Athletes Warned Not to Take NSAID, Ibuprofen Painkillers before Exercise

A huge number of athletes and team sport players regularly take Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen BEFORE exercise because they believe it will reduce pain and injury.

Many soccer players take these drugs before training and matches to reduce existing musculoskeletal pain from previous injuries. Many also take the drugs to reduce the impact of anticipated strain and injuries.

Athletes and team players believe that taking NSAIDs improves athletic performance by enabling athletes to perform better at more intensive training sessions. However there is no clear evidence for this despite its common practice.

The proportion of athletes using NSAID drugs such as Ibuprofen is alarming: ranging from 12% for cyclists to 70% of distance runners. More than 90% for professional soccer players routinely take the drugs, before or after exercise.

NSAID drugs are known to cause stomach and intestinal problems including ulcers, bleeding and perforations. Exercise, itself has been shown to cause damage to the intestine even when drugs are not taken. This article reviews the research that has triggered a warning about the risks of taking NSAIDs including Ibuprofen, before or during exercise.

The potential adverse effect of NSAIDs on the gastrointestinal tract is well known for all patients.

The drug-facts sheet that accompanies ibuprofen, in most countries, states that ibuprofen should only be used for short-term relieve minor pains and aches. It also warns that ibuprofen may cause stomach bleeding, especially in people over 60 of age.

Previous research has shown that 60 minutes of high level physical activity, without drugs can cause injury to the small intestine and short-term loss of gut barrrier function in otherwise healthy individuals.

The latest research involved a detailed study of whether the short-term NSAID consumption and exercise-induced risk of injury to the intestine injury could combine to elevate the risk to athletes.

The research found that even small doses of ibuprofen, taken at night and in the morning cause evidence of cellular damage to the small intestinal cellular damage. The signs of the damage were short lived and disappeared one hour after the exercise. However the researched were concerned about the long term effect of repeated damaging episodes especially with larger doses of the drug.

The study involved nine healthy men who trained regularly, typically undertaking 3-10 hours of endurance sports activity every week.

The subjects undertook a series of 60 minute cycling exercises, when ibuprofen was taken either before or after the exercise, and when no drugs were taken. Various indicators of intestinal injury were evaluated for each of the treatments and controls.

The study found that the damage indicators were much higher when ibuprofen was taken before the cycling test was commenced.

Cycling without taking the drugs, and taking the drugs without cycling, both caused increases in the gut damage indicators.

The taking ibuprofen before exercise also decreased the barrier function of the intestine, leading to a risk that bacteria in the intestines could enter the bloodstream.

Although the study was confined to male athletes, findings would most likely apply to women as well.

Besides potential gastrointestinal damage from taking these drugs there are also other major risks. If painkillers are taken before strenuous workouts, the painkiller may mask the symptoms and lead to more serious injuries.


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