Breaking the Pill Drill

Why athletes need to pause before popping ibuprofen

by Matt Morrison | 12 Oct 2015 at 5:17 AM

Once or twice a week, Jeff McDonald heads to the local golf course near his home in Saratoga, California.

Before his regular round with friends, McDonald warms up for 20 to 30 minutes on the driving range.

“That’s how long it takes for the drugs to kick in,” the former minor league baseball pitcher, now in his mid-50s, said with a grin.

There is nothing illicit, as his expression might imply, about the "drugs" McDonald mentions. He's referring to a double dose of Advil, the popular brand name for the anti-inflammatory ibuprofen. He said he takes it to loosen his back and shoulder muscles before hitting the links.

It’s been part of his routine for a long time.

“There was always a big plastic bottle of Advil in the trainers' room or somewhere around the clubhouse,” McDonald said of his few seasons as an aspiring major leaguer who topped out in the minors. “We went through that stuff. A lot of guys used (ibuprofen) before, during, after games, to get loose or to ease the soreness that you knew you’d feel later.”

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Why ibuprofen and not other over-the-counter pain relievers such as aspirin, Tylenol or Aleve?

“It just works better for me -- better, maybe just faster than aspirin,” McDonald said. “And Aleve doesn’t seem to do anything for me. Maybe it works for a headache, I don’t know.”

“Do not mix exercise on ibuprofen. There is no advantage whatsoever,” Nieman said.

His story is not unique among high-performance athletes or others weekend warriors. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) is commonplace for many athletes in contact and endurance sports.

But this is worth reconsidering.

Dr. David Nieman, a health sciences professor at Appalachian State University and director of the Human Performance Lab at the research campus in Kannapolis, North Carolina, warns athletes against using ibuprofen with strenuous exercise.

“There is no benefit to it, and it can only cause damage,” Nieman told LifeZette.

In addition to authoring other studies on ibuprofen and athletic performance, Nieman looked at ultramarathon runners who use the drug to minimize pain during a race. His findings, published in the journal Medicine & Science in Sports & Exercise, indicated that athletes have an increased risk of intestinal damage linked to the pain reliever.

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“Ibuprofen, used with this kind of exercise, is shown to damage the inner lining cells of the colon,” Nieman said. “That leads to bacteria leaking into the blood stream. It can also cause mild kidney dysfunction.”

The study showed that internal systems including the intestines, kidneys, and liver can be inflamed by up to 50 percent after exercise on ibuprofen. Nieman said prolonged use with physical exertion erodes the inner intestinal lining, leading to serious digestive tract problems and blood toxicity.

Why, then, do so many high-level competitors still routinely use ibuprofen if it’s been shown to be ineffective and even dangerous? What about some of the other over-the-counter options?

“For some reason, people just believe it helps them. Vitamin ‘I,’ they call it. It’s ingrained in their routine,” Nieman said. “People use ibuprofen far and above other pain meds. No. 2 is aspirin. Aleve is in the same class, but for some reason it may not have the same effect.”

“Do not mix exercise on ibuprofen. There is no advantage whatsoever,” Nieman said. “There’s no physiological reason to use it with exercise, and it can only be a disadvantage.”

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