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Anti-Inflammatory Drugs in Sports and Exercise

Do They Do More Harm Than Good?

By

Updated December 28, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Chest Press

Hard Workouts Can Cause Sore Muscles

(c) Paul Rogers

Anti-inflammatory (AI) medications are a class of pharmaceuticals designed to relieve inflammation in body tissues in order to relieve pain and stiffness. Examples of AI medications are prednisone, ibuprofen, aspirin, celecoxib and diclofenac.

Anti-inflammatories can also be categorized as 'steroidal' and 'non-steroidal' drugs. Prednisone is a well-known AI in the steroid class, and ibuprofen and aspirin are over-the-counter products in the non-steroid class, called non-steroid anti-inflammatory drugs, or NSAIDs.

Except for more serious medical conditions, sports enthusiasts and exercisers — including weightlifters and weight trainers — generally use NSAIDs for pain relief from muscle injury and soreness, and occasionally for fevers. Aspirin also reduces blood clotting, so longer-term use of aspirin in high doses is not recommended. Ibuprofen has become very popular among exercise trainers and athletes, not only for existing pain relief, but also as pre-emptive treatment in advance of workouts or competition for anticipated muscle soreness.

Ibuprofen and Athletes

Over time, following various studies on athletes taking NSAIDs, concerns have risen about how this practice might affect health outcomes and performance. The New York Times reported that up to 70 percent of distance runners and other endurance athletes take the pills before every workout or competition as a precaution against muscle soreness. Such use is also relatively common among serious weight training athletes.

Ibuprofen, as one example, is known to have adverse intestinal effects when used excessively. One concern is the additional damage that may occur to intestines, considering the stress of athletic training and competition. A study in the journal Medicine and Science in Sports and Exercise found that ibuprofen aggravated exercise-induced small intestinal injury and induced gut dysfunction in healthy individuals.

In another examination of ibuprofen use in endurance athletes, ibuprofen and other NSAIDS were found to increase the susceptibility of athletes to hyponatremia, a serious and sometimes fatal condition caused by low blood sodium, and usually related to excess water consumption. But stress on the kidneys by NSAIDs might increase the risk of hyponatremia when other conditions are met.

Experts have warned that there is little justification for pre-emptive use of ibuprofen or other NSAIDs before or after training or competition to prevent muscle soreness, and that such indiscriminate use could have health consequences.

How to Use NSAIDs for Muscle Soreness

The best approach seems to be to only use NSAIDs for treatment of muscle and skeletal injuries when serious pain relief is required, and then only for as short a course as possible. Pre-emptive use should be strongly discouraged.

Sources

Med Sci Sports Exerc. 2012 Dec;44(12):2257-62. Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes. VAN Wijck K, Lenaerts K, VAN Bijnen AA, Boonen B, VAN Loon LJ, Dejong CH, Buurman WA.

Med Sci Sports Exerc. 2006 Apr;38(4):618-22. NSAID use increases the risk of developing hyponatremia during an Ironman triathlon. Wharam PC, Speedy DB, Noakes TD, Thompson JM, Reid SA, Holtzhausen LM.

J Appl Physiol. 1999 Feb;86(2):598-604. Effects of acetaminophen and ibuprofen on renal function in the stressed kidney. Farquhar WB, Morgan AL, Zambraski EJ, Kenney WL.

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