THE ARTICLE
That study was conducted by David Neiman, physiologist and director of the Human Performance Laboratory at the North Carolina Research Campus. The runners who had taken ibuprofen actually had more inflammation and a higher immune system response than runners who hadn’t taken them. To make things worse, those who used ibuprofen also had evidence of mild kidney impairment and mild endotoxemia, where bacteria leak into the bloodstream from the colon. Neiman said, “These findings disturbing, especially since this wasn’t a minority of the racers. There was widespread use and very little understanding of the consequences.” In fact, seven out of ten of the runners had used ibuprofen.
This level of use is not uncommon, according to other studies. A study published in April in the British Journal of Sports Medicine showed that almost 60 percent of the participants in the 2008 Ironman Triathlon in Brazil reported using NSAIDS (non-steroidal anti-inflammatory painkillers), which include ibuprofen. They used them at some point during the three months before the race and almost half took them during the event itself. Eight-six percent of professional Italian soccer players reported using NSAIDS during the 2002-2003 soccer season. Stuart Warden, an assistant professor and director of physical therapy research at Indiana University, who has extensively studied the physiological impacts of the drugs, says, “For a lot of athletes, taking painkillers has become a ritual.”
Why are active people using NSAIDs so much? The triathlon participants in Brazil said they did it to prevent pain. They believed it would help them get through the race and then prevent some of the soreness afterward. However, current research shows that ibuprofen and other NSAIDS actually have no effect or even the opposite effect during activity. Neiman’s group placed water stops at various locations in the race, and researchers asked the runners how they felt as they went through. They found no difference between those runners who had taken ibuprofen and those who had not. After the race, those using ibuprofen had no reduction in muscle soreness, either.
In laboratory experiments, ibuprofen has been shown to slow healing of damaged muscles, ligaments, tendons, and bone. While they may reduce pain, the price for that effect is slowed healing. NSAIDs work by suppressing prostaglandin production, a substance that is involved in perception of pain and in collagen production. Lower levels of prostaglandins result in less collagen, which slows the healing of injuries.
In addition, the stress of intense exercise usually activates a process that stimulates collagen production and leads to stronger muscles and denser bones. Taking ibuprofen regularly inhibits this training response. Your bones and muscles won’t respond as well as they should to exercise and they may even be less able to withstand the next exercise session. In addition, less collagen is produced to help heal the normal micro-tears that muscles suffer during every intense workout.
If you have an acute injury, resulting in inflammation and pain, NSAIDS can be very effective in the short-term. However, it’s a serious mistake to take them before every workout. The British Journal of Sports Medicine recently published an editorial on the topic that concluded, “…there is no indication or rationale for the current prophylactic use of NSAIDs by athletes, and such ritual use represents misuse.”
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