Just Pop another Advil (or not)
For years I have been advising my clients to limit the use of NAIDS (non-steroidal anti-inflammatory drugs) such as ibuprophen for the treatment of tendonitis-type and other soft-tissue ailments, not to mentions DOMS a natural side -effect from unaccustomed exercise bouts that include eccentric muscle action. I want to share, with you, the rationale behind my advice.
Some history first…..In 2003 and 2004, during my time in graduate school, I spent months reviewing the research in the area of muscle damage. Recovery and more specifically, ‘regeneration’ was of great interest to me as a practicing strength coach. I wanted to know every trick in the book to facilitate the best training protocols and schedules and monitor the adaptation process for each athlete under my supervision. I was working with elite level basketball players at the time. The gym was my lab. I have always been committed to making sure my clients work hard, but are also well-‘regenerated.’ I examined, and even did some pilot work of my own, on adaptation markers such a creatine kinase (CK) to measure the severity of insult to the tissues after heavy eccentric work. I assessed, just as the researchers I was following did, the timelines of healing and the series of events following a training bout. During my research, I had a chance to also look at the influence on NSAIDS, specifically ibuprophen, in the healing process.
Today, I own and operate a busy Strength Training company in Vancouver called Human Motion and see athlete-clients as well as fitness enthusiasts on a weekly basis. As an aside, I will see anyone who is enthusiastic about fitness; they do not have to be a high performance athlete. I simply love sharing my knowledge with those who I have the privilege to coach. I also play flag football in a competitive women’s league and teach an Active Health class here in Vancouver, so I am exposed to many active people who have many fitness-related questions. One question I get often is whether or not it is OK to take ibuprophen after training, or competition to reduce muscle and joint pain.
NSAID’s work by blocking an enzyme called cyclooxygenase (COX). This enzyme catalyzes the production of various protanoids that play a role in inflammation and algesia. Algesia is the sensitivity to pain. In theory, by reducing prostanoids, we can alleviate the muscle and joint pain response. Using CK as a marker of muscle damage and comparing those who take the NSAIDS and those who did not, there is no scientific difference between the two, possibly concluding that NSAIDS have little effect on treating what actually causes the pain. The majority of studies actually show no differences in pain scale ratings (using visual analogue scores) between those who take the NSAIDS and those who do not.
Now, let me explain the implications for my clients….the hard core exercisers!
Scientists also know that prostaglandins regulate protein metabolism and they specifically aid in the stimulation of protein synthesis. Protein synthesis is what allows muscles to grow stronger and allows muscles to repairs themselves from the training bout(s). Studies have shown that muscle protein synthesis in completely impaired following the ingestion of a NSAID (ibuprophen). So, if your goal is to see muscular development and strength gains through that development….even with rehabilitative protocols, then flush those bad boys down the toilet.
It is important for my clients to understand the damage, inflammation and repair process as a normal and necessary part of a positive training adaptation. The inflammatory response and soreness following an intense training session is actually part of the healing process and when recovery days are instituted within the training week, then supercompensation will result. If there is soreness after training, the best thing to do is to keep moving. Begin your day with 20 minutes of joint mobility work, move onto a lighter, more metabolic circuit for training with lots of extension movement to open up the tissue and allow nourishment via blood flow. The key is to move and move often. Once movement begins, the pain will subside and just like a New Year’s Day hangover the pain will eventually subside!