Anti-inflammatories and running

By Dr. Jon Hooper

Most runners, particularly those training for longer distances, have had their fair share of muscle and joint aches and pains.

Treatments vary but usually involve rest, ice, stretching, massage, and some form of physiotherapy.

Anti-inflammatory drugs (NSAIDS) are frequently recommended and can work wonders. Typical drugs in the NSAID class include Ibuprofen (Motrin, Advil), Naproxen (Aleve, Naprosyn), Celecoxib (Celebrex), Indomethacin (Indocid), Meloxicam, Diclofenac (Voltaren) to name just a few.

However, there is reason to be concerned about using these medications on race day.

NSAIDS have a number of side effects that can be exacerbated by prolonged physical exertion (like running a half or full marathon).

NSAIDS can have serious adverse effects on your kidneys, particularly when you are dehydrated or over heated, which are very common occurrences in runners.

Some NSAIDS can be very hard on your stomach, which also can be affected by the effects of running long distances.

Some NSAIDS can increase the chance of blood clotting, which can lead to heart attacks, which are already a concern on race day.

NSAIDS have been linked to a condition where your sodium can drop to life-threatening levels (hyponatremia), which is yet again a risk on race day even without the help of NSAIDS.

I know many runners have taken NSAIDS prior to their race, either for that nagging injury or to help prevent the inevitable ouch of a hard long run.

The best medical advice would be to not take NSAIDS prior to a long distance race, and not in the first 24 hours after (or until you’re back to eating, drinking and urinating normally).

If you have a serious musculo-skeletal injury that requires NSAIDS, you should probably re-evaluate the wisdom of running a long race.

If you decide to go ahead and run with the help of NSAIDS please do not overheat, or become dehydrated, or overhydrated (which may cause your sodium levels to drop).

Yes, you will probably hurt after running a marathon, but for the first 24 hours after, use good old-fashioned ice for sore joints, a hot bath tub for those achy muscles, along with massage and stretching.