) you will get some flare ups. Especially following activities like a progression in your exercise programme, a day where you have been on your feet a lot or prolonged sitting. When this happens take the time to get your feet up and get some ice on to that area. 

Here I am icing my knee with a bag of frozen sweetcorn at a friend’s. She had kindly put on a high tea to get me out the house. I am aware that I am having a glass of bubbly but this was 10 days post op. I was no longer having to follow the HARM (heat, alcohol, re-injury and massage) acronym which are things to avoid 72 hours post injury. 

• When applying ice to the injured area make sure there is no direct contact between the ice and the skin by wrapping the ice up. 
• Do not ice for longer than 20 minutes at a time. 
• Do not ice if you have any circulatory/ vascular conditions or reduced sensation/ numbness. 
• If your swelling is caused by a chronic issue or if you have any adverse effects from icing you should see your doctor.