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Athletes and Painkillers

We all like to say it after an intense workout or particularly grueling race: no pain, no gain. And it’s true. We push ourselves to our limits with a goal in mind—shed time, increase speed, maximize efficiency, and the list goes on. At the same time, who likes pain, right? Ibuprofen has become almost as essential to the training regimen as shoes, goggles, and helmets. Some athletes pop a painkiller every four hours on race day to help keep the pain away. Many follow every training session with a carb + protein snack… and a painkiller. Is our reliance on ibuprofen just smart training by maximizing our effort without all the pain? Or are we undercutting ourselves, blindly following a routine without concern for hidden side effects?

A pair of recent studies by Dr. Grant Lipman sought to shed light on the impact of the athlete’s love affair with ibuprofen. Dr. Lipman, associate professor of medicine at Stanford University and medical director for several ultramarathons, was principally interested in a few case studies he’d heard of that linked ibuprofen to kidney problems. In one of the studies, tracking 89 runners running 50-mile portions of an ultra, Dr. Lipman said he felt sure the results would be that ibuprofen is perfectly safe and athletes should continue on.

As it would happen, the results were pretty conclusive. They were not, however, what Dr. Lipman was expecting. The study concluded that runners who use ibuprofen while running very long distances double their risk of acute kidney injury. Due to dehydration, decreased blood flow to the kidneys, and rhabdomyolysis—muscle breakdown resulting in kidney-damaging proteins in the blood — many ultramarathoners experience acute kidney injuries. Most of these injuries resolve themselves in a matter of days. What this study tells us is that ibuprofen makes the incidence of a kidney issue more likely.

Per Dr. Lipman, while this study doesn’t provide insight for use among the non-endurance athlete crowd, he says that endurance racers and distance runners of all stripes should think twice before choosing ibuprofen for pain management.

So, where from here? Dr. Lipman has opted for acetaminophen over ibuprofen for pain relief associated with distance training and racing. He’s also turned to the good ole ice bath for relief.

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