Don’t race on ibuprofen

Fun runners taking part in the 2006 Bristol Ha...

A study on ibuprofen use in marathon runners shows that it is associated with adverse effects and does not offer any benefits.

Have you ever taken ibuprofen, or anything similar, before a race? If so, you are not alone, and I have to admit…

Ibuprofen and similar substances such as diclofenac are from the family of the non-steroidal anti-inflammatory drugs or NSAID. They are analgesic and anti-inflammatory, and as they can be obtained without prescription, they are very popular between endurance athletes.

Michael Kuster and his colleagues have just published a study in BMJ Open about the adverse effects of taking such analgesics before a marathon. They had given a questionnaire to all the participants of the 2010 Bonn marathon and half marathon, asking them about drugs taken before the race and about any adverse effects suffered during or after the race. 3913 runners returned the questionnaire, of who 49% had taken NSAID. Most runners had taken them without prescription to retard or avoid pain during or after the race.

The adverse effects ranged from cramps, joint and muscle pains, gastro-intestinal discomfort, haematuria (blood in urine) to cardio-vascular symptoms. Except for muscle cramps, all the adverse effects were 4 to 10 times more frequent between runners who had taken analgesics. There was no difference between the two groups in the number of runners who had to withdrawn.  Joint and muscle pains after the race were more frequent in the group who had taken analgesics.

The authors concluded that taking analgesics before a race can harm you and does not have any benefits.

Could the study be biased?

Of course, it is possible that the two groups (runners who had taken NSAID and those who had not) were not really comparable. There might have been differences, such as concerning other drugs they were taking, age or body mass index (BMI), which could have influenced the results. Moreover, not all the runners returned the questionnaire, which means that the researchers might have worked on a sample that does not reflect the reality. There is no way that they could have avoided these problems with the settings they used for their study. However, the results are thought-provoking, as the difference in frequency of adverse effects between the two groups is so large.Coated 200 mg ibuprofen tablets, CareOne brand...

Can I take NSAID when I’m training?

Your body uses inflammation as a defence system (e.g. against infection) and for “house maintenance”.  After a hard workout for example, damaged muscle fibres have to be removed. After this clean-up, satellite cells, which are the muscles’ stem cells, move in and become the new, stronger muscle fibres you need for your next workout. Anti-inflammatory drugs however, block this process.

Studies have also shown that they decrease protein synthesis after training.

The end result is a reduced gain in muscle strength and a poorer training effect.

Disclaimer: this article is for general information only, and does not replace medical advice. It cannot be used to diagnose or guide treatment. If you have any concerns or questions, you should talk to a qualified health provider.

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