Connect with us

Opinion & Analysis

Are golfers wasting their time icing injuries?

Published

on

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.

You can read the entirety of Dr. Mirkin’s post here.

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.

Your Reaction?
  • 0
  • LEGIT0
  • WOW0
  • LOL0
  • IDHT0
  • FLOP0
  • OB0
  • SHANK0

13 Comments

13 Comments

  1. leftright

    Apr 30, 2014 at 8:08 pm

    Icing an injury, especially an acute tendonitis, mild muscle injury or a joint that has been over extended works quite well. I have been observing results for 4 decades and despite the good doctor’s turn around it is still preferable to doing nothing at all. I can even say, observable results from non-iced to iced injuries will take longer to heal and can actually cause chronic conditions. Instead of RICE, maybe another acronym like NIE would be better, NSAIDS, Ice and elevation. Compression usually does not work and if done incorrectly will cause more injury and swelling. ACE wraps are more for mild immobilization than compression anyway. To do away with ice in a sports environment, especially at a higher level of play is tantamount to negligence and assuredly will cause exacerbation of conditions in the long term. This article reminds me of the “Sugar Blues” book that came out in the 70’s that ended up not being worth the paper it was printed on.

    • Dean ATC

      Apr 30, 2014 at 11:34 pm

      There are so many things wrong with this post….I don’t even know where to start. So I’ll do it this way…

      1. Compression DOES work; and it’s even more effective when used with exercise

      2. Compression will NOT cause more injury and swelling (seriously, where did you come up with that one?)

      3. ACE wraps don’t immobilize anything (and unless something is fractured, there is really no reason to completely immobilize anything)

      4. The only thing ice is good for is mild analgesia. That’s the only reason I use it on my athletes. After 24 hours…..no more ice.

  2. Dr. G

    Apr 29, 2014 at 6:37 pm

    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”

    Any physician not recommending nearly complete offloading for a stress fracture is beyond ludacris. Should that stress reaction turn into a frank fracture due to a lack of informing a patient that it is a possibility with “loading of bone”, the physician will find themself in a sticky situation. Wait 4-6 weeks, observe films along with signs and symptoms, then move on with loading.

    • Em

      Apr 30, 2014 at 8:28 pm

      Ludacris? You mean ludicrous? You ain’t no Dr.

      • Chris

        Apr 30, 2014 at 11:35 pm

        Ain’t? Do you mean are not? I love the grammar battles.

      • Travis

        May 1, 2014 at 8:44 am

        Maybe he’s talking about the rapper… so perhaps he means “beyond controversial”.

  3. Alex the Athletic Trainer

    Apr 29, 2014 at 2:35 pm

    Ben, first of all please refrain from calling us “trainers” we go to school for 4-6 years to become a certified athletic trainer from an accredited program at an accredited university as opposed to “trainers” who take an online class and teach people how to lift. Secondly, I have been following this article for a while now, and have done a lot of research on my own. Ice is important to help with pain management as well as to keep inflammation at a manageable level. I agree that icing after 24 hours is more or less a placebo/band aid for what is going on. Rehab is the only thing that will help to repair the damage done from an acute injury.
    There is still a lot of research that needs to be done, but ice is not the enemy like Dr. Mirkin and his followers like to portray.

  4. The Dr

    Apr 29, 2014 at 12:01 pm

    Just take an anti-inflammatory medication instead, as long as you are not allergic. But – ice is definitely good for concentrated, directed use onto the area immediately inflamed by impact.

    But lets not bring up bone fractures into this mix – you’re confusing different issues there, entirely. No amount of ice is going to HEAL bone fractures. It will, however, still alleviate some of the pain in the area surrounding the bone fracture IF there is any inflammation of the muscle or tissues.

    Reducing inflammation is the issue, and ice is OK for those who do not want to ingest any kind anti-inflammatory medication.

    • Dean ATC

      Apr 30, 2014 at 11:42 pm

      But that gets to the central question around this entire issue….which is why do we want to stop inflammation? Somewhere along the way we have gotten it into our heads that inflammation is the devil. When in fact, it is necessary for healing. It is our bodies natural reaction to injury and illness…..so it’s obviously supposed to occur (our body is pretty smart). Yet we want to ice and take NSAIDS and intentionally stop our bodies natural healing mechanism. Makes no sense.

  5. Chris

    Apr 29, 2014 at 10:44 am

    While I agree that sharp, sudden injuries may not benefit from ice (ACL, torn muscle, dislocated shoulder) I think it is important to understand that ice treatment can be greatly beneficial to long term injury prevention.

    If someone has tendinitis, but still wants to play the sport that is causing the tendinitis, frequent icing will keep the inflammation at a manageable level allowing the athlete to continue to compete. For example, you’ll see most basketball players icing their knees after a game. Similarly baseball pitchers will ice their entire throwing arm after an outing. Again, this helps control the inflammation and pain to allow the athlete to continue to be healthy and effective throughout a long season.

    • Joe

      Apr 29, 2014 at 3:20 pm

      It is becoming more common for pitchers to limit their icing. More influence is coming from Japan, where pitchers don’t ice their arm and have far fewer arm injuries. Correlation is not causation but it has been noticed. Active stretching and heat are becoming en vogue.

      • leftright

        Apr 30, 2014 at 8:13 pm

        I would be more inclined to cite genetics versus treatment of chronic arm conditions, especially in pitchers at the professional level. Another thing that contributes is the way young people are taught to play the game versus Japan. A study, maybe by one of those educated trainers trying to get his MS or PhD. would provide more insight into Japan versus the US pitchers.

  6. Pete

    Apr 29, 2014 at 10:28 am

    On most occasions the bullet: Stop exercising immediately is struck over and the round or what ever payed scheduled tennis court or alike is exploited to it’s full extent. Unless one cannot do anything but roll in pain and agony.

Leave a Reply

Your email address will not be published. Required fields are marked *

Opinion & Analysis

The History of Course Design is Yours to Play at Oglebay

Published

on

There is a much-talked about “New Golden Age” of golf course design underway that is driven by demand for ever-more spectacular courses at the top end of the resort golf market. Destinations such as Streamsong, Bandon Dunes, Cabot Links, Sand Valley and others provide the traveling golfer a spectacular golf experience; unfortunately, it comes at a price tag that is equally spectacular. When a week playing golf in Florida can cost as much as a week in Scotland, where do you go for a golf getaway that doesn’t require a second mortgage?

Oglebay Golf Resort in Wheeling, West Virginia, doesn’t just provide an affordable golf vacation option; with its three golf courses, it provides players the chance to experience a condensed history of American golf course design through its three courses. The resort sits on land that was once owned by a wealthy industrialist and is now a part of the city park system. Located about an hour from Pittsburgh, Oglebay draws the majority of its golfers from Pennsylvania, Maryland, Ohio, Virginia and West Virginia. It’s kind of cool that when you drive to Oglebay from the Washington, D.C., you hit all of those states except Ohio, which is just a few minutes away from Wheeling. The area is especially picturesque in the autumn months when the changing colors of the leaves are at their peak.

The property has a rich history in the business and sporting history of West Virginia, but the three golf courses, Crispin, are a special prize that taken together form a primer on the history of golf design in the past 90 years. The 5,670-yard Crispin course is a one-off design by local golf enthusiast Robert Biery that was completed in 1930 and is a fascinating study of design techniques of that era. The slopes and elevation are severe and extreme by today’s standards. A clue was the raised eyebrow of the assistant pro when I said that I would walk the course. Uneven lies are the order of the day, the product of a time when there was neither the money nor equipment readily available to create gentle slopes and even surfaces; the course is true to the original contours of the West Virginia hillside.  There is little relief on the greens, which run a little slower than typical greens but make up for it in size and slope. It is by far the shortest of the three courses but the par-4 8th hole and par-5 9th holes are a thousand yards of joy and pain.

Hole No. 6 at the Klieves course

The Klieves Course is a 6,800-yard, par-71 Arnold Palmer design that was completed in 2000. The design features broad fairways, mildly undulating greens and opportunities for heroics on short par-4’s, all the prototypical characteristics of modern resort golf courses. While some architects choose to torture and torment, Palmer courses put a premium on fun and this one is no exception. The par-5, 515 yard 6th is a great example of the risk/reward available without that challenges the resort golfer without the need to humiliate. The course is very well maintained tee to green, and you’ll want to keep a fully charged battery to take photos of the vistas from the elevated tee boxes.

Hole No. 13 at the Jones course

In my humble opinion, the true gem is the Robert Trent Jones course. The 7,004-yard, par-72 Course carries a healthy 75.1 rating/141 slope from the back tees. It utilizes a gorgeous piece of land that meanders across the West Virginia hills to give a mesmerizing collection of holes that are equal parts scenery and challenge. Both nines start from elevated tee boxes hitting down into valleys that offer classic risk/reward propositions. Usually I have no problem identifying a favorite hole or two, but on this course it’s difficult. Having said that, the stretch of No. 4 (par 3, 193 yards), No. 5 (par-5, 511 yards) and No. 6 (par-4, 420 yards) are among the best I have played anywhere as a show of nature’s beauty and the at of laying out a golf hole. And the four par 3’s are not the place to pic up an easy birdie. The only one less that 190 yards from the tips is the 158-yard 15th, which is protected by a small, undulating green. All in all, it’s a perfect representation of the genius of Robert Trent Jones.

The golf is good at Oglebay and the prices are better. You can get in 18 at the Oglebay courses for as little as $32…on the weekend. And when you’re not playing golf, you can take advantage of the myriad of outdoor sports activities, tour the Oglebay mansion, hit the spa or visit the Glass Museum on the property (I promise it’s a lot more interesting than it sounds). There’s a lot of great new golf resorts out there and that’s a good thing for the golf industry, but destinations like Oglebay prove that there’s a lot of life left in the old classics as well.

Your Reaction?
  • 41
  • LEGIT3
  • WOW2
  • LOL0
  • IDHT0
  • FLOP0
  • OB0
  • SHANK2

Continue Reading

Podcasts

Two Guys Talkin’ Golf: “Are pro golfers actually underpaid?”

Published

on

Equipment expert Brian Knudson and GolfWRX editor Andrew Tursky argue whether PGA Tour players are actually underpaid or not. They also discuss Blades vs. Cavity backs, Jordan Spieth vs. Justin Thomas and John Daly’s ridiculous 142 mph clubhead speed.

Click here to listen on iTunes.

Your Reaction?
  • 3
  • LEGIT0
  • WOW0
  • LOL0
  • IDHT0
  • FLOP2
  • OB0
  • SHANK24

Continue Reading

Podcasts

Legend Rees Jones speaks on designing Danzante Bay in Mexico

Published

on

Hall-of-Fame golf course architect Rees Jones talks about his newest course design, Danzante Bay at Villa Del Palmar in Mexico. Also, Jeff Herold of TRS Luggage has an exclusive holiday discount offer for GolfWRX listeners!

Click here to listen on iTunes.

Your Reaction?
  • 2
  • LEGIT1
  • WOW0
  • LOL1
  • IDHT0
  • FLOP0
  • OB0
  • SHANK8

Continue Reading

19th Hole

Facebook

Trending