I've noticed recently that a lot of people mention in their race reports that they take ibuprofen either before or during their races. I wanted to mention that there are some serious health risks associated with taking NSAIDs.
First and foremost, taking NSAIDs before or during a race means that you are taking it with the intent of masking pain. In other words, you are less likely to experience the pain your body may naturally indicate when something is wrong. Obviously, there is good pain (wow, this race is making me tired) and bad pain (my ankle hurts, but I sure am glad I took that ibuprofen). In the good pain situation, you should feel some pain - you're racing! But in the bad pain situation, you risk further injury by inhibiting those pain management receptors that NSAIDs block.
On the other hand, if you experience an acute injury (you just returned from a run and feel immediate pain), it is OK to take some kind of NSAID to help manage the pain AFTER the workout. However, this is not a long term solution and it will not necessarily help solve the problem. A better solution would be to reduce inflammation by ice and let your body heal the issue. Depending on what it is, it could just be a case where ice and rest can resolve it. Other issues may require more focused therapy/self massage. In either case, NSAIDs are not going to cure the problem and they should not be replied upon to do so, despite their frequent use among endurance athletes.
This post was partly inspired by a recent article describing the inheirent risks of NSAID usage amongst endurance athletes. Among the many side effects of NSAID usage is GI bleeding and additional stress on the body, which can create further dehydration. When you carry that over the course of a long distance endurance event, you find that cramps and other muscular issues result - something everyone tries to avoid if at all possible An interesting result from that study referenced in the article was this:
Between 2002 and 2006, Dr. D.C. Nieman, director of the human-performance lab at Appalachian State University, conducted a study comparing the finishing times, rate of perceived exertion and physical states (using pre- and post-race blood samples) between two groups of competitors at the Western States 100. Members of one group took between 600 and 1200 mg of ibuprofen before and during the race, and members of the other group took no pain relievers.
Dr. Nieman's study found little variance between the two groups when it came to muscle soreness or race performance, but did find greater instances of inflammation and endotoxemia (when toxins leak into the bloodstream from the colon) among the ibuprofen users.
"Ibuprofen had no beneficial effect on muscle soreness or pain," says Nieman. "When I presented these findings at a seminar for Western States runners, just about everybody said they would continue using ibuprofen."
So ultimately, you're doing yourself more harm than good by taking NSAIDs. As far as natural anti-inflammatories go, fish oil is always considered one of the best sources. I think the common perception that taking a pill is somehow magically better than taking something natural has led to the misuse over time. And if you notice the conclusions from another study regarding the increased risk of heart attacks and stroke when taking NSAIDs, I think you might be able to draw some type of relationship between the recent increase in deaths during endurance races. Sure there are other factors at play, but it is highly likely that many of these same people took a few NSAIDs (because everyone else was doing it) and suffered. Each person is different and just because you're friend has taken something with "success", doesn't mean you should.
Hopefully the next time you are thinking about popping another pill, just remember that it very likely isn't going to benefit you the way you are hoping it will. So save yourself the risk and use an alternative approach.