Anti-inflammatories and Running

Here’s a interesting question from Randy about anti-inflammatories like Ibuprofen. You may have heard me talk about this in our Ask the Coach podcast episode . . .

What do you think about very occasional use of ibuprofen/anti-inflammatories? Not referring to daily or prophylactic use. When, if ever, might it be appropriate? -Randy

Anti-inflammatories and Running

Studies have found that a large percentage of runners take pain medication in the weeks leading up to a race and even before races. People assume that they’re safe because they’re over the counter and that taking NSAIDs before a race will boost their pain tolerance (many runners refer to it as Vitamin I).

A 2006 study found that there was no statistical difference between race times, muscle damage, perceived effort, or reported soreness between the groups who took NSAIDS and those who didn’t. But some members of the medicated group did have one big consequence.

“The ibuprofen disrupted the integrity of the lining cells of the colon; there was a leakage of bacteria into the bloodstream.”

This can cause a condition called endotoxemia, which can lead to septic shock in extreme cases. What runners are more likely to experience is amplified inflammation and oxidative stress (the breakdown of certain cells), which can increase soreness and delay recovery. https://www.runnersworld.com/health/a-guide-to-over-the-counter-pain-meds/slide/1

NSAIDS like Ibuprofen, Advil and Aleve help control swelling and discomfort by blocking an enzyme that creates inflammation in the body. However they also decrease blood flow to the kidneys so this is not a good combination while running (especially in combination with any dehydration). They can also contribute to GI distress mid-run.

Tylenol (acetaminophen) is a pain reliever but is not an anti-inflammatory. This means that it’s gentler on the stomach and kidneys but can be hard on the liver when taken frequently or in large doses. You also don’t want to mix alcohol use with Tylenol because it increases the liver toxicity. If you need to take a pain reliever near the time of a run then Tylenol may be the safest choice.

Aspirin (Bayer, Excedrin) is an anti-inflammatory and low doses are often recommended for those with a risk of heart disease or stroke. However it can also cause GI distress during running and can impair blood clotting leading to increased swelling or bruising if you fall.

I sometimes take a dose of NSAIDs post-marathon (as long as I’m well hydrated). But generally having inflammation is a sign that the body needs more recovery time or better nutritional support and NSAIDS (or any over the counter pain medication) shouldn’t be taken for more than four days in a row without medical supervision. I am a big fan of Tissue Rejuvinator from Hammer Nutrition which is very helpful for reducing inflammation and great for the joints.

Foods that are good for decreasing inflammation include (but are not limited to): broccoli, berries, beets, ginger, tomatoes, walnuts, almonds, pineapple, green tea, salmon and fatty fish, garlic, dark chocolate, eggs, apples, spinach and green leafy veggies, cherries, chili pepper, turmeric, cloves, cinnamon, rosemary, grapes, avocado, and olive oil.

Foods that increase inflammation include fried foods, soda and sugary drinks, refined carbohydrates, processed meats, margarine and trans fats like hydrogenated vegetable oils.

For more info see this article: https://www.runnersworld.com/health/a-guide-to-over-the-counter-pain-meds/slide/1

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