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Sat Nov 17, 2007 1:40 pm

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From my Health Research Column in Muscular Development magazine.

NSAIDs Can Make Muscle Soreness Worse
Intense, prolonged exercise causes tissue injury and muscle soreness. Part of the resulting pain is due to the generation of free radicals that damage tissue. Cells produce highly reactive free radicals naturally during metabolism that contribute to muscle soreness, DNA damage, aging, and blood vessel disease. Many bodybuilders and other athletes take large quantities of non-steroidal anti-inflammatory drugs (NSAIDs) to treat muscle soreness and reduce joint and muscle pain. NSAIDs help relieve pain, reduce fever, and fight inflammation but can have negative effects in athletes. A study by Steven McAnulty and colleagues from the Department of Health, Leisure, and Exercise Science at Appalachian State University showed that athletes who used NSAIDs during the Western States Endurance Run (a 100 mile race over the Sierra-Nevada mountains in California) showed increases in markers of oxidative stress. Intense, prolonged exercise causes tissue damage, which triggers the release of phagocytic cells to promote repair. These cells produce free radicals that cause further cell damage. The study found that NSAID users had higher levels of protein carbonyls (markers of oxidative stress) and greater muscle soreness the day after the race. Other studies found that NSAIDs interfered with muscle cell repair and hypertrophy (Journal Applied Physiology 103:415-416, 2007). Athletes should use NSAIDs sparingly.
(International Journal Sports Medicine 28: 909–915, 2007)

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Sat Nov 17, 2007 3:45 pm

 
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NSAIDs? Are we talking Ibprofen and other over the counter pain relievers?



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Sat Nov 17, 2007 3:57 pm

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Yes; NSAIDs include aspirin, ibuprofen, and naproxen



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Sun Nov 18, 2007 8:59 pm

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Discusdoc wrote:
Intense, prolonged exercise causes tissue injury and muscle soreness. [snip, snip] ...athletes who used NSAIDs during the Western States Endurance Run (a 100 mile race over the Sierra-Nevada mountains in California)...Athletes should use NSAIDs sparingly.


Discusdoc, thanks for the article.

So to me "sparingly" means its OK to take moderate or prescribed doses of NSAIDs for normal workouts and exercise - would you agree with this interpretation of the article? Is the point of this piece to cite the dangers of extremes: "don't take high doses of NSAIDs while performing 100 mile runs or 5 hour weightlifting sessions"? I'm searching for the practical application of this information, especially since I am currently taking a prescribed NSAID.



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Sun Nov 18, 2007 10:34 pm

 
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Tom, this is very interesting. In my world, NSAIDS like ibuprofen have been studied for years in the setting of oxidant mediated lung injury with tantalizingly mixed results. Early in the 1990’s ibuprofen clearly reduced oxidative stress in some in vitro models of oxidant injury. This lead to human studies in Acute Respiratory Distress Syndrome (NEJM, March 27, 1997). Alas, while it improved fever and modulated some markers of lung injury a little-it demonstrated no improvement in survival at all. It also seemed to augment biologically active metabolites such as TNF which may aggravate oxidant injury. The study you cited that showed no improvement in DOMS or performance seems consonant with what we found in lung injury. There may a reason for all of this: We humans are fearfully and wonderfully made and drugs like ibuprofen have more than one effect on the human body. In earlier studies it was shown that - glutathione – a substance made in our livers in small amounts - was vitally important in protection against all sorts of oxidant-induced stress. It turns out that while ibuprofen seems effective at blocking certain mediators of oxidant stress (cyclooxgenase and some cytokines) it simultaneously blocks glutathione. This may lead to the mixed effect it produces in complex human systems that were not seen in simple experiments. Conclusion: as you said, be careful what you put in your body. The Law of Unintended Consequences can be brutal.

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