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Re: [RC] Ibuprofen and muscle recovery - Beverley H. Kane, MDI looked into this issue a while ago, and here are my random conclusions from my increasingly senile memory. Disclaimer: I am personally a long-time, intermittent user of hot-and-cold running naproxyn sodium (Naprosyn/Aleve) for half marathons, endurance riding, and other sports, and I decided not to change my behavior based on my evaluation of the medical literature. 1. I recall that studies on ibuprofen that were most specific, well conducted, and conclusive were on bone healing pathophysiology on rats, not muscle repair in endurance riders. Many orthopedic surgeons are discouraging the use of NSAIDs after bone fracture. 2. The article quoted a couple of posts ago http://www.insidetri.com/portal/news/news.asp?item=108213cited studies that are hard to generalize to myself and other endurance riders, e.g., one w/ 44 male non-athletic volunteers. From a methodological standpoint it seemed like* a bad (small, non-randomized, male only) study and ludicrous to generalize to, say, female endurance riders. 3. I am not aware of perpetuation of the pain cycle in NSAIDs, and would predict there is none, as they act directly on the site of inflammation, for better or worse. There *is* a perpetuation of pain when taking certain *centrally* (on the brain)-acting pain killers like narcotics. This effect is due to a complex interplay of drug receptors on the cell membrane and in the nucleus, and the tachyphylaxis (tolerance) that develops in certain reverberating circuits in the spinal cord. 4. Each drug--ibuprofen, naproxen, COX-2s--has to be studied separately. They can't be lumped together. *It's always important to read the original study, not the _report_ of a study in a newspaper, sports magazine, or online. There are good studies, bad studies, and studies that are good but don't generalize to individuals outside the study group. My overall impression of the studies on NSAIDs (aside from the kidney damage, which is real in long-term high doses) is that the description of the effect on muscle physiology is "scientifically valid but clinically insignificant" for the average person. Reminds me of a joke about a famous software company. See Appendix A. Beverley Appendix A: There's a pilot flying a small single engine charter plane, with some important executives on board, headed for Seattle. He's nearing the destination in thick fog with less than 10m visibility when all his instruments go out, leaving him with just a hand compass. So he begins circling around looking for landmark. After an hour or so, he starts running low on fuel and the passengers are getting nervous. Finally, a small opening in the fog appears and he sees a tall building with one guy working alone on the fifth floor. The pilot banks the plane around, and shouts to the guy "Hey, where am I? The guy replies "You're in a plane." The pilot makes a 275 degree turn and proceeds to execute a perfect blind landing on the Sea-Tac runway 5 miles away. Just as the plane stops, so does the engine, as the fuel has run out. An astonished executive asks, "How did you do that?!" "Easy," replies the pilot. "I asked the guy in that building a simple question. The answer was 100 percent correct but totally useless. So I knew right away that we were 45 degrees NW of the airport at Microsoft's support office." On 9/17/07 9:08 AM, "Nancy Sturm" <sturmranch@xxxxxxxx> wrote: And while you're answering this (un-named expert medical person), would you address something our children's physical therapist told me about her believe that use of Motrin (my drug of choice), Tylenol, Aleve and the other drugs in those classes actually perpetuates a pain cycle. If that is true, how would a person stop the cycle? Nancy =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Ridecamp is a service of Endurance Net, http://www.endurance.net. Information, Policy, Disclaimer: http://www.endurance.net/Ridecamp Subscribe/Unsubscribe http://www.endurance.net/ridecamp/logon.asp Ride Long and Ride Safe!! =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= _____________________________________________ Beverley Kane, MD Program Director, Medicine and Horses Stanford School of Medicine Center for Education in Family and Community Medicine 1215 Welch Road - Modular H Palo Alto, CA 94305-5408 650-868-3379 bkane1@xxxxxxxxxxxx http://familymed.stanford.edu/ See Emmy Award-winning Stanford "Medicine & Horses" on NBC-TV http://www.horsensei.com/nbcnews.html _____________________________________________ =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Ridecamp is a service of Endurance Net, http://www.endurance.net. Information, Policy, Disclaimer: http://www.endurance.net/Ridecamp Subscribe/Unsubscribe http://www.endurance.net/ridecamp/logon.asp Ride Long and Ride Safe!! =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
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