Risks and Benefits of Using Pain Medications in Endurance Sport
What is this episode about?
INTRO 0-3:50
Amy shares feedback from a listener - we always love hearing from you all!
Questions to Consider Regarding Pain Medications in Endurance Sport
Deciding whether or not to take pain medication during training and racing depends on the answers to a few questions: What is the severity of the pain and why is an athlete taking the pain meds? If an athlete is taking pain medication to help manage pain so they can sleep, that is okay (short term) and important because if we aren't sleeping we aren't recovering. But, if pain is bad enough we aren’t sleeping then it means it’s bad enough we are NOT training. We do not take pain meds so we can continue to train.
What are the Risks?
There are three main types of over the counter pain medications and each has slightly different risks:
1) Non Steroidal Anti-inflammatory (NSAID) which people know most commonly as Ibuprofen, Alive, or Advil. NSAIDs are the most risky of the three types of pain meds because of the damage they can do to the kidneys during long or hard workouts (including rhabdomyolysis). Although they are anti-inflammatories, NSAIDS can actually increase inflammation during extreme exercise in addition to exacerbating gut issues, decreasing muscle strength and size, and delaying bone healing.
Even if athletes don’t take NSAIDs during their training/racing, they may be inclinded to use them after to manage pain. This isn’t ideal because they impeed recovery. However, if you do take them after a workout, make sure you are properly hydrated first (monitor this by ensuring you are urinating at a normal frequently and it's light yellow in color).
2) Tylenol - The active ingredient in Tylenol is acetaminophen. The risk with Tylenol is that it's toxic to the liver especially when athletes are overheated. This damage is irreversible so we need to be aware.
3) Aspirin - Many people take Aspirin as prescribed by their doctors to help manage blood clots. None the less, it’s important to be aware of the issues that come with using Aspirin as an endurance athlete. Make sure you talk to your doctor about this. The main concern is that, because it thins the blood, Aspirin increases bleeding which is risky in combination with the increased muscle damage from training. Aspirin also impacts the blood vessels and muscles of the heart as well as the gut.
There are wide variety of opinions from doctors so talk to a health care professionals you trust to help you make a good decision for your own situation.
What are Natural Alternative?
Using pain medication during endurance exercises carries risk of damaging the liver, kidney, heart, stomach, and GI lining is a risk and can cause nausea. Because they mask pain, athletes may accidentally train to the point of further damage.
Foods with anti-inflammatory can be a way to boost recovery and manage pain (though you always want to check with your doctor!). Foods such as turmeric, tart cherry extract, omega 3 (fish oil), ginger are a few examples. Read Foods to Eat When Recovering from Injury: Boost Anti-Aging, Sports Performance and Recovery for additional information and ideas.
Reference List:
Thirupathi A, Pinho RA, Ugbolue UC, He Y, Meng Y, Gu Y. Effect of Running Exercise on Oxidative Stress Biomarkers: A Systematic Review. Front Physiol. 2021 Jan 20;11:610112. doi: 10.3389/fphys.2020.610112. PMID: 33551836; PMCID: PMC7854914.
Küster M, Renner B, Oppel P, et al Consumption of analgesics before a marathon and the incidence of cardiovascular, gastrointestinal and renal problems: a cohort study BMJ Open 2013;3:e002090. doi: 10.1136/bmjopen-2012-002090
Lipman GS, Shea K, Christensen M, et al Ibuprofen versus placebo effect on acute kidney injury in ultramarathons: a randomised controlled trial. Emergency Medicine Journal 2017;34:637-642.
Blog post: Foods to Eat When Recovering from Injury: Boost Anti-Aging, Sports Performance and Recovery