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Ibuprofen use
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Not sure what forum to post this to... it's not an injury or accident and feels too specific for the General Climbing forum, so forgive me if it's misplaced here. My gf and I were talking about ibuprofen use for bouldering. I often have nascent tendinopathy in my elbows and/or shoulders as well as chronically sore fingers after a session and I will frequently take ibuprofen both before and after climbing to limit the discomfort. She thinks it's going to lead to problems and she tries to limit her use of the drug to 1 week a month (you can guess which week). Wondering how common the practice of using "vitamin I" is out there among people who boulder seriously (meaning you push your limits a few times a week). |
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It’s not a vitamin. From a simple search: Long-term effects As long as you’re not exceeding the dose range and timing, it’s probably okay to occasionally use ibuprofen for pain, inflammation, fever. I wouldn’t push the guardrails too much and I’d take it with a bit of food to go more gently on your stomach. |
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It’s not good. I used it way too much over the years and now deal with occasional stomach bleeds. Also, newish science suggests the anti inflammatory aspects of ibuprofen limit muscle and tendon adaptation... meaning you diminish gains from a good workout. |
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I used Ibuprofen significantly when I was young and it often lead to significant nosebleeds and since its a blood thinner they could last for an hour or more at times. I highly recommend you only use it when absolutely necessary. |
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Hi Nate, Some research done at the University of Pittsburgh in the early 2000’s showed that the class of drugs that ibuprofen belongs to (NSAIDs) blocks the healing of muscle. It is quite striking how consistent this effect was. I was part of a group that established this. Many other scientists have repeated this and expanded on it. I reserve ibuprofen for when I have an injury to limit pain. (I.e. after my knee surgery or after a season ending ankle sprain) If you take it before and after climbing, you are making it harder for your muscles to get stronger. Also you are masking the natural signals from your body that let you know whe you are injured. Basically, you are making yourself weaker and more prone to injury.
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WillF wrote: Subscribed! Care to share your research methodology and results? |
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I just started this to back off the Ibuprofen use. See how it goes I guess  |
Double J wrote: From Wikipedia: Although curcumin has been assessed in numerous laboratory and clinical studies, it has no medical uses established by well-designed clinical research.[25] According to a 2017 review of more than 120 studies, curcumin has not been successful in any clinical trial, leading the authors to conclude that "curcumin is an unstable, reactive, non-bioavailable compound and, therefore, a highly improbable lead". Bold Mine |
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If I was in your shoes, I'd put down the I, and look into some prehab/stretching routines. And maybe some weed. |
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Sounds like a recipe for a GI bleed. |
Long Ranger wrote: I just got a pack of gummies from a trusted friend that lives near Lyons. Much better than smoking anything IMO. MN had better get with the program and legalize this stuff soon. |
Lee Harris wrote: Relevant Biology to understand studies: NSAIDs (alleve, Ibuprofen, aspirin, etc.) all inhibit 2 enzymes Cox1 and Cox2. Inhibiting Cox1 can lead to GI discomfort. Inhibiting Cox2 leads to a reduction of pain and inflammation. The below publications focus on PGE2 which is made by the enzyme Cox2. If you inhibit Cox2 and thus PGE2, you block pain and inflammation. Unfortunately PGE2 is critical for bone and muscle growth, and that is the focus of the articles below. Ibuprofen inhibits both enzymes. Very strong pharmacological inhibitors were removed from the market due to side effects on the heart. Why did we study that? In the Late 90's/ early 00's, there was extensive off label use of strong NSAIDS given to athletes. (i.e. if you were an injured steeler or a penguin you would have received this by sports medicine physicians) The previous research showed that general inhibitors like Ibuprofen were bad for muscle healing, but that was general practice. Still I believe (not a clinician) if there is pain, NSAIDs are often given as they are less addictive than opioids and reduce swelling. Anecdotally, I've heard of several cases of patients that had bad results after muscle healing. This is the published results from our study if you want to see the data, methods and results. We were not the first to publish and others have expanded on that work. (what I look for when I want to trust a published finding) Having processed all the microscopy of injured muscle in this study, I can tell you it is more striking than any injured muscle I had seen under the microscope. Drugs delay healing, while loss of Cox2 enzyme leads to far far less healing than normal. This was done in mice, but if you look on pubmed there are studies from this year replicating the biochemistry and physiology in human muscle cells. https://pubmed.ncbi.nlm.nih.gov/16778000/ Dr. Blau's group from Stanford expanding on muscle regeneration and PGE2. https://www.pnas.org/content/114/26/6675.long https://science.sciencemag.org/content/early/2020/12/09/science.abc8059.long |
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From what I understand:
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Long Ranger wrote: This is exactly right, and the science backs this up! |
WillF wrote: Excellent, thanks! I have some knowledge of molecular genetics, biochem, etc. Interested for sure. |
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What about Tylenol? |
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Does this mean that any anti-inflammatory process after a workout is actually negating the workout benefits? Or is this specific to NSAID drugs? What about other supplements that are supposed to be anti-inflammatory, such as turmeric? As noted above with curcumin, whether turmeric is actually anti-inflammatory is debatable, but let's just assume for the sake of argument it is. Going with the summary that Short Term inflammation due to a workout is good, Chronic inflammation is bad, should we only be taking anti-inflammatories if you are specifically trying to address a chronic inflammation issue (or very short term pain issue)? Edit: after reading WillF's post above about the mechanism for how NSAIDS work by inhibiting PGE2, I Googled "Curcumin PGE2" and there is some evidence that some of the possible anti-inflammatory mechanisms are the same. So I guess I would conclude that taking Turmeric or Curcumin regularly is generally not a good idea if I'm trying to maximize my muscle building with workouts. |
hifno wrote: It doesn't track that two bads make a good, so I would be of the opinion that no: you shouldn't become dependent on a drug to deal with long-term pain. So what instead? Stretching, massage, yoga, PT, surgery, modify your activities, even modify your diet (certain foods can cause joint inflammation in some individuals) - things like that. I'll add to that: you may just have to live with the pain. That time I broke my knuckles on some kid's jaw in Catechism? I still feel it, every day. My shoulder, where I torn it on a bike accident that totalled my bike? Still feel it. My ankle after that bad bouldering fall? Still feel it. I'm not going to get on NSAIDS everyday, let alone opiods because of this pain. It's there, too bad for me. You can explore the idea that one can modify the nervous system's reaction to the chronic inflammation through the use of meditation if you'd like. Or reach for some ice every once in awhile. Either way, welcome to life, you're not alone. |
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Lots of good info on Ibuprofen, already... Unfortunately, there is no silver bullet. You have to rest and recover to allow super-compensation to occur. Ligaments and tendons do not recover and strengthen at the same rate as muscles. So, while your muscles may be fully recovering between bouldering sessions, your tendons and ligaments are likely getting weaker. Your tendinopathy and chronic soreness are classic signs of overtraining. If you continue down this path, you will likely end up with an acute and possibly debilitating injury. I suggest taking an extended break from bouldering and eliminating Ibuprofen use, while you read the book “Training for Climbing”. Once you read that book, you should hopefully have a better idea on how to resume climbing and training without injuring yourself. |
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Lots of good posts above. I'll only reiterate that as stated above, masking pain with drugs is not a good idea. |
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"Sure it'll cause some intestinal bleeding... but you just have to weigh that against how much you like your ankle not hurting..." https://www.dailymotion.com/video/x6xc3r7 (Apologies to those triggered by Louis CK since he's still on the "bad" list, I believe) |
