Athletes: When NSAIDs are a no-no

It’s tempting, with the many aches and pains that seem to go hand-in-hand with my recreational activities, to pop some ibuprofen before a run to minimize anticipated soreness. I see lots of other runners faster than me doing it — and I need all the help I can get — so why not?

Surprisingly, the practice could be at odds with my exercise goals, actually inhibiting my body’s healing and preventing me from benefiting from my hard work. And then there are the intestinal concerns written about today in the New York Times.

New York Times blogger Gretchen Reynolds wrote that in a survey, 70 percent of distance runners and other endurance athletes reported taking ibuprofen before every workout or competition to ward off soreness. The practice is popular — and the risks are real.

There is a time and place for taking NSAIDs, says Stuart Warden, associate professor of physical therapy in the School of Health and Rehabilitation Sciences at IUPUI, but pain should not be masked.

“These agents are treatments for the symptoms of an injury, not the injury itself,” says Warden, whose research at IU focuses on musculoskeletal health and sports medicine. “They may allow an athlete to exercise or train at a certain level, but pain occurs for a reason. It is basically the body’s mechanism of saying, ‘Hang on, you’ve got some sort of injury that should not be ignored.'”

NSAIDs are recommended for use after an injury to reduce swelling or pain and should be taken at recommended doses for no more than a week after an acute injury. Warden said the misuse of NSAIDs can cause a range of problems, such as interfering with healing, inhibiting the body’s ability to adapt to challenging workouts, the development of stomach ulcers and possibly an increased risk for cardiovascular problems.

He told the Canadian Broadcasting Corp. this week that there is no reason for athletes to use NSAIDs beforehand because of the risks and because there is no evidence of any actual benefit. A media tip that Warden helped me prepare goes into more detail of some of the risks. He also editorialized about this several years ago in the British Journal of Sports Medicine.

“I want people, including recreational athletes, to think about the perceived benefits versus potential risks of taking NSAIDs, and to ask themselves why they are taking these agents,” Warden says. “They need to ask, ‘Do the benefits outweigh the risks?”

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