Ibuprofen for training and racing

For races and hard training sessions, the risks of taking ibuprofen seem to outweigh the questionable benefits.
Ibuprofen is an over-the-counter non-steroidal anti-inflammatory drug (NSAID) typically sold under the brand names Advil or Motrin.

Many athletes, typically those in longer ultra-endurance events, often take ibuprofen during the course of a race or long training session. But is this necessarily a good idea?

Ibuprofen interferes with the production of a hormone called prostaglandin, which functions partly to keep the vessels of the kidneys open to maintain adequate blood flow.

Add dehydration -- often encountered in a long race or training session, particularly in the heat -- to the mix, and the problem is compounded. Renal (kidney) failure becomes a real possibility. Who wants to have a dialysis machine for their next best friend?

Ibuprofen use may also blunt your recovery after racing or training. Research suggests that ibuprofen reduces protein synthesis, one of the ways the body repairs muscles.

Other research points to increased gastrointestinal permeability during endurance exercise concurrent with ibuprofen use. This may be one of the reasons that research among runners using ibuprofen at the Western States 100 ultramarathon suggests an increase in some inflammatory markers post-race.

In this study, there was little or no difference in reported muscle soreness between ibuprofen users and non-users.

Ibuprofen is an accepted choice for dealing with the aches and pains of daily life. But does it help during a race? Probably not, and it can hurt you if you take too much and become dehydrated. For races and hard training sessions, the risks seem to outweigh the questionable benefits.

As a follow-up, I would like to offer the results of some just-published research:

In an article by Tim Noakes and others (Wharam, Speedy, Noakes, Thompson, Reid and Holtzhausen) entitled "NSAID Use Increases The Risk of Developing Hyponatremia during an Ironman Triathlon" in the journal Medicine & Science in Sports & Exercise (Vol. 38, No. 4), the authors concluded (in part): "This study shows that NSAIDs are commonly used in ultraendurance events and that their use is associated with an increased risk of the development of biochemically diagnosed exertional hyponatremia. The effect is likely due to an alteration of renal function."

Please note that the subjects -- participants in the 2004 Ironman New Zealand -- were clinically diagnosed with hyponatremia but were asymptomatic. However, NSAID use appears to be a contributory factor to them developing clinically diagnosed hyponatremia based on blood sampling post-race. Just another factor to consider if you were thinking of taking NSAIDs during that next ultraendurance event.

Anthony C. "Woofie" Humpage, C.S.C.S., is an Ultrafit Associate and USA Triathlon certified coach. He coaches Masters and female athletes for ultra-endurance events. Woofie specializes in performing in extreme environments. Contact him at woofie@teamwoofie.com.

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