Advil / NSAIDs *before or during* workout or race?

gonnzo

I regularly get sore knees and muscles during a workout and have wondered about taking some advil in advance to try to avoid or ease the pain.  I'm also thinking this for race day: I never hear of anyone taking things like this during the event.

Does anyone do this, or is there maybe a good reason why one shouldn't do it - either by rule or just sound medical practice?

Thanks!

Hasanbaydoun

Brian,

Disclaimer: I am an ortho resident - so not in any manner a thinking doctor! and you will get some good replies from them shortly. In the meantime here's my take on this:

taking NSAIDs prior to running might not be the best thing to consider, particularly on race day. If you want to decrease the inflammatory response, I recommend you take some as soon as you come back from a run (granted you are at your pre-workout weight to ensure that you are at adequately hydrated)
the reason NSAIDs are a big no is b/c they do cause shunting of blood from the kidneys.
to date there is only one report of acute renal failure in an ironman triathlete. is that a lot no. but this guy's life has been changed forever. you will ask, but i know people who do it? absolutely!!!! in one study from IM south africa, up to a quarter of the participants took NSAIDs during the race!!!!!

Personally, I do take NSAIDs, after long runs/rides, and after i hydrate myself. NEVER have, and WOULD NEVER consider NSAIDs before or during

let's wait for the smart people for updates

Coach Patrick

@Brian, what Hasan said. Instead of treating, let's try some troubleshooting / prevention stuff. Is it on the run? Bike? Both? Right away or later in the workout or only after? What have you done to take care of it?

Hasanbaydoun

@Brian: sorry I forgot to talk about that aspect, and assumed you were mostly referring to arthritic vague pain that is in your knee. but yes knowing where the pain is is very helpful, what causes it, when does it come along, any specific point tenderness, previous injuries?
man, do i need to be kept in check ;-) thanks Coach
-hb

William Jenks

In particular, ibuprofen (advil) is hard on the kidneys, particularly if your hydration isn't just right. Of all the NSAIDs, a lot of us think it's the most effective, but it's also the one one you should really stay away from during workouts. If you "must", the reputation is that acetominophen (Tylenol) is safer.

I know an ultramarathoner-pediatrician who tells me that she sees a fair number of kidney issues even with youth athletes taking ibuprofen and playing football or other sports where they get dehydrated.

gonnzo

Great responses everyone!  I figured there was a good reason that I don't regularly hear of folks doing this, but now I understand what it is.  Thanks!

To my particular pains, I have some general soreness in the muscles, generally quads and hamstrings, and sometimes calf.  I attribute this to general training stresses.  The joint issues are a combination of specific knee pains, coming mainly from my bike setup I think (details below), and more widespread soreness in the joints and hips that I attribute more to being 42 years old, overweight (5'10", 210), and relatively new to the sport.  The weight is coming down slowly (from 223 Jan 1) as I work my way through the training, but I'm sure it adds to the stresses.

Knee pain detail: left knee only, along the inside, running about 4" long from just above the knee to just below.  I can feel a band of connective tissue or muscle along that line that will be sore for a day or two after a tough workout on the trainer.  I've been playing with the bike setup for weeks and can't seem  to find the right fit.  I think I need a new bike .   I have just my old road bike right now but saving up for a tri bike later this summer.  $$ are tight or I'd go get a fitting, but that's just not in the cards right now.

For running shoes, I need shoes with extra stability to help with overpronation - does that translate to anything in the bike setup that might be playing into the knee pain?  Wedges or insoles?  Bike shoes are Specialized road comps, 170mm cranks, 32" inseam.

Thanks all, and it sounds like my kidneys should thank you too

Brian

 

ghernand

Brian:

Your liver will also thank you for not taking tylenol.  Both meds (tylenol and NSAIDs) are generally safe for their indications, but to use them during conditions where you might become volume depleted is not recommended.

The bike fit seems like a big expense...but more expensive is the damage to your body from riding extended periods in the wrong position.  since you are already experiencing pain, then it is even more worth the money in your case.  wedges (one side may need more than the other), seat height, etc. all will make a world of difference.  your knees and tendons will thank you.

You need a 'fitting' for your running shoes also.  overpronator/under pronator/etc. and the shoes that go with them are like NSAIDs and tylenol for your feet.  they mask the problem and if overused will cause more harm than good.  your goal is to be a neutral runner.  since you are a big guy, then you can get away with having a more bulky shoe, but strive for neutral.  your feet and knees (again) will thank you.  if your feet are strong and flexible, then so will your other running muscles and you will no longer be any classification other than neutral.  this will result in balanced running and less injury.  life long running is all about technique, but proper technique requires strong and fexible running associated anatomy.

the above takes lots of patience, but will keep your body able to train for a long time to come.

of course, the meds are there for when you really need them, but if you were my patient i would prescribe the above.

good luck,

GH

gonnzo

@Gilberto - the cost of the fitting makes perfect logical sense, I just can't find the money right now. As it is, it looks like I'll have to drop out of EN for a while to make ends meet.
What did you mean by a shoe "fitting"? It took months of driving around to different running stores in the area and have them all check my feet and gait to come up with the "stability" shoes I use now (NB 767). Is this it, or did you have something else in mind? We do have an Endurance House in town which boasts video analysis of you running on their treadmill but I haven't tried them yet.

Thanks much,
Brian

ghernand

Brian:

Sorry for the confusion, I didn't mean an actual fitting for your running shoe, but rather to make it your goal to run neutral.  Those machines that analyze your foot strike, even if designed properly, would only tell you what you already do.  That's actually useful information.  however, the next step should be to get everyone to shift towards neutral running, since it would result in less strain on your anatomy/less injury.  instead, they say, 'you over pronate' and then give you a shoe that doesn't allow you to pronate at all.  pronation is a part of proper running.  if you over-pronate, then you need to strengthen the foot structures and leg structures that result in the over pronation, NOT have a shoe that does it for you or even worse, prevents you from doing it.  the latter will start to cause havoc at other places.

your anatomy is correct, in most cases.  so, by conditioning your running muscles, foot, etc. to support you running neutrally, then you are assured of running optimally and avoid injury, etc.  start to gradually transition over to neutral shoes, first wear them for your daily activiies and eventually run in them.  example, some anti pronation shoes have a thick piece of gray rubber or whatever to keep your foot from pronating.  mizuno shoes have less of that gray material, so would be a good transition shoe on your way towards a neutral shoe.

good luck, gh