Chronic connective tissue injuries occur in both tendons and fascia from repetitive occupational and sports loading, causing tissue failure.
- Rotator cuff
- Golfers / Tennis elbow
- Plantar fasciitis
It is important to ensure these injuries are managed effectively in the acute stage. Early and appropriate loading will promote healing and quality of tissue repair, allowing a much faster recovery and reducing the likelihood of recurrence of the injury.
Current research provides better understanding of how to treat these conditions most effectively and has changed our management approach for optimal recovery. The old age adage was RICE, where ‘R’ is for Rest, however with these types of injuries, a new acronym ‘POLICE’ is a much better approach, as it is one that actually aids the healing process much earlier. The ‘ICE’ principal should be used especially when the injury feels aggravated with pain above 6/10 on the pain scale.
In the new acronym, ‘P’ stands for Protect. The ‘OL’ which stands for ‘Optimal Load’ refers to the adequate amount of load on the injured tissue that will aid tissue healing and recovery.
Pain (acute pain) is important as a guide to know when we are causing further damage. Pain within 1-3/10 is safe and WILL NOT damage the tissues, but will actually start strengthening the tissues to heal earlier due to appropriate loading.
Pain DOES NOT equal damage:
Remember “Pain” DOES NOT equal damage and “Rest” is not ideal for the promotion of early healing within the connective tissue. Tendinopathies can be difficult to manage. The diagram below explains the ‘Optimal Loading Principal’ and how to monitor and determine an acceptable level of discomfort during and after exercise. Seek help from a qualified physiotherapist to help guide you through the healing process and manage a safe return to work and sport.
Optimal loading: key variables and mechanisms
Philip Glasgow, Nicola Phillips, Christopher Bleakley
PRICE needs updating, should we call the POLICE?
C M Bleakley, P Glasgow, D C MacAuley