You’re midway through a performance or a battle, or simply just at a training session. Suddenly you experience a sharp ache or stabbing pain, or burning sensation while dancing. You manage to finish up, or you’re forced to stop because it’s too sore to continue dancing. The pain doesn’t stop even after you’ve rested and now it’s sore when you move. This lasts for a few hours, possibly days. You’re injured! You feel like you’ve died and gone to a dancer’s hell!
If You’ve personally experienced this scenario, I’m sure you’ve wondered how you can bounce back stronger and faster from an acute injury like this. If you’ve never been injured to the point of missing out on dance, I’m sure you’d agree that you’d want to know what to do in the event of it happening. Well, here’s what you need to know to safely and successfully manage acute injuries:
It is widely understood that the first 48-72 hours after an injury are quite critical to ensuring that your body has the best environment for healing itself (see FitBase article #3 for more info). To help the body heal itself and get yourself battle ready or back into training as quickly as possible, it is useful to know what You can do in this early phase to aid recovery. So, with that in mind let’s consider what the PRICE of MEAT has to do with RICE and the POLICE. Wait, What?!
RICE | PRICE | POLICE | MEAT
These acronyms have been used to describe acute injury management protocols. Although there is little evidence in research to suggest one method over the other, there has been a progression in thinking about specific applications of the protocols. Let’s breakdown the details of each protocol and then discuss when and how you should apply them.
R-I-C-E = Rest, Ice, Compression, and Elevation
This classic protocol is widely known among dancers and other athletes as the way to treat all injuries. The primary idea of R-I-C-E is to rest and prevent excessive blood flow to the injured area. The Ice application details vary but a 15 to 20-minute period of Ice every 2-3 hours in the first 24-48 hours, followed by Ice 3-4x per day for the next 24 hours (total of 72 hours) is recommended.
P-R-I-C-E = Protection + RICE
This modification of the R-I-C-E protocol came about as we understood that protection of the injured area during early healing (first 72 hours) could help prevent re-injury. This could be with the use of a brace or taping to protect during training and performance, or even crutches in some instances to unload a lower body injury.
P-O-L-I-C-E = Protection, Optimal Loading, Ice, Compression and Elevation
The P-O-L-I-C-E protocol is the latest progression from the R-I-C-E and P-R-I-C-E models as we have improved our understanding of how to best treat acute injuries. “P” + “I-C-E” is added to the growing research evidence showing that early movement is useful. Therefore, “Optimal Loading” (O-L) replaces “Rest”, as we are encouraged to gently move the injured area with specific rehabilitative exercises prescribed by a health practitioner.
M-E-A-T = Movement, Exercise, Analgesics, and Treatment
Another more modern and progressive protocol comes in the form of M-E-A-T. Much like “Optimal Loading”, early “Movement” and injury specific rehabilitation “Exercises” are useful to improve blood flow into the tissue, and to gently stretch the area to stimulate flexible scar tissue formation. For dancers, the “M-E” component may even include some activities or drills that do not specifically load the injured area – allowing you to continue to remain active by changing focus for a short period while you allow the injured area to heal. We call this Active Rest.
“Analgesics” refer to the use of painkillers. Here, one should be careful of self medicating and rather aim for natural products, but consult with a professional for advice on safe use of painkillers. Also note that “Analgesics” do not include Anti-inflammatories. Inflammation is a natural process in this early stage and therefore should be allowed to complete it’s course.
“Treatment” refers to receiving Physiotherapy or any sports medicine practitioner which involves manual therapy and rehabilitative therapy.
So which is best, M-E-A-T or P-O-L-I-C-E?
If we consider that blood circulation is different in different types of tissues, we can understand that muscle injuries do better with decreasing blood flow (I-C-E) and that tendon and ligament injuries do better with increasing blood flow through movement/ exercise (M-E) and heat. We could therefore say that muscle injuries should do well with the P-O-L-I-C-E protocol and that tendon or ligament injuries should do better with the M-E-A-T protocol. However, there are some joint injuries such as ligament sprains, which do well with I-C-E in the early phase to decrease excessive swelling.
Essentially, early movement and exercise is known to be best for your injury recovery. This is great news for dancers, who want to get back to training and performance as soon as possible. Using “Active Rest”, a dancer can allow the injured area time to heal but develop another area of your body/ repertoire that may be weak/ in need of attention. But, there may be more guidance needed depending on the type of injury, and that requires professional examination and assessment.
I must note that there is always plenty of room for Your personal experience of what works well for you and your body. Learning how to manage your own injuries and finding the combination that works for your body is the first step to taking control of your career as a dancer. So take the time to read more of this kind of content, find sources local to you that you can trust, and as always, take care.