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Are golfers wasting their time icing injuries?

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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.

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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.

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19th Hole

Vincenzi’s 2024 Zurich Classic of New Orleans betting preview

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The PGA TOUR heads to New Orleans to play the 2023 Zurich Classic of New Orleans. In a welcome change from the usual stroke play, the Zurich Classic is a team event. On Thursday and Saturday, the teams play best ball, and on Friday and Sunday the teams play alternate shot.

TPC Louisiana is a par 72 that measures 7,425 yards. The course features some short par 4s and plenty of water and bunkers, which makes for a lot of exciting risk/reward scenarios for competitors. Pete Dye designed the course in 2004 specifically for the Zurich Classic, although the event didn’t make its debut until 2007 because of Hurricane Katrina.

Coming off of the Masters and a signature event in consecutive weeks, the field this week is a step down, and understandably so. Many of the world’s top players will be using this time to rest after a busy stretch.

However, there are some interesting teams this season with some stars making surprise appearances in the team event. Some notable teams include Patrick Cantlay and Xander Schauffele, Rory McIlroy and Shane Lowry, Collin Morikawa and Kurt Kitayama, Will Zalatoris and Sahith Theegala as well as a few Canadian teams, Nick Taylor and Adam Hadwin and Taylor Pendrith and Corey Conners.

Past Winners at TPC Louisiana

  • 2023: Riley/Hardy (-30)
  • 2022: Cantlay/Schauffele (-29)
  • 2021: Leishman/Smith (-20)
  • 2019: Palmer/Rahm (-26)
  • 2018: Horschel/Piercy (-22)
  • 2017: Blixt/Smith (-27)

2024 Zurich Classic of New Orleans Picks

Tom Hoge/Maverick McNealy +2500 (DraftKings)

Tom Hoge is coming off of a solid T18 finish at the RBC Heritage and finished T13 at last year’s Zurich Classic alongside Harris English.

This season, Hoge is having one of his best years on Tour in terms of Strokes Gained: Approach. In his last 24 rounds, the only player to top him on the category is Scottie Scheffler. Hoge has been solid on Pete Dye designs, ranking 28th in the field over his past 36 rounds.

McNealy is also having a solid season. He’s finished T6 at the Waste Management Phoenix Open and T9 at the PLAYERS Championship. He recently started working with world renowned swing coach, Butch Harmon, and its seemingly paid dividends in 2024.

Keith Mitchell/Joel Dahmen +4000 (DraftKings)

Keith Mitchell is having a fantastic season, finishing in the top-20 of five of his past seven starts on Tour. Most recently, Mitchell finished T14 at the Valero Texas Open and gained a whopping 6.0 strokes off the tee. He finished 6th at last year’s Zurich Classic.

Joel Dahmen is having a resurgent year and has been dialed in with his irons. He also has a T11 finish at the PLAYERS Championship at TPC Sawgrass which is another Pete Dye track. With Mitchell’s length and Dahmen’s ability to put it close with his short irons, the Mitchell/Dahmen combination will be dangerous this week.

Taylor Moore/Matt NeSmith +6500 (DraftKings)

Taylor Moore has quickly developed into one of the more consistent players on Tour. He’s finished in the top-20 in three of his past four starts, including a very impressive showing at The Masters, finishing T20. He’s also finished T4 at this event in consecutive seasons alongside Matt NeSmith.

NeSmith isn’t having a great 2024, but has seemed to elevate his game in this format. He finished T26 at Pete Dye’s TPC Sawgrass, which gives the 30-year-old something to build off of. NeSmith is also a great putter on Bermudagrass, which could help elevate Moore’s ball striking prowess.

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19th Hole

Vincenzi’s 2024 LIV Adelaide betting preview: Cam Smith ready for big week down under

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After having four of the top twelve players on the leaderboard at The Masters, LIV Golf is set for their fifth event of the season: LIV Adelaide. 

For both LIV fans and golf fans in Australia, LIV Adelaide is one of the most anticipated events of the year. With 35,000 people expected to attend each day of the tournament, the Grange Golf Club will be crawling with fans who are passionate about the sport of golf. The 12th hole, better known as “the watering hole”, is sure to have the rowdiest of the fans cheering after a long day of drinking some Leishman Lager.  

The Grange Golf Club is a par-72 that measures 6,946 yards. The course features minimal resistance, as golfers went extremely low last season. In 2023, Talor Gooch shot consecutive rounds of 62 on Thursday and Friday, giving himself a gigantic cushion heading into championship Sunday. Things got tight for a while, but in the end, the Oklahoma State product was able to hold off The Crushers’ Anirban Lahiri for a three-shot victory. 

The Four Aces won the team competition with the Range Goats finishing second. 

*All Images Courtesy of LIV Golf*

Past Winners at LIV Adelaide

  • 2023: Talor Gooch (-19)

Stat Leaders Through LIV Miami

Green in Regulation

  1. Richard Bland
  2. Jon Rahm
  3. Paul Casey

Fairways Hit

  1. Abraham Ancer
  2. Graeme McDowell
  3. Henrik Stenson

Driving Distance

  1. Bryson DeChambeau
  2. Joaquin Niemann
  3. Dean Burmester

Putting

  1. Cameron Smith
  2. Louis Oosthuizen
  3. Matt Jones

2024 LIV Adelaide Picks

Cameron Smith +1400 (DraftKings)

When I pulled up the odds for LIV Adelaide, I was more than a little surprised to see multiple golfers listed ahead of Cameron Smith on the betting board. A few starts ago, Cam finished runner-up at LIV Hong Kong, which is a golf course that absolutely suits his eye. Augusta National in another course that Smith could roll out of bed and finish in the top-ten at, and he did so two weeks ago at The Masters, finishing T6.

At Augusta, he gained strokes on the field on approach, off the tee (slightly), and of course, around the green and putting. Smith able to get in the mix at a major championship despite coming into the week feeling under the weather tells me that his game is once again rounding into form.

The Grange Golf Club is another course that undoubtedly suits the Australian. Smith is obviously incredibly comfortable playing in front of the Aussie faithful and has won three Australian PGA Championship’s. The course is very short and will allow Smith to play conservative off the tee, mitigating his most glaring weakness. With birdies available all over the golf course, there’s a chance the event turns into a putting contest, and there’s no one on the planet I’d rather have in one of those than Cam Smith.

Louis Oosthuizen +2200 (DraftKings)

Louis Oosthuizen has simply been one of the best players on LIV in the 2024 seas0n. The South African has finished in the top-10 on the LIV leaderboard in three of his five starts, with his best coming in Jeddah, where he finished T2. Perhaps more impressively, Oosthuizen finished T7 at LIV Miami, which took place at Doral’s “Blue Monster”, an absolutely massive golf course. Given that Louis is on the shorter side in terms of distance off the tee, his ability to play well in Miami shows how dialed he is with the irons this season.

In addition to the LIV finishes, Oosthuizen won back-to-back starts on the DP World Tour in December at the Alfred Dunhill Championship and the Mauritus Open. He also finished runner-up at the end of February in the International Series Oman. The 41-year-old has been one of the most consistent performers of 2024, regardless of tour.

For the season, Louis ranks 4th on LIV in birdies made, T9 in fairways hit and first in putting. He ranks 32nd in driving distance, but that won’t be an issue at this short course. Last season, he finished T11 at the event, but was in decent position going into the final round but fell back after shooting 70 while the rest of the field went low. This season, Oosthuizen comes into the event in peak form, and the course should be a perfect fit for his smooth swing and hot putter this week.

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Opinion & Analysis

The Wedge Guy: What really makes a wedge work? Part 1

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Of all the clubs in our bags, wedges are almost always the simplest in construction and, therefore, the easiest to analyze what might make one work differently from another if you know what to look for.

Wedges are a lot less mysterious than drivers, of course, as the major brands are working with a lot of “pixie dust” inside these modern marvels. That’s carrying over more to irons now, with so many new models featuring internal multi-material technologies, and almost all of them having a “badge” or insert in the back to allow more complex graphics while hiding the actual distribution of mass.

But when it comes to wedges, most on the market today are still single pieces of molded steel, either cast or forged into that shape. So, if you look closely at where the mass is distributed, it’s pretty clear how that wedge is going to perform.

To start, because of their wider soles, the majority of the mass of almost any wedge is along the bottom third of the clubhead. So, the best wedge shots are always those hit between the 2nd and 5th grooves so that more mass is directly behind that impact. Elite tour professionals practice incessantly to learn to do that consistently, wearing out a spot about the size of a penny right there. If impact moves higher than that, the face is dramatically thinner, so smash factor is compromised significantly, which reduces the overall distance the ball will fly.

Every one of us, tour players included, knows that maddening shot that we feel a bit high on the face and it doesn’t go anywhere, it’s not your fault.

If your wedges show a wear pattern the size of a silver dollar, and centered above the 3rd or 4th groove, you are not getting anywhere near the same performance from shot to shot. Robot testing proves impact even two to three grooves higher in the face can cause distance loss of up to 35 to 55 feet with modern ‘tour design’ wedges.

In addition, as impact moves above the center of mass, the golf club principle of gear effect causes the ball to fly higher with less spin. Think of modern drivers for a minute. The “holy grail” of driving is high launch and low spin, and the driver engineers are pulling out all stops to get the mass as low in the clubhead as possible to optimize this combination.

Where is all the mass in your wedges? Low. So, disregarding the higher lofts, wedges “want” to launch the ball high with low spin – exactly the opposite of what good wedge play requires penetrating ball flight with high spin.

While almost all major brand wedges have begun putting a tiny bit more thickness in the top portion of the clubhead, conventional and modern ‘tour design’ wedges perform pretty much like they always have. Elite players learn to hit those crisp, spinny penetrating wedge shots by spending lots of practice time learning to consistently make contact low in the face.

So, what about grooves and face texture?

Grooves on any club can only do so much, and no one has any material advantage here. The USGA tightly defines what we manufacturers can do with grooves and face texture, and modern manufacturing techniques allow all of us to push those limits ever closer. And we all do. End of story.

Then there’s the topic of bounce and grinds, the most complex and confusing part of the wedge formula. Many top brands offer a complex array of sole configurations, all of them admittedly specialized to a particular kind of lie or turf conditions, and/or a particular divot pattern.

But if you don’t play the same turf all the time, and make the same size divot on every swing, how would you ever figure this out?

The only way is to take any wedge you are considering and play it a few rounds, hitting all the shots you face and observing the results. There’s simply no other way.

So, hopefully this will inspire a lively conversation in our comments section, and I’ll chime in to answer any questions you might have.

And next week, I’ll dive into the rest of the wedge formula. Yes, shafts, grips and specifications are essential, too.

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