Andrew Jagim, Ph.D, CSCS
It makes sense right? It’s the day after a tough workout, you’re sore, it hurts to move but you have to move because you have another session with your trainer in two hours. So, what do you do? You pop some non-steroidal anti-inflammatories (NSAIDs) to take the edge off and get back out there for round 2! The question is: Is this doing more damage than good? It seems as though there has always been some controversy regarding the administration of NSAIDs. Are they safe? How much is too much? However, some recent evidence has shed some new light on the topic, showing that they may be doing more harm than good in terms of the recovery process.
Much of the soreness that may follow intense workouts is typically a result of varying degrees of muscle damage that often cause inflammation. NSAIDs work by disrupting the cyclooxygenase (COX) pathway. The COX pathway is a series of reactions that lead to the production of prostaglandins that help promote inflammation. However, this inflammation can be experienced as pain or delayed onset muscle soreness due to increased pressure on some of the free nerve endings within the muscle. NSAIDs are believed to help alleviate pain by blocking the COX pathway and ultimately reducing this inflammation. But what if this inflammation is part of the natural healing process and in fact, an essential stimulus for muscle growth?
It is difficult to compare research findings about the effectiveness of NSAIDS on the reduction of delayed onset muscle soreness due to differences in the protocols used (i.e. how muscle soreness was induced, quantified, and assessed). Researchers have also sought to investigate what kind of an effect NSAIDs have on muscle growth. The prostaglandins that are produced as a result of muscular damage have been shown to stimulate satellite cell proliferation. Satellite cells are dormant stem cells located on the membranes of skeletal muscle cells that are thought to be major players in muscle repair and growth. There is some evidence that NSAIDS may block the satellite cell response as well as the acute increase in protein synthesis that is common following resistance training. Therefore NSAIDs may inhibit muscle growth over time with continual use.
So is taking NSAIDs for pain and inflammation counterproductive to training goals? Or is it a Catch 22? If you’re too sore to work out, you won’t get any bigger and stronger because you aren’t training. Or, if you continually take NSAIDs so that you are able to work out, are you hindering your ability to get bigger and stronger? At this time it’s a tough call. More research is needed on trained individuals and how NSAIDs may affect training adaptations over time.
For further reading on this topic:
Lanier, AB. Treating DOMS in sport with NSAIDs. International SportMed Journal. 2004. 5(20:) 130-140. http://digitalcommons.kennesaw.edu/facpubs/2555/
Trappe, TA., Fluckey, JD., White, F., Lambert, CP., Evans, JW. Skeletal muscle PGF2 and PGE2 in response to eccentric resistance exercise: Influence of Ibueprofen and Acetaminophen. The Journal of Clinical Endocrinology & Metabolism. 86(10). 2001. http://www.ncbi.nlm.nih.gov/pubmed/11600586