When Anti-Inflammatory Drugs Go Wrong (And When They Go Right)

Hi. My name is Cat, and I’ve taken ibuprofen before, during and after a race.

Many runners who face twinges, inflamed tendons, or muscle soreness from training have also popped a few non-steroidal anti-inflammatory drugs (NSAIDs for short, such as ibuprofen) to keep running.

I thought I was hard-core for running through pain and helping my recovery by reducing inflammation with Ibuprofen and Advil. But recent research concludes that anti-inflammatory drugs may hinder the training benefits we’re hoping to achieve. However, NSAIDs can facilitate healing in cases like an acutely sprained ankle.

Here are a few things to consider before popping Advil at the start line.

Inflammation and Recovery

Inflammation gets a bad rap with a lot of athletes, understandably. Inflammation is behind pain and swelling after a hard workout or during the early stages of an injury. But inflammation is also a critical part of the healing process. By taking anti-inflammatory drugs, you prevent the inflammation you need to heal. Since running involves breaking down muscles just to be repaired stronger, it’s easy to see how taking NSAIDs can inhibit recovery.

Multiple studies indicate that anti-inflammatory drugs harm athletes. One study showed that taking ibuprofen during endurance training negated muscular skeletal adaptations specific to run training. Another study found that using of NSAIDs after exercise slowed the healing of muscles, tissues, ligaments and bones.

To Take The Edge Off

Runners often rely on ibuprofen to take the edge off of post-race pain or to help prevent a previous injury from bothering them during a race. In a 2008 survey of Ironman competitors, 50% of racers reported using NSAIDs immediately before or during the race.

But taking anti-inflammatory drugs during a race doesn’t actually dull the discomfort of pushing your limits. Studies of runners at the Historic Western States 100 miler found no perceived or actual difference in effort between the runners using ibuprofen during the race and those who weren’t.

Finally, masking the pain with an NSAIDs may allow you to toe the line. But it’s likely to lead to a more severe and longer lasting injury later.

More Serious Consequences

A 2012 New York Times article warned athletes about the dangers of taking ibuprofen before running, citing a study that tested blood samples of endurance athletes and found protein levels indicating intestinal leakage and demonstrating that ibuprofen and running could cause gastrointestinal damage.

In an earlier study, also conducted at the Western States 100, researchers found that runners who regularly took ibuprofen before running demonstrated small amounts of colonic bacteria in their bloodstream, indicating that frequent use of the drug can also lead to colonic seepage, which increases systemic inflammation. The study found that athletes who routinely combined running with the anti-inflammatory drug ibuprofen wound up with higher levels of overall bodily inflammation.

So When Should I Take NSAIDs?

Like anything, taking NSAIDs too often is a problem. But when taken sparingly, during the initial stage of an acute injury, NSAIDs can help your body heal.

Research shows that during the first 2-3 days of an acute injury, when swelling is beyond the normal wear and tear of training, NSAIDs help heal injuries. But after that 2-3 day window, you should let your body’s natural healing mechanisms take over.