Even in a world of “doctors used to say it was good for you, now they say it’s bad,” this one is a shocker: The doctor who coined the acronym RICE (rest, ice, compression, elevation) in 1978 has decided that the (complete) rest and ice are not beneficial to treating injuries.
Dr. Gabe Mirkin, whose RICE treatment plan has been the standard method of dealing with sports injuries for more than 30 years, recently published a blog post that says, in part:
When I wrote my best-selling Sportsmedicine Book in 1978, I coined the term RICE (Rest, Ice, Compression, Elevation) for the treatment of athletic injuries … Ice has been a standard treatment for injuries and sore muscles because it helps to relieve pain caused by injured tissue. Coaches have used my “RICE” guideline for decades, but now it appears that both ice and complete rest may delay healing, instead of helping.
This information is significant and could represent a paradigm shift in the treatment of sports injuries in general and golf-related injuries in particular. Simply, reducing inflammation was previously seen as essential to healing. Now Dr. Mirkin and others view inflammation as vital to the healing process. Certainly, there is a gross parallel here with allowing your body to fight off infection vs. antibiotic overkill. As I am not a doctor, however, I’ll leave it at that.
Returning to the matter at hand, as anti-icing advocate Josh Stone of Stone Athletic Management writes: “A shift in paradigmatic treatment is on the horizon. Exercise is heating up and ice is melting down.” By “exercise,” it seems, Stone means load bearing and rehabilitation (alternated with rest) is the advisable course of action. In another post on his website, Stone gives the example of an athlete with a stress fracture to the leg whose been advised to wear a non-weight bearing boot. Stone’s remedy? “An intricate balance between rest and mechanical loading of bone to obtain optimal healing”
In keeping with this idea: Generally, Dr. Mirkin’s advice following injury is as follows:
- Stop exercising immediately.
- If possible, elevate the injured part to use gravity to help minimize swelling.
- If the injury is limited to muscles or other soft tissue, a doctor, trainer or coach may apply a compression bandage.
- Ice may be applied to reduce pain, however, it’s pointless to apply ice more than 6 hours after injury.
- If the injury is severe, follow your doctor’s advice on rehabilitation.
- If the injury is minor, you can usually begin rehabilitation the next day.
The entirety of the new direction of treatment following Dr. Mirkin’s study may only be apparent only to the most progressive doctors, kinesiologists, trainers and exercise physiologists. It is clear, however, that if Mirkin’s current suggestions catch on in the same way as his directions in 1978 did, your rehab and treatment for injury (golf or otherwise) won’t involve anything that lives in the freezer.