How to Manage Acute Injury Using the P.O.L.I.C.E. Principle


An acute injury is generally defined as a sudden injury resulting from a traumatic event. An example of a traumatic event is when you’re running down the stairs and you trip, landing on the outside of your ankle and resulting to a painful and swollen ankle. However, acute injuries may also result from repetitive strain or repetitive microtrauma leading to an inflammatory response; such as when you start feeling mild pain on the outside of your knee after running for 10km and then you can hardly walk after running 5km more.

The best thing to do after any trauma, especially if you have signs and symptoms of serious injury, is to see a professional. Signs and symptoms of serious injury include deformity, severe pain, swelling, and inability to bear weight. But as immediate treatment, most physiotherapists recommend the P.O.L.I.C.E. Principle, which is a modern or modified first aid method of treating musculoskeletal injuries. This acronym stands for:


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Following an injury, you need to rest the affected area for a short period. During this time, a splint, brace, or crutches may be used to ensure that the injured parts are protected. The length of period for rest will depend on the severity of the injury. For most injuries, 2 to 3 days rest is adequate, but for severe ligament sprains, the resting period may take up to 10 days.

Optimum Loading

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While protecting the injured body part, gentle movement should be introduced. In acute lateral ankle sprains, for instance, introducing gentle walking earlier on has been shown to help reduce the swelling and improve recovery. Optimal loading has been shown to promote healing and reduce joint stiffness and muscle weakness.


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Applying ice every 2 hours for 20 minutes for the first 2 to 3 days helps reduce pain and swelling of the injured muscle or joint. You can use a plastic bag containing crushed ice or a commercial ice pack. Use a wet towel when applying ice to protect the skin from ice burn.


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Compression after an injury helps to prevent further swelling, proprioception, and immobilization. Compression is usually applied using a bandage on top of ice wrapping. The bandage should not be too tight, as this can cause discomfort or interfere with blood flow.


This will also help in reducing pain and swelling. Rest the injured ankle or knee on pillows, with the leg above the level of the pelvis. To elevate an elbow or wrist, you may use a sling.

How Physiotherapy Can Help

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While the P.O.L.I.C.E. Principle is recommended immediately following an acute injury, it is ideal to visit a physiotherapist who can determine the best protection for your injury. Your physiotherapist can also give you advise on how much protection your injured body part needs and tell you when it is time to stop protecting the injury and start moving the injured body part. You will be guided as to how to perform optimal loading, with simple exercises and motions that would allow your injured muscle or ligament to heal properly. And as your injury heals, your physio can prescribe other exercises that would further help in your recovery.