P.O.L.I.C.E. protocol – the future of conservative treatment of traumatic injuries

R.I.C.E. protocol in the conservative treatment of traumatic injuries has been given a worthy successor – we present to you the P.O.L.I.C.E. protocol!

Methodsof treating sports traumatic injuries

Protection, Optimal Load, Ice, Compression, Elevation – P.O.L.I.C.E.!

Traditional methods of treating traumatic injuries of the locomotor system have proven to be useful methods of repairing such types of injuries and as such have been in use for decades, practically without exception. These are non-invasive methods whose application cannot do any harm, and can bring significant benefits in the form of reducing the extent of injury and shortening the time required for complete recovery.

All methods are based on the fact that traumatic injuries of the locomotor system are most often accompanied by bleeding or tissue damage, in which an inflammatory process develops that will result in swelling of the injured tissue. The primary goal of treating such injuries is to repair the cause of the bleeding (the source of the inflammatory process) in the shortest possible time, in order to minimize tissue edema and thus provide the tissue with an opportunity for complete recovery. The first procedure in this process is the immediate cessation of sports activity, given the fact that further continuation of activity can lead to greater bleeding and a greater extent of tissue damage, and thus to stronger symptoms and prolonged recovery time. Until recently, further remediation procedures included a number of methods covered by the acronym “RICE” – Rest, Ice, Compression, Elevation. The combination of these procedures has been proven in numerous studies and scientific papers, so their use has become a kind of axiom in the acute treatment of sports injuries, especially when we talk about soft tissue injuries. Additionally, the letter P was sometimes added to this acronym at the beginning as an abbreviation for the term Protection(PRICEprotocol).

Protectionrefers to the immobilization of an injured site in terms of preventing the exacerbation of an existing injury. Because several times more blood circulates through the muscles during exertion than at rest, the risk of massive bleeding into a muscle in the event of damage to a blood vessel increases proportionally, and it is important to reduce the blood supply by disrupting the damaged muscle.

Restis a procedure that is recommended in the treatment of all sports injuries accompanied by structural tissue damage. The tissue needs to be given time to recover and return to its original state and therefore this instruction is a routine part of conservative treatment of sports injuries.

Ice, ie cooling, is used to reduce swelling at the site of injury, but with a high level of caution. Ice should not be applied directly to the skin because there is a high risk of frostbite, and it is necessary to pay attention to the duration of its application. The effect of ice is achieved through analgesia of the injured area, but also through its effect on the blood vessels of the surrounding area, where vasoconstriction occurs and reduced blood flow, which will directly reduce the potential hematoma at the site of injury.

Elastic bandage (compression) is of great benefit since its example increases the pressure in the tissue thus reducing the blood supply to the tissue. After applying the compress, it is important to control the skin distal to the application site of the bandage, to avoid ischemia of uninjured tissue. Any appearance of cold and pale skin, paresthesia or absence of pulse distal to the placed bandage, is a sign that the bandage should be loosen.

Limb elevationis a marginal part of this procedure, but its usefulness cannot be denied if applied correctly. The limb must be at least 30cm above the level of the heart, so that gravity reduces the flow of blood to the injured area.

Currently, in the acute treatment of sports injuries, the so-called “POLICE” protocol (Protection, Optimal Load, Ice, Compression), Elevation. The only new term in relation to the PRICE protocol is “optimal load“, which refers to the load to which the injured tissue is exposed, and it is used in combination with mechanotherapy to speed up the healing process. It is important to optimally assess what load the tissue can withstand, on the one hand so as not to aggravate the existing injury, and on the other hand so that recovery is not unnecessarily delayed due to complications such as contractures, which are a direct result of inadequate therapy.


Poliklinika Ribnjak jedinstvena je ustanova na području Republike Hrvatske. Objedinjuje različite grane medicine, a sve kako bi ostala vjerna svom sloganu “Zdravlje i Ljepota. Zajedno”. Ortopedija, napredna sportska dijagnostika, funkcionalna i kineziološka rehabilitacija, estetska kirurgija i tretmani, usluge su koje pružamo svakodnevno, stručno i u skladu s najnovijim profesionalnim standardima.


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