No More Vitamin "I"

by Neil Anderson

Have you been taking Ibuprofen or other NSAIDs before or after workouts (or during) to recover faster from the workout and decrease pain?  You might be making it worse. 

The British Journal of Sports Medicine (43: 548-549, 2009) reported that more than half of all exercisers are self-medicating with Ibuprofen in an attempt to alleviate pain from their workouts.  They are convinced that popping a couple “vitamin I” is as important to their workouts as pulling on their exercise shoes.  While those who take these pain killers swear by their effects, it appears their own blood work would disagree. 

David Nieman a well-known physiologist and director of the Human Performance Laboratory at the North Carolina Research Campus took a look at the stresses that exercise places on the bodies of race participants.  He found that rigorous exercise affects runners’ immune systems and muscles negatively.  This was to be expected, however during the study he found something even more “disturbing.”  He found a majority of runners were supplying their own physiological stress, in tablet form.  Some were even taking it during the race.  While their intention was to decrease the inflammation caused by extreme exercise, he found they were in fact doing quite the opposite.  After looking at the blood work of those taking anti-inflammatories he found that the markers of inflammation were much higher over those who hadn’t taken them.   He also found signs of mild kidney impairment and, both before and after the race, of low-level endotoxemia, a condition in which bacteria leaks from the colon into the bloodstream. 

Researchers have long known that popping NSAIDs before or after workouts was counter-indicated.  Stuart Warden, an assistant professor and director of physical therapy research at Indiana University, who has extensively studied the physiological impacts of drugs and exercise found (along with other researchers) that NSAIDs actually slowed the healing of injured muscles, tendons, ligaments and bones.  “NSAIDs work by inhibiting the production of prostaglandins,” substances that are involved in pain and also in the creation of collagen, Warden says.  Collagen is the basic building block of most tissues.  So fewer prostaglandins means less collagen, “which inhibits the healing of tissue and bone injuries,” Warden says.  This includes the micro-tears and other types of trauma to the muscles and tissues that can occur after any strenuous workout or race.    So, blunting the effect of collagen through the use of NSAIDs will, over time, weaken tissues and bone.  This can eventually lead to breakdown and injury.  Chronic use of NSAIDs can also cause ulcers and gastrointestinal distress. 

The weird part of the study was that Warden et. al. found that the painkillers weren’t really helping the racers in the first place.  In one study they conducted, researchers were placed at water stops along the route of several races.  They asked participants if they had taken NSAIDS or not.  They also asked what their pain levels were.  They found there was no reported difference between pain levels for those who were taking them and those who were not.    Conclusion: it doesn’t help. 

When does it help to take NSAIDs?  Proper usage is between you and your doctor.  Generally, you should only take NSAIDs during times of acute injury or inflammation as per doctor’s instructions.