NSAIDs are a popular grouping of mostly over the counter pain relieving drugs. As you can tell from their name, they act as anti-inflammatory drugs. Some of the most common ones include ibuprofen (Advil, Motrin), naproxen sodium (Aleve), and aspirin. Acetaminophen (Tylenol). There are many other prescription-only NSAIDs as well.
NSAIDs work by stopping the production of chemicals known as prostaglandins. They are responsible (in part) for pain production and they protect the lining of the stomach. And so while NSAIDs block pain, they also prevent the stomach from protecting itself leading to the very common side effect of gastrointestinal bleeding. Larger doses and more frequent use cause more side effects.
Up until very recently, many athletes were advised that taking an NSAID before, during and after an event would be helpful. Well there is nothing further from the truth. NSAIDs have been shown to create several problems for athletes in recent months. If your doctor is still advising you to take them before an event or even over an extended period of time, its time to find a doc who is knowledgeable about the alternatives (and dangers) that these drugs pose to exercisers.
In a recent landmark study looking at the effects of NSAIDs on runners at the Western States Endurance Run, researchers discovered some startling things about runners that took ibuprofen before the race. (1)
Runners that took ibuprofen before and during the race actually had more markers of inflammation in their blood after the race than runners that did not take the drug. The ibuprofen takers also had signs of kidney impairment and –yikes- a condition called endotoxemia in which bacteria leak from the colon into the bloodstream. (REF) Ewww. Talk about a great way to get really sick, take some ibuprofen and then go exert yourself.
It is thought that slightly more than half of athletes at events take some form of NSAID drug before or during their races. Taking “Vitamin I” as many athletes call it is quite commonplace.
Of course, the reason so many athletes take these drugs is for pain prevention both during and after their competition.
However, researchers have shown that taken in this manner, NSAIDs don’t work to reduce pain during races or prevent soreness afterwards.
In addition, taking NSAIDs excessively before or during events can actually help you get into the medical tent. Given the negative effect on the kidneys, its not uncommon for athletes to have kidney and therefore hydration problems when taking too many NSAIDs during competition. They even increase the amount of oxidative stress produced during exercise. (2)
Perhaps just as much of a concern is the finding that NSAIDs slow the healing of tendons, ligaments, muscles and bones. Remember those chemicals prostaglandins that the NSAIDs inhibit? Well prostaglandins are super important for repair of and production of collagen, the protein from which these structures are made.
Taking NSAIDs continually can actually slow the repair of the damage that strenuous exercise produces.
Further, NSAIDs blunt the body’s response to exercise at even deeper levels. By slowing the body’s response to exercise, the very tissues which exercise strengthens are not able to benefit from the normal bodily stimulus to strengthen those tissues. In the end, this can lead to weaker tissues that are more prone to injury and less able to heal.
Sure, if you are in pain and need some relief, NSAIDs can certainly help. But as we just reviewed, they aren’t meant to be taken preventively, or on an ongoing basis.
If you are in so much discomfort that you need to seek pain relief before an event, chances are you shouldn’t be competing. It’s not worth getting injured.
If you have an injury (which most of which are caused by inflammation) that causes you to reach for the ‘Vitamin I’ you should get it checked out, and find a safer medical solution.
Fish oil is a potent anti-inflammatory, as are the herbs Picrorhiza, Boswellia and Turmeric. Plant enzymes (link to Wobenzyme) such as Bromelain, and topical homeopathic compounds like Traumeel can all provide effective pain relieve without the side effects of NSAIDs.
References:Nieman DC, Henson DA, Dumke CL, et al. Ibuprofen use, endotoxemia, inflammation, and plasma cytokines during ultramarathon competition. Brain Behav Immun. 2006 Nov;20(6):578-84. Epub 2006 Mar 22. McAnulty SR, Owens JT, McAnulty LS, et al. Ibuprofen use during extreme exercise: effects on oxidative stress and PGE2. Med Sci Sports Exerc. 2007 Jul;39(7):1075-9.
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