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[RC] Ibuprofen and muscle recovery - Kristi Schaaf

When I read the article in the AERC News about the
detrimental effects of using ibuprofen at rides, I was
bummed. From reading ridecamp I was under the
impression that endurance riders are popping Advil
like M&M's to have a pain free ride weekend. Because
of some back and old injury issues, I can get
stiff/sore, so I started pre-loading Advil on the Fri
of a ride weekend, and continued taking it through
Sunday, thinking that I was not only giving myself
some pain relief, but also lowering the inflammatory

But, after reading that blip in the AERC News, I went
online to find out more and came across the below,
which bums me out even more. Can anyone who
understands the pain/pain killer/inflammation process
AND is involved in distance riding provide some
feedback? Is it worth the loss of 'muscle growth' to
keep from being stiff and sore during a ride? (since
that potentially negatively affects our horses). Does
something different like Tylenol actually help with
muscle soreness as much as Advil? 


The effect of NSAIDs such as aspirin, ibuprofen, and
acetaminophen on muscle growth. 

If you are one of the many people who take a few Advil
aspirin,or any other NSAID after a workout or in the
days following to alleviate muscle soreness, think
again! There is recent research that conclusively
shows that taking NSAIDs after exercise-induced muscle
damage significantly reduces levels of the
prostaglandin, PGF2-á, which is intimately involved in
the protein synthesis that occurs post-exercise; we
work out, tear down our muscles, and the anabolic
process of tissue repair and hypertrophy is dependent
on levels of this prostaglandin.(1,2). It has been
known for some time that maximal, prescription-level
doses of NSAIDs will inhibit skeletal muscle protein
synthesis, as the study in reference (2) below was
performed in 1982. Most of these studies, however,
utilized in-vitro systems where cultured myocytes were
exposed to a stretch-stimulus to induce tissue damage
and then protein synthesis was measured with-and
without the presence of a high concentration of NSAID.
As those of us in the field of pharmacology have
(painfully) witnessed time-and time again, in-vitro
systems are rarely representative of what actually
occurs in-vivo. Because of this the notion that NSAID
use after a workout might decrease muscular gains was
passed off as an artifact of the experimental systems
used; and not representative of what somebody would
experience when taking over the counter doses of

A group in 2001, however, using eccentric contractions
in human subjects to induce muscle damage, showed that
post-exercise NSAID use drastically reduced the
increase in protein synthesis normally seen in
response to muscle damage. This study is relevant to
real workouts because the researchers used a model for
muscle damage that is very similar to what what
happens during a normal weight training workout and
the doses of NSAIDs used in the study were normal
therapeutic doses, not unlike those that most people
would take for a headache or after a tough workout for
soreness. The results of this study were that, in the
untreated subjects, post-exercise muscle protein
synthesis (24 hours post-workout) increased in upwards
of 76%, while subjects that received either
acetaminophen or ibuprofen saw no significant increase
at all. The implications of this study are huge; if
you are into taking a few Advil after a tough workout
to alleviate soreness, think again; you may be
severely hindering your progress. 

It is important to know the mechanism behind such a
phenomena because it may be possible that we can use
this to our advantage. NSAIDs inhibit the enzyme COX-1
and COX-2, which basically take a common substrate,
arachidonic acid, and through a cascade of biochemical
reactions create a number of prostaglandins. Some
Prostaglandins cause inflammation and are largely
responsible for the pain response we get after a
workout. Reducing prostaglandin synthesis by
inhibiting the COX enzyme can reduce pain and
inflammation, but at the same time reduction of the
specific prostaglandin, PGF2-á has a dramatic effect
on the ability of muscles to hypertrophy(2,4).
Intuitively, this makes sense, because inflammation is
intimately involved with the healing process. Although
there are certainly situations when reducing
inflammation is beneficial, after a training workout
is clearly not one of them. 

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