by If you've been a triathlete for any amount of time, you "know" that anti-inflammatory painkillers (NSAIDS) like Ibuprofen (aka Vitamin "I") helps with reducing inflammation and pain during and after exercise. Per the New York Times:
And now... just as everyone "knew" the earth was round, our knowledge has been proven false. Well... I'll let you form your own opinion.when the Western States runners were polled, most told the researchers that “they thought ibuprofen would get them through the pain and discomfort of the race,” Nieman says, “and would prevent soreness afterward.” But the latest research into the physiological effects of ibuprofen and other NSAIDs suggests that the drugs in fact, have the opposite effect.
The quotes in this post are from the New York Times article Does Ibuprofen Help or Hurt During Exercise The question of effectiveness of Ibuprofen and other NSAIDs during exercise all started several years ago when David Nieman, a well-regarded physiologist and director of the Human Performance Laboratory at the North Carolina Research Campus, was asked to study the affects of a 100-mile race on the affects of muscle and the immune systems of the participants.
After looking at racers’ blood work, he determined that some of the ultramarathoners were supplying their own physiological stress, in tablet form. Those runners who’d popped over-the-counter ibuprofen pills before and during the race displayed significantly more inflammation and other markers of high immune system response afterward than the runners who hadn’t taken anti-inflammatories. The ibuprofen users also showed signs of mild kidney impairment and, both before and after the race, of low-level endotoxemia, a condition in which bacteria leak from the colon into the bloodstream.
Are you catching this? It was not only not productive, it was harmful. It doesn't sound like there were severe issues but I can assume that mild problems like these are definitely not helpful during a race.
How could this be though? NSAIDs are known to reduce inflammation and to decrease pain. We couldn't have gotten it that wrong, could we? Well, it looks like we listened to the marketing and didn't see exactly what it was doing.
NSAIDs actually slowed the healing of injured muscles, tendons, ligament, and bones. “NSAIDs work by inhibiting the production of prostaglandins,”substances that are involved in pain and also in the creation of collagen, Warden says. Collagen is the building block of most tissues. So fewer prostaglandins mean less collagen, “which inhibits the healing of tissue and bone injuries,” Warden says, including the micro-tears and other trauma to muscles and tissues that can occur after any strenuous workout or race.
It does reduce pain but it does it by blocking the same thing that helps build collagen, which helps you rebuild. It also looks as though use of NSAIDs before and during exercise can reduce the effectiveness of the muscle break-down and recovery process...
The painkillers also blunt the body’s response to exercise at a deeper level. Normally, the stresses of exercise activate a particular molecular pathway that increases collagen, and leads, eventually, to creating denser bones and stronger tissues. If “you’re taking ibuprofen before every workout, you lessen this training response,” Warden says. Your bones don’t thicken and your tissues don’t strengthen as they should. They may be less able to withstand the next workout. In essence, the pills athletes take to reduce the chances that they’ll feel sore may increase the odds that they’ll wind up injured — and sore.
It sounds like you won't get as much of a benefit from training by using NSAIDs. When should we use Ibuprofen and other NSAIDs then? Should we go out and throw away our 1,000 tablet containers?
“When you have inflammation and pain from an acute injury,” Warden says. “In that situation, NSAIDs are very effective.” But to take them “before every workout or match is a mistake.”
I know our resident Dr. In Training Holli will want to weigh in on this but I don't think I'll be using Ibuprofen as liberally as I have in the past. What do you think?
