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Mookie
November 7th, 2008, 09:55 AM
Let's tackle NSAIDs and swimming/working out. My ortho recently started me on them for an unrelated injury, and says it is OK to keep swimming - but he isn't a swimmer! What are the risks of taking NSAIDs and vigorous excersise? Benefits? A search of the forums doesn't yield much direct discussion of this. Let's get the collective wisdom for ibuprofen and the rest out in one place.

As a starter, my ortho doc wants me to take 500 of Naproxen every twelve hours. It's for a forearm injury that doesn't impact my swimming, amazingly enough, so I'd like to keep up with my Masters swim team. I gotta tell you, I don't like the Naproxen, it makes me a little jittery. I asked the doc if I could take the Naproxen in the morning, and 800 of Ibuprofen (makes me sleepy!) instead at night. He said OK.

What are the risks and benefits of NSAIDs with vigorous excersise?

Leonard Jansen
November 7th, 2008, 11:21 AM
Let's tackle NSAIDs and swimming/working out. My ortho recently started me on them for an unrelated injury, and says it is OK to keep swimming - but he isn't a swimmer! What are the risks of taking NSAIDs and vigorous excersise? Benefits? A search of the forums doesn't yield much direct discussion of this. Let's get the collective wisdom for ibuprofen and the rest out in one place.
What are the risks and benefits of NSAIDs with vigorous excersise?

I'm not a doctor, nor do I play one on TV, but...

I have a back injury and take between 2 and 4 OTC Naproxen tablets a day (most days just 2 tablets in the AM) to keep the ache level down. 2+ years ago, when I was training for MIMS, I was getting in up to 55,000/week and had no problems. That said, Naproxen is the only NSAID that I can take that doesn't upset my stomach too much. No idea why.

Hope that helps.

-LBJ

anita
November 7th, 2008, 06:59 PM
I take a lot of medication, mostly central nervous system depressants, and many times will add Tylenol or Advil, depending.
What I have noticed over the last 3 years of exercising on and off (in and out of pool) is that the days I don't exercise I feel overmedicated and sleepy. The days I exercise, my system seems more balanced and I have better quality to my days.
So, I've come to the conclusion that, for me, exercising helps my body metabolize my medications faster, and perhaps it works the same with NSAIDs.
If you take Advil or the like due to an injury before exercising, I can see that you may not be as conscious of the pain and therefore make the injury worse.
<---not a doctor, just a patient. :blah:

Big Jim the finger
November 7th, 2008, 09:11 PM
Even though this thread is not likely to have a large response, it is thoughtless of you not to explain what NSAIDs are to the uninitiated.

jim thornton
November 7th, 2008, 09:39 PM
NSAIDs are non steroidal anti inflammatory drugs. They include ibuprofen (Advil, Motrin, generic ibuprofen) and Naproxen (Alleve). There are a bunch of others available by prescription only that are closely related, and aspirin probably falls in, or close to, this category.

They are pain relievers, fever reducers, and anti-inflammation drugs, though I am pretty sure you have to take reasonably large doses for a reasonably long period of time to get the anti-inflammation reaction.

They work, in part, by kiboshing natural compounds called prostaglandins. Prostaglandins, alas, come in various forms and perform various roles in the body. Some prostaglandins, for instance, promote inflammation, which is one of the body's healing responses. Other prostaglandins protect the integrity of the stomach lining, and still others promote fluid flow through the kidneys. The drug industry tried to make more targeted NSAIDs, like Vioxx, that supposedly targeted primarily the inflammatory prostaglandins, but these drugs ended up having rare but serious heart-related side effects, and were pulled from the market.

In recent years, the research community has been a bit divided about the willy-nilly use of NSAIDs for chronic sports injuries. The gist of the controversy:

most overuse sports injuries, it turns out, are not particularly inflammatory. shoulder tendinitis, for example, is probably misnamed--most cases are actually shoulder tendonopathy, characterized by fraying and wearing down of tissues, not inflammation of same.

some animal studies have found that for certain forms of orthopedic injury, NSAISs may remove pain but at the expense of delaying healing, and sometimes even making the final result worse.

there is also the problem of simply masking pain, allowing athletes to worsen an existing injury. pain is often a signal to reduce activity, not continue grinding away. lepers lose their fingers not because of anything the disease does to finger tissue, but because it kills the nerves that feel pain. the result: a victim doesn't notice it when he or she bangs a finger, or places it on a hot surface, etc. over time, the absence of pain allows so much trauma to accumulate that the limb can no longer overcome the damage. pain, in other words, is critical to health.

you might want to ask your doctor about other approaches, such as ice after and heat before exercise. possibly look into the nitroglycerine patch that appears to help promote blood flow to poorly vascularized tissues like tennis elbow.

it is very important if you are taking lots of NSAIDs and exercising hard to make sure you get enough fluids. Dehydration makes your kidneys work even harder to filter your blood, and NSAIDs hinder the prostaglandins that help fluid move through the kidneys--a double whammy.

At the ACSM (American College of Sports Medicine) last summer, a couple doctors forom Ohio State did a talk on the evidence pro and con NSAIDs for various orthopedic injuries. A lot of the data is mixed, and lot of it is on animals, but I came away thinking that a lot of athletes (myself included) tend to pop these powerful pills like Skittles, believing that since the FDA approved them for over the counter sales, they can't be harmful. The OSU guys suggested trying Tylenol or aspirin instead, which provide the same pain relief but may be safer and have less unwanted side effects.

Hope this helps.

Mookie
November 8th, 2008, 07:39 AM
Thanks Jim,

That's a great response, as are the others. Seems like Caveat Emptor. This is the only relevent thing I found on the net

http://sportsmedicine.about.com/od/medicationanddrugs/a/NSAID_endurance.htm

Jazz Hands
November 8th, 2008, 05:30 PM
Good post by jim thornton. NSAIDs can mask the pain from overuse injuries, allowing you to train when you really should be resting.

Ian Smith
November 9th, 2008, 09:39 PM
I'm not sure if this applies to swimming (maybe in training?) but back to the New York Marathon's "Official Handbook" and what they have to say regarding NSAIDs.

Their warning is in the section pertaining to "Medical Advice Regarding Hydration" (p38) and not heart attacks per se.

They list 12 points under "To avoid hyponatremia, follow these guidlines:"

One of these points is:

"Stop taking NSAIDs such as ibuprophen and naproxen sodium 24 hours before your race and do not start again until a minimum of six hours after finishing the race"

The other points are more diet and fluid intake oriented as well as a "don't take any products containing ephedra".

The consequences of hyponatremia, in the most serious cases, are stated to be "seizures, coma and death"

craiglll@yahoo.com
November 10th, 2008, 03:47 AM
NSAIDS are evil. I have a major irritation to them similar to an asthma attack. Many people develop this when they take NSAIDS over a long period of time. Some are born with the condition. Once I took Alka Seltzer not knowing there was aspirin in it. I ended up in the hospital with blood pressure of 284/179. Dr. Brown at Jewish in St. Louis got so mad at me because I walked to the ER. It screwed up my hearing and I have scar tissue in my lungs because they had to tube me. It is the only time in my life I have been tubed because of my breathing. I have severe asthma.

If you hurt so much that you have to take pain regulators frequently, stop and relax for awhile. Nothing will heal if it keeps getting irritated. My pain doctor says if you have to take more than 3 doses a day of something for more than 3 days to stop the pain, stop the activity. He also says never take more than the directions say when you take it. Three will not work better than will 2 or one. Follow the directions on the bottle.

There is suppose to be a new pain killer coming out that has the characteristics of NSAID in that it pinpoints the injured area but doesn't cause the other side effects. Also remember too much Tylenol can cause sever liver and kidney problems.

I'm not a doctor I've just been treated by many of them.:blah::toohurt::toohurt: i just got off of crutches on Friday.