You finish an intense workout, head to the shower and look in the medicine cabinet to review your options: Advil? Motrin? Raised ? Maybe you reflexively grab a bottle and swallow two pills in one gulp without hesitation.
“Unfortunately, many distance runners are chronic users of ibuprofen. They primarily believe it will reduce the pain associated with exercise,” David Nieman, Ph.D., FACSM, Director of the NCRC Human Performance Lab at Appalachian State University recount The runner’s world.
But in fact, the opposite is true. Researchers have proven that persistent use of painkillers for runners can have negative health effects. According to a study conducted by Nieman, chronic ibuprofen use in long-distance runners stimulated mild endotoxemia – bacteria escaping from the colon into the bloodstream due to ibuprofen intake – and increased inflammation.
In another study, Nieman and his colleagues found that taking ibuprofen during intense exercise amplified oxidative stress — an excess of free radicals (molecules that can damage your cells and cause disease) in your body. Too much oxidative stress can overwhelm your muscle tissue and eventually lead to injury.
“Ibuprofen – especially [in] those who use it chronically before racing, training, and during racing tend to disrupt the cells in the lining of the gastrointestinal tract,” says Nieman. Researchers found that long-distance runners who took ibuprofen a week after completing a 100-mile run did not experience inflammation or reduced muscle soreness. Instead, Nieman says, it made things worse. “Their kidney function was negatively impaired,” he says.
And recent studies confirm Nieman’s findings. In a 2016 study, researchers found that ultramarathon runners who took ibuprofen suffered from acute kidney injury – a sudden decrease in kidney function – at higher levels than those who received a placebo.
You don’t have to be an ultra super stud to want to numb a creaking knee. Bill McOarberg, MD, founder of the Ohronic pain management program at Kaiser Permanente in San Diego, Calif., says the use of over-the-counter pain medication trickles down from competitive athletes to recreational runners. “People assume they’re safe because they’re sold without a prescription, but painkillers, especially NSAIDs, can be risky,” he says.
To lower the risk, sticking to a rainbow diet — eating lots of colorful fruits packed with polyphenols — may help athletes naturally reduce inflammation. and recovery assistance, says Nieman.
But of course, runners rely on over-the-counter medications to treat more than just running-related pain. So here’s how to safely take pharmacy drugs to treat your ailments and woes.
Ibuprofen (Advil, Motrin)
Pain: You twisted your ankle while running, or you ran a tough half-marathon and going down the stairs makes you wince.
Good: Relieves swelling and pain by blocking an enzyme that creates inflammation in the body.
The bad: May impair kidney function, more so if taken before or during a race. (NSAIDs inhibit blood flow to the kidneys. Renal circulation can also be suppressed by dehydration. Thus, a dehydrated NSAID using an athlete’s kidneys could have difficulty maintaining proper fluid and electrolyte balance.) May cause gastrointestinal distress, especially if taken before or mid-course.
The Rx: Take 1 tablet (200mg) 2-3 hours after running (once you are rehydrated) for acute injury or severe pain. Do not take more than four days.
Naproxen sodium (Aleve)
Pain: You twisted your ankle while running or ran a tough half-marathon and you have a family history of heart disease.
Good: Inhibits the body’s inflammatory response. Provides longer lasting relief than ibuprofen. NSAIDs associated with a lower risk of heart attack.
The bad: May impair kidney function, especially if taken before or during a race. May cause gastrointestinal upset, especially if taken before a race.
The Rx: Take 1 tablet (220mg) 2-3 hours after a run (once you are rehydrated) to relieve acute injury or severe pain. Do not take more than four days. (Taking NSAIDs can increase muscle soreness if taken before or too soon after exercise. Ibuprofen can allow endotoxins to slip into your bloodstream, which can cause cells to oxidize and lead to muscle aches.)
Pain: You woke up with a deadly headache and you got a deadly workout. Or your foot hurts but you’re ready to run anyway.
Good: Acts as an analgesic but is not an anti-inflammatory, which means it relieves pain without impacting the stomach or kidneys.
The bad: May adversely affect your liver if taken frequently or in high doses.
The Rx: Take 1 regular strength tablet (325mg) before or after a run. Skip the alcohol. Alcohol increases the liver toxicity of the drug. Do not take more than four days.
Aspirin (Bayer, Excedrin)
Pain: You are on a daily regimen of low-dose aspirin prescribed by your doctor.
Good: Anti-inflammatory that inhibits blood clotting to protect against heart disease and stroke. Analgesic that reduces pain.
The bad: May cause gastrointestinal distress if not used to it. Even a low dose of 81 mg can impair your blood’s ability to clot. (NSAIDs block an enzyme that produces a layer of mucus that protects your stomach. Without it, you’re prone to nausea, diarrhea, and stomach cramps.)
The Rx: Safe before a race, if you are on a diet. Trail (or clumsy) runners may want to jump due to the risk of bleeding. May also aggravate swelling and bruising.
Quercetin & Polyphenol
Pain: You’re aiming for a big goal and want to reduce the general soreness that comes with a long, hard workout.
Good: Diets rich in quercetin (found in onions, apples, berries) and polyphenols (found in grapes, plums, coffee) reduce inflammation in athletes.
The bad: Supplements should be discussed with your doctor and should not be overdosed.
The Rx: Eat foods high in these natural anti-inflammatories. During particularly intense training periods, you may choose to take a supplement to increase the benefits.
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