Ask The Experts: Massage, Bloating and Pain Meds

I'm a 43-year-old triathlete who specializes in sprint- and Olympic-distance races. The week after racing I sometimes experience a bloated feeling in my abdomen and swelling in my ankles (though the swelling isn't noticeable to others), and my skin feels tight. It seems like I should feel "slim" after racing. Any ideas?

There are a number of reasons you may have these symptoms, but chances are your bloated feelings may have more to do with your diet and lifestyle than with racing.

A bloated stomach is often caused by a sudden increase in fiber from vegetables, fruits and beans. If this is the cause of your bloating, try easing up on these foods and reintroducing them into your diet gradually.

Bloating can also be a result of hyponeutremia (water intoxication) but this generally occurs during racing. If you're drinking large quantities of water in the days following racing, this could be the problem. If so, decrease your water consumption and increase sodium intake until your symptoms subside.

Since your ankles are also swelling and your skin "feels tight," general fluid retention (having nothing do to with diet) may be the problem. Possible causes of fluid retention include:

  • Premenstrual syndrome
  • Oral contraceptive pills
  • High intake of alcohol, salt or processed foods
  • Too little protein

Does sports massage offer any performance benefits beyond relaxation? Also, is it more beneficial to get a massage before or after a big race, or both?

Post-exercise massage may aid recovery by increasing blood flow to the muscles, which helps reduce muscle soreness. However, studies suggest these benefits occur when massage is given at least one to two hours after a workout. In a recent experiment, when participants were given massages immediately after exercise, blood flow increased to the skin but not the muscles, which suggests that massage immediately after exercise may actually hinder muscle recovery by diverting blood from the muscles. A possible reason for this: Blood flow can remain elevated for 30 minutes or more following exercise, which could explain why the study did not see big changes in blood flow to the muscles.

In another study, massage immediately after exercise had no impact on recovery, but post-exercise muscle soreness was reduced significantly when massage was administered two to six hours later. In addition, there is some suggestion that endorphin release after massage provides a psychological benefit, but this needs further research.

It's generally accepted that getting a massage a week before racing (during your taper) offers a good metabolic "flush" with no energy expense. If you're considering a massage in the days before an event, opt for a light, relaxing massage and avoid deep-tissue treatments.

Is it safe to take ibuprofen during a race or workout? If so, should I take it with food?

Pain medications such as ibuprofen (Advil, Motrin IB, Nuprin) and naproxen sodium (Aleve) are non-steroidal anti-inflammatory drugs (NSAIDs). Despite many studies over the last decade, there is still much disagreement about the usefulness and safety of NSAIDs for the prevention and treatment of exercise-induced muscle injury and soreness. Most likely this difference of opinion exists because of the various methods to induce, assess and quantify muscle injury.

Take NSAIDs with food or milk to reduce your risk of side effects. Enteric-coated pills (such as Advil) are an exception, but follow label directions when taking them.

Older athletes, particularly women over the age of 50, should be especially careful using NSAIDs for various reasons. In addition to possibly inducing gastric ulceration, there is evidence that the use of NSAIDs significantly increases the risk of congestive heart failure in older patients, especially those with a prior history of heart disease.

Don't use NSAIDs if you:

  • Are pregnant
  • Are breastfeeding
  • Have a history of stomach ulcers
  • Are taking blood-thinning medication

Use NSAIDs only under physician supervision if you have:

  • Asthma
  • Liver problems
  • Heart problems
  • Kidney problems

As an alternative to NSAIDs, fish oil supplements may be effective in reducing post-exercise muscle soreness and promoting faster recovery. They have been shown to reduce pain and inflammation of disorders such as rheumatoid arthritis. More studies are needed to substantiate this claim; however, fish oil supplements may prove to be a beneficial non-pharmacological intervention for the pain and inflammation associated with exercise.

Tim Mickleborough, Ph.D., is a professor in the Department of Kinesiology at Indiana University and is a former professional triathlete. He writes the monthly Speed Lab for Triathlete magazine.

Discuss This Article