What You Don’t Know About OTC Pain Meds Can Hurt You.

Popping a couple of ibuprofen or aspirin pre and/or post workout to help you push through the delayed onset muscle soreness (DOMS) that you know is coming may be one of the worst things you can do for your skeletal muscles and your gut.

Whether you’re trying to reduce the pain and inflammation caused by a long run, heavy lifting session, or an injury, taking non-steroid anti-inflammatory drugs (NSAIDs) inhibits post-workout muscle repair and growth, and delays the healing process in the case of injuries.

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Post-Workout Pain Relief

A number of studies have been done that show that NSAIDs and, in particular, ibuprofen, have the ability to limit the body’s natural ability to repair the tissue damage caused by exercise and injury.  Muscle regeneration is also affected.

Significant research by Dr. Louis Almekinders and his team at the University Of North Carolina School Of Medicine looked at the effects of NSAIDs on tendonitis.  Using four test groups, they broke the athletes in the following categories.  They were as follows:

Tendons received no treatment; they were not exercised and they did not receive an NSAID.

  1. Tendons were exercised.
  2. Tendons were exercised and the anti-inflammatory NSAID Indomethacin was given.
  3. Tendons were not exercised; Indomethacin was given.

Tendons in the four groups underwent injury through repetitive motion, similar to what would occur during athletic training. Seventy-two hours later the only group with increased levels of prostaglandins, which are the body’s own potent mediators of inflammation, was Group #2.  Groups #3 and #4 had significant lower levels of prostaglandins.  The participants in Group #4 that only received the NSAID had almost no prostaglandins in the sample, which signals a complete inhibition of the inflammatory healing process.

Not only does the use of NSAIDs inhibit the body’s natural healing process, they also cause a significant decrease in strength of flexor tendons, maybe as much as 300 percent over four weeks.

This theory was proven through a study done on acute ankle sprains in the Australian reserve military where Piroxicam was used to treat the injury.  Results showed that in the participants that used the NSAID Piroxicam, ligament healing was stopped.  And, even though the participants using the NSAID felt better and were able to resume activity, their ankles were considerably more unstable leaving them prone to injury.

An in-depth article discussing the treatment of skeletal muscle injuries by The International Scholarly Research Network (ISRN) Orthopedics has this to say:

“Whether or not NSAIDs should be used in the treatment of muscle injuries is still controversial.  They have long been the first choice to relieve pain after a skeletal muscle injury. NSAIDs may suppress the [the body’s own] inflammatory response and thus reduce the pain and swelling.  However, this response is an essential phase in the healing of injured skeletal muscle.  Attempts to inhibit this phase will lead to an incomplete functional recovery.  [Also], experimental investigations showed that NSAIDs might also decrease the tensile strength of the injured muscle.”

ISRN researchers concluded that using NSAIDs is so detrimental to the health process they recommend they not be given until 48 hours after the injury so that the body’s natural recovery response is not interrupted.

What About Pre-Workout Pain Relief?

If we know we’re going all out for a workout or run we may decide to pay it forward and take our pain killers before we exercise.  Beyond limiting muscle regeneration, taking NSAIDs pre-workout can mask the pain for us during the workout making us more prone to injury.  Remember, pain is how our body tells us that we’re overdoing it and it’s time to scale back, or, in cases of acute pain, suspend the workout.

But, there may be an ever better reason to skip taking a couple of Advil before we go to the gym.  In studies done on healthy, trained men, NSAIDs aggravated exercise-induced injury in the small intestine.  It only took a couple of doses of ibuprofen to register intestinal cellular damage in the athletes.

You might think about switching to an acetaminophen like Tylenol, but beware that overuse of these products increase the likelihood of liver and kidney toxicity even in healthy people. If you’re on a steady diet of acetaminophen and like to have a couple of beers after a long run, you’re flirting with disaster.

Better Options

NSAIDs are so good at numbing the pain from delayed onset muscle soreness and injuries that we consequentially think they must be helping us heal.  We figure we hurt less so we must be getting better, when in fact muscle and tendon repair is being impeded and our strength is being compromised.

No doubt there are times when taking an anti-inflammatory over-the-counter medication is needed and warranted.  However, taking them on a regular basis to avoid pain may, in the long term, be a costly mistake.

And there are some better, healthier options.

Believe it or not studies have shown that drinking tart cherry juice after a workout reduces soreness and promotes muscle recovery.  Low-fat chocolate milk is also a nutritious high-protein drink that hydrates and promotes muscle healing and strength.  Coffee has also proven to decrease post-workout muscle soreness when taken before exercising. Some other post-workout methods to consider are an ice bath, massage, and a session of light exercise.

*In the case of an acute injury, apply RICE (rest, ice, compression, elevation) and contact your doctor.

The good news is muscle soreness after a workout lets us know we worked hard and if we allow ourselves time, the muscles will repair and be stronger than before.   The last thing we want to do is something that makes us feel better temporarily but hinders our progress long-term, which is what the use of NSAIDs will do.

Over To You

What’s your secret for treating muscle soreness and pain?  Please share.

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