Ibuprofen….or suck it up buttercup??

Jul 22, 2013

Let's talk about athletes and the use of anti-inflammatory drugs. About halfway through my collegiate career, I jumped ship from baseball to track and field. Launching myself headlong into running, jumping and throwing...I subsequently found myself on the trainers table with shin splints.  With the season looming and my "points" needed by the team, the trainer prescribed 1000mg of Ibuprofen 2X a day for two weeks.  I was never a big fan of drugs, and after 3 days I stopped popping and researched other ways to heal my shin splints.  Using myofascial techniques along with NOT OVERTRAINING, I was able to improve and return to the track.  Over the next 15 years, recovery and techniques to enhance healing would become a major topic of growth and understanding for me as I progressed as a collegiate to national, and finally world class athlete.  

If I had to end my article here and condense my feelings into one simple statement it would be this:  If you want to do a great deal of internal damage to your body, while at the same time gaining literally no athletic advantage whatsoever, then continue swallowing your Advil and Motrin.  It'd be great if I could end here and get back to programming your tortuous weekly workouts, but I know you're all of the highly inquisitive and data driven persona, so let me arduously continue.

If I were to ask why you take Ibuprofen, the most likely answers would be to reduce inflammation and stop the pain.  If I then asked you the next question of why you want to reduce inflammation and reduce pain, you'd likely respond that a) inflammation is bad and b) pain is painful.  My response a) inflammation is in fact good and necessary and b) suck it up buttercup!

The science.  Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID).  NSAIDs work through the inhibition of cyclooxygenase (COX), subsequently preventing prostaglandin synthesis. Prostaglandins are hormones (chemical messengers) that help control and mediate inflammation and pain.  They also protect the stomach lining, regulate blood pressure, and are involved in collagen production which aids repair or almost all tissues.  You can think of Prostaglandins as the siren that goes off to let the cells in your body involved in repair know where they're needed.  It's even got a name: inflammatory proliferative phase of healing.  So imagine what happens when you turn that siren off.  Bad things.  

Study after study now reveal the detrimental effects of Ibuprofen.  If you're having trouble falling asleep at night and want the links to the actual articles let me know and I'll send them to you.  Otherwise let me summarize the findings. 

  • Gastrointestinal bleeding which can lead to endotoxemia (bacteria leaking into the bloodstream)
  • Impaired kidney function by constriction of blood vessels leading to an increase in the likelihood of rhabdomyolysis
  • Low blood sodium levels known as hyponatremia
  • Delayed healing of muscles
  • Delayed healing of tendons, ligaments, and cartilage through the inhibition of fibroblast reproduction
  • Delayed healing of bones specifically the tendon attachment points

These negative effects can last in the body for up to 28 days.  Upon full recovery, tests then show a reduction in the strength of the healed tissues.  Tendons were shown to be weaker by up to 300%.  Breaking force of tendons was reduced from 12.0 newtons to 3.5 newtons. Some sports professions suggest that Ibuprofen plays a major role in Achilles tendon ruptures as well as other catastrophic ligament and tendon failures.  Ouch.  I'm sure Pfizer will keep this reality out of the public eye for another 10 years though :)

My fellow athletes...swelling and pain are part of the process that makes you a better athlete.  It's necessary!  You can almost look at NSAID use following a workout as erasing all the hard work you did during the training.  Please, please don't take meds for pain...geez.  Toughen up.  Pain tells us where our limits are and when we need to stop.  Mask it and you risk further injury.  If your ability to function in everyday life in restricted by the pain then you can do two things: 1) come to the gym and throw your shoes at me because I seriously screwed up the programming (although shoes may be thrown back at you if it's discovered a coach told you to back off and you didn't)  2) take some acetaminophen which is not anti-inflammatory (but too much and your liver can be toast)

We are fearfully and wonderfully made machines that have an amazing ability to heal.  Trust the design and use other methods to aid the process. These include: Proper nutrition, adequate sleep, fluid intake, contrast bath, fish oil, active recovery, stretching, massage, etc.

For more information on these methods, see your Coach or myself...we'd be glad to help.