Anti-Inflammatory Drugs in Sports and Exercise

two Ibuprofen pills on wooden tabletop next to package
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Anti-inflammatory (AI) medications are a class of pharmaceuticals designed to relieve inflammation in body tissues in order to relieve pain and stiffness. Examples of AI medications are prednisone, ibuprofen, aspirin, celecoxib, and diclofenac.

Anti-inflammatories can also be categorized as "steroidal" and "non-steroidal" drugs. Prednisone is a well-known AI in the steroid class, and ibuprofen and aspirin are over-the-counter products in the non-steroid class. These are called non-steroid anti-inflammatory drugs, or NSAIDs.

Sports enthusiasts and exercisers—including weight lifters and weight trainers—generally use NSAIDs for pain relief from muscle injury and soreness, and occasionally for fevers. Aspirin also reduces blood clotting, so the longer-term use of aspirin in high doses is not recommended.

Ibuprofen has become very popular among exercise trainers and athletes, not only for existing pain relief but also as a pre-emptive treatment in advance of workouts or competition for anticipated delayed onset muscle soreness.

Effects of Ibuprofen Use Among Athletes

Anti-inflammatory medications are often used as a precaution against muscle soreness. Over time, following various studies on athletes taking NSAIDs, concerns have risen about how this practice might affect health outcomes and performance.

The New York Times reported that up to 70% of distance runners and other endurance athletes take inflammatory medications before every workout or competition. Use of the medication is also very common in strength-trained athletes.

Ibuprofen, as one example, is known to have adverse intestinal effects when used excessively. One concern is the additional damage that may occur to intestines, considering the stress of athletic training and competition. A study in the journal Medicine and Science in Sports and Exercise found that ibuprofen aggravated exercise-induced small intestinal injury and induced gut dysfunction in healthy individuals.

In another examination of ibuprofen use in endurance athletes, ibuprofen, and other NSAIDS were found to increase the susceptibility of athletes to hyponatremia, a serious and sometimes fatal condition caused by low blood sodium, and usually related to excess water consumption. Stress on the kidneys by NSAIDs might increase the risk of hyponatremia when other conditions are met.

Experts have warned that there is little justification for the pre-emptive use of ibuprofen or other NSAIDs before or after training or competition to prevent muscle soreness and that such indiscriminate use could have adverse health consequences.

The best approach seems to be to only use NSAIDs for treatment of muscle and skeletal injuries when serious pain relief is required, and then only for as short a course as possible. Pre-emptive use should be strongly discouraged.

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