Five years ago, when someone sprained their ankle, what did everyone tell them to do? RICE! Rest, ice, compression, and elevation!
Some of the ideas behind the old acronym for acute injuries remain the same, but RICE was often taken too far. Individuals hindered their recovery by resting the injured body part too long. Because of this, RICE has been replaced by a new acronym, POLICE:
P: Protect the injured joint, ligament, or muscle – this means resting the area for a few days, and then after that, when you do start moving the area, continuing to protect it (for an ankle sprain, this might look like using crutches).
OL: Optimal Loading – while still in the protection phase but after a few days of rest, you should start gently moving the joint, first passively, then actively, and finally with exercises. In the past, injuries often lead to lots of muscle atrophy and stiffness; this optimal loading focuses on beginning to move and strengthen the muscle at the appropriate time rather than getting stuck in the “rest” phase as the muscle continues to weaken and the joint stiffens up.
I: Ice can help temporarily decrease the swelling around your injury. The inflammation is one of the contributors to the pain you feel around your injury, so icing for 20 minute increments can help manage your pain.
C: Compression can also help with swelling. Think: ACE bandage, compression sock, etc.
E: Elevation: Placing the injured body part up is another means of reducing swelling and inflammation. If your ankle is injured, try lying down and placing your ankle/leg on a stack of pillows.
The main difference is that “rest” has been replaced with “protection” and “optimal loading”. Protecting the injured area and getting a few days of rest is important, but it is also essential to begin moving the area and progressively loading it as your body heals, for optimal recovery.
If you’ve just experienced a strain or sprain, whether mild or severe, and have questions on how to handle it, feel free to call and ask for one of our experienced physical therapists! They will be able to give you guidance to help you recover as quickly (and fully) as possible: 616-662-0990.
By: Lisa Pfotenhauer, C-EP
When people complain of heel and foot pain, one of the most common terms tossed around is “Plantar Fasciitis”. Exactly what is Plantar Fasciitis? It is inflammation of the plantar fascia, or in layman’s terms, inflammation of the thick band of tissue that connects the heel bone to the toes. It is responsible for supporting the arch of your foot.
It presents itself as a sharp pain in the bottom of the foot. It is usually around the heel or just in front of the heel bone. The pain is usually worse when you first get out of bed or get up after sitting for a long time. In addition, being on your feet for long periods of time usually exacerbates the pain. Discoloration and significant visible swelling do not usually occur. It is, however, tender to the touch.
What is the best treatment for Plantar Fasciitis? Common sense says if it hurts, don’t use it. This is impossible, since we all need to walk! I recommend three basic steps to begin the healing process. First, always wear shoes, even around the house. It is important to wear shoes with good arch support. A quality tennis shoe works well. This will take some of the pressure off the plantar fascia. Going barefoot usually increases pain due to the lack of support.
Second, stretch your calves. One of my favorite stretches is to create an incline that you can comfortably stand on for 1-2 minutes at a time. By making the calves more flexible, some of the pressure is taken off the plantar fascia.
Third, ice the painful areas of your feet. This helps take some of the inflammation and, in turn, pain out of the foot (since inflammation is contributing much of the pain). My favorite way to ice is to freeze a water bottle and roll it on the bottom of the foot over the painful area. This not only ices the area but massages it as well.
Plantar Fasciitis treatment is usually pretty straight forward but requires time and patience. Two things are important to remember: First, “no pain no gain” is not a good approach. You want to keep your treatment pain to a minimum while still making strides to stretch the area when pain is minimal. Second, try to catch it early! If you can catch it before it gets bad, it is much easier to treat. Give it a month or so of supportive shoes, resting, and stretching, and it should improve. If not, it is time to see your local physical therapist to try some more exercises and treatment options.
By: Brian Colvin, PT
Steve Bartz, PT