Appalachian State

How Does Ibuprofen (Advil, Motrin) Before a Race Affect Your Body?

October 04, 2016
Highlights

  1. Almost 60 percent of runners use non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
  2. Taking ibuprofen before a race has not been found to reduce muscle damage and pain.
  3. Even in runners, long-term use of ibuprofen can lead to heart disease, heart attacks, and strokes.

Whether running toward a goal or running away from stress, everyone runs for different reasons.

Some people run to stay in shape, others run to clear their minds, and others run to train for a race. Competitive distance running in the Unites States has recently surged in popularity, with over 18 million people participating in 28,000 different types of running events this past year, from 5Ks, to 10Ks, to full marathons.

However, all those logged miles can take a toll on your body. Training for a high-impact event like a race may cause muscle soreness, joint pain, shin splints, tendinitis, and more. To combat this, some runners turn to over-the-counter pain medications to help alleviate or prevent pain that comes with training.

After all, what’s the harm with over-the-counter pain medications? Many believe that if these meds can cure a pounding headache, surely they can help the body survive pounding the pavement.

Part 2 of 5: Prevalence

Everybody’s doing it

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 In an attempt to either curb or prevent pain, the use of over-the-counter medications by runners is high, both when training for and immediately before a race. Almost 60 percent of runners use non-steroidal anti-inflammatory drugs (NSAIDs) in the months leading up to a race with almost 50% taking them right before their race. Within the running world, ibuprofen is referred to as “vitamin I” by its legions of fans due to its consistent use.

However, what many runners don’t realize is that ibuprofen is not helping them, but rather hurting them, especially before running a race. Marathons and other distance races can put your body through a great amount of stress, and adding a seemingly harmless drug like ibuprofen into the mix can actually make things worse.

The list of side effects is long, ranging from increased inflammation to gastrointestinal discomfort to kidney failure, and in extreme cases, heart attack and stroke. And there are no proven benefits. Taking these medications before a race has not been found to reduce muscle damage and pain.

Part 3 of 5: How it works

What is vitamin I?

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 Ibuprofen is a popular over-the-counter medication in a class of drugs called NSAIDs. These drugs are some of the most used in the world, with over 30 billion over-the-counter medications sold in the United States alone.

NSAIDs are also extremely popular among athletesfor muscle pain and soreness. Advil is one of the trade name for ibuprofen, and many runners use it to deal with the injuries and pain that comes with running long distances. These drugs work by halting the body’s production of enzymes that cause inflammation, pain and fever.

When used as directed, ibuprofen can be quite effective in treating a range of ailments, from headaches to arthritis to cramps. However, when it comes to racing, it turns out that these anti-inflammatory pills can actually causeinflammation.

Part 4 of 5: Effects

How does Ibuprofen effect you during a race?

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 Some runners take Ibuprofen before a race to proactively ward off pain, viewing it as a preemptive strike against muscle aches and joint soreness. However, research shows this can cause much more harm, and relatively no good.

Dr. David Nieman, DrPH, a professor in the College of Health Sciences at Appalachian State University and director of the Human Performance Lab at the North Carolina Research Campus, conducted a landmark study of ultramarathoners and the use of ibuprofen. He found that those who use the drug saw no benefits from ibuprofen use. There were not better race times, nor lowered rate of perceived exertion (RPE), nor lessened muscle soreness.

Instead, what he found was that ibuprofen use contributed to “increased inflammation, mild kidney impairment and bacterial seepage, meaning bacteria from the intestines leaked into the bloodstream.” Additionally, use of ibuprofen resulted in worsened post-race inflammation.

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Nieman

While most athletes are in peak physical condition, what many forget is that strenuous exercise, such as a marathon, is stressful on the body. During long bouts of running, digestion and other functions are stalled as the body pushes blood to the working muscles.

Taking ibuprofen before a race taxes the body even more, with studiesshowing it can aggravate exercise-induced digestion issues and lead to gut-barrier dysfunction in normally healthy people. Studies have also found that it can increase oxidative stress, which is a disturbance in balance between the production of free radicals and the body’s ability to detoxify and repair itself. This can cause even more muscle soreness and inflammation.

One explanation as to why, from the British Medical Journal, explains that “painkillers block enzymes called cyclooxygenases, which regulate the production of prostaglandins. However, prostaglandins also protect tissues when the body is under extreme stress, such as during endurance sports.” That is to say, popping an Advil or Motrin before a hard run can actually hamper your body’s natural ability to protect itself.

In addition to the increased inflammation, gastrointestinal side effects, and kidney impairment, it turns out that prolonged use of ibuprofen can actually increase the risk of heart attacks or strokes, with the FDA recently releasing a warning about the risks. For health-conscious runners, the fact that increased frequency and dosage of ibuprofen during training can up their risk for heart disease can be concerning.

Part 5 of 5: Alternatives

So if not ibuprofen, what should you take?
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If you are experiencing pain during training or racing, Timothy Coyle, M.S. Ed, an exercise physiologist and Assistant Professor at Long Island University, advises taking a step back and looking at your training protocols. Before looking to medication he suggests asking yourself questions such as the following:

  • Did I give myself enough time to prepare for this race?
  • Did I change my training shoes regularly enough?
  • Am I over-training?
  • How is my core training regimen and how is my balance?
  • Am I properly warming up and cooling down?
  • How is my stride and foot strike?
  • Is there something in my nutritional protocol I could fix?

Asking yourself these questions can help you further understand and pinpoint exactly what may be causing your pain. Coyle emphasizes that the “big thing to remember is running a race is a commitment, however big or small. The human body prefers small, consistent changes.”

Diet

Dr. David Nieman, who himself has run 58 marathons, suggests a diet high in fruits and vegetables, as this can provide a natural anti-inflammatory effect. He recommends consuming a wide variety of produce in a range of colors, such as blueberries, oranges, and spinach, as these brightly colored fruits and veggies contain compounds called polyphenols, specifically flavonoids, that are naturally protective against free radicals and anti-inflammatory. Fresh produce is a naturally abundant source of these polyphenols, and according to Nieman, these dietary antioxidants can help to ease the aches and pains that can come with running long distances.  Of course, adequate protein to repair muscle and adequate carbohydrate to refuel, along with healthy fats to help reduce inflammation, are also important.

Alternative pain relief

If a runner insists on using a painkiller, Nieman recommends using aspirin instead.  In his studies he did not see the same ill effects associated with aspirin as with ibuprofen use. However, aspirin still has no proven benefitsfor exercise performance. The important thing to remember, says Nieman, is that “every drug, even those seemingly harmless ones we can buy at the grocery store, has a side effect.” When it comes to taking ibuprofen before a race, your best bet is to run from it.

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