Nearly every runner has dealt with muscle soreness, little niggles in joints or tendons, or even full-blown injuries.
Although there are quite a few ways to relieve delayed-onset muscle soreness and reduce discomfort, taking anti-inflammatory drugs like ibuprofen is one of the more common ways runners seek to achieve temporary pain relief.
In fact, it’s not uncommon for runners to pop a couple ibuprofen tablets or soft gels before a run to quell soreness from a previous workout or relieve the aches from a mild running injury like an early case of plantar fasciitis, runner’s knee, or shin splints.
Some runners even swear by “vitamin I,” elevating the drug ibuprofen to the illustrious status of a beneficial vitamin like vitamin C or vitamin D, due to its ability to allow them to train through acute or chronic pain or muscle soreness from working out.
But, is it safe to take NSAIDs before running? Should you take ibuprofen for exercise? In this guide, we will discuss taking ibuprofen for exercise and whether it’s safe to take NSAIDs before running or to reduce muscle soreness after a hard workout.
In this guide, we will cover:
- What Is “Vitamin I” (Ibuprofen)?
- How Does Ibuprofen Work?
- Should You Take Ibuprofen for Exercise?
- Risks Associated With Taking Ibuprofen Before Exercise
- Risks Associated With Taking Ibuprofen After Exercise
- The Takeaway: Ibuprofen “Vitamin I” for Exercise
Let’s get started!
What Is “Vitamin I” (Ibuprofen)?
Most runners have heard of ibuprofen, or its various trade names, such as Advil or Motrin, or to some runners as vitamin I. However, even though many of us are apt to mindlessly take a couple ibuprofen tablets here or there, we don’t often think twice about what it is.
According to the FDA, ibuprofen is a drug that belongs to a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs), which also includes drugs such as naproxen sodium (Aleve), Celebrex, and aspirin.
Ibuprofen is used to treat pain and fevers associated with headaches, arthritis pain, muscle aches, the common cold and other viruses, menstrual cramps, toothaches, and backaches.
Runners may take ibuprofen after exercise to reduce the discomfort associated with delayed-onset muscle soreness (DOMS), or before a run to alleviate joint, muscle, tendon, ligament, or other musculoskeletal pain to make it more comfortable or feasible to run.
The standard over-the-counter (OTC) tablet or gel capsule of ibuprofen contains 200 mg of ibuprofen, with directions for adults to take 1-2 tablets every 4-6 hours.
Doctors may prescribe up to 800 mg tablets with a prescription for short-term pain relief for more significant injuries, such as after a tooth extraction or during or after an acute injury.
How Does Ibuprofen Work?
So, when you take Advil or Motrin for a headache, fever, or achy knees, how exactly do these medications reduce pain and body temperature? How does ibuprofen work?
Like other NSAIDs, ibuprofen works by blocking cyclo-oxygenase (COX) enzymes, which are a group of enzymes involved in biological chemicals called prostaglandins.
Prostaglandins have numerous functions on the body. The COX-1 and COX-2 enzymes both produce prostaglandins that are associated with pain, inflammation, and fever.
Therefore, because ibuprofen blocks the production of COX-1 and COX-2 enzymes, and these enzymes are needed to make prostaglandins that are involved with pathways that yield pain, inflammation, and fever, taking Advil, Motrin, or generic ibuprofen can reduce pain, inflammation, and fever.
One interesting note is that the common side effects of ibuprofen—namely irritation of the gastrointestinal lining and GI bleeding—are additional effects that result from blocking the production of the COX-1 enzymes.
COX-1 enzymes help produce beneficial prostaglandins involved in the protection of the mucosal lining of the GI tract and in the activation of platelets associated with blood clotting.
For this reason, high doses or prolonged use of ibuprofen or other NSAIDs increases the risk of abdominal bleeding, stomach ulcers, and increased intestinal permeability.
Should You Take Ibuprofen for Exercise?
It’s natural to think that if ibuprofen can reduce pain, inflammation, muscle soreness, and joint discomfort associated with arthritis or swelling, then it would be helpful to take “vitamin I” before or after exercise when you have musculoskeletal discomfort.
In fact, one study of triathletes found that about 50% of Ironman competitors took ibuprofen before the race, but many endurance athletes don’t think NSAIDs before exercise actually helps all that much.
However, most research indicates that taking ibuprofen before running or working out can be dangerous and taking ibuprofen after exercise for muscle soreness can inhibit recovery from your workout.
For these reasons, it is not recommended that you take ibuprofen before exercise or after working out.
Risks Associated With Taking Ibuprofen Before Exercise
Because ibuprofen and other NSAIDs block the COX-1 enzymes that are needed to produce prostaglandins that protect the GI tract and prevent excessive bleeding, taking ibuprofen or NSAIDs before running can increase your risk of stomach ulcers and adverse intensional leakage.
One small study examined the changes in intestinal permeability (which is indicative of gut lining damage) due to taking ibuprofen before exercise.
Researchers tested four conditions twice with the subjects:
- Taking ibuprofen before exercise: Subjects took 400 mg of ibuprofen (2 standard tablets) before cycling at a high intensity for one hour
- Not taking ibuprofen before exercise: Subjects completed the same high-intensity cycling workout for one hour without taking ibuprofen beforehand
- Taking ibuprofen without exercise: Subjects took 400 mg of ibuprofen and then rested instead of exercising
- Not taking ibuprofen and resting: Subjects didn’t take ibuprofen and did not exercise
Blood samples were taken after each condition to analyze the levels of intestinal fatty acid binding protein (I-FABP), a biomarker for injury to the small intestine.
After comparing the lab values for each condition, it was found that taking ibuprofen before exercise yielded significantly higher levels of I-FABP than the other three conditions.
In fact, taking ibuprofen before exercise nearly doubled the value of every condition and was more than 2.5 times higher than the non-ibuprofen situations.
The mean peak I-FABP values were 875 pg/mL for ibuprofen before cycling, 474 pg/mL after cycling without ibuprofen, 507 pg/mL after taking ibuprofen but not cycling, and 352 pg/mL without either.
Moreover, when taking ibuprofen before working out, blood markers remained elevated for up to two hours after exercise.
The researchers concluded that taking ibuprofen before endurance exercise is contraindicated, especially because endurance athletes might take even more than 400 mg of ibuprofen before exercise and work out for longer than one hour.
Either of these cases would likely cause even further intestinal damage than was observed in the study with one hour of cycling.
Taking ibuprofen before running or other endurance exercise is also associated with acute kidney damage, and evidence has demonstrated that taking NSAIDs before exercise can increase the risk of exertional hyponatremia.
Another study found that not only does taking ibuprofen before running or exercise increase the risk of injury because it can mask pain, but it also can inhibit the production of collagen.
Collagen is a vital biological protein needed for building and repairing muscles, tendons, cartilage, ligaments, and bones. Thus, collagen production is crucial for recovery from exercise.
Essentially, collagen is needed to repair the micro-tears in your muscles and connective tissues and build back bone cells.
Unfortunately, the same COX enzymes that NSAIDs block to reduce pain, inflammation, and fever are responsible for producing the prostaglandins associated with producing collagen.
However, because collagen production facilitates muscle repair and recovery after exercise, taking ibuprofen before exercise can compromise your recovery, increase the risk of injury, and delay the healing from injuries and musculoskeletal damage.
Another study found that taking a high dose of ibuprofen once a day reduced the strength improvements and muscle gains over the course of an 8-week resistance training program.
In other words, taking ibuprofen limits the fitness improvements from training.
These limitations don’t stop with resistance training. Evidence also suggests that taking ibuprofen before running prevents the normal, favorable skeletal muscle adaptations due to endurance training.
In other words, taking ibuprofen before running long distances can at least partially negate all your hard work.
Risks Associated WIth Taking Ibuprofen After Exercise
As mentioned, ibuprofen and NSAIDs block the COX enzymes needed to make prostaglandins that produce collagen to repair tissues.
Inflammation is also an important part of tissue healing, and ibuprofen is an anti-inflammatory drug. Inflammation signals your body that it needs to increase the delivery of blood, oxygen, and nutrients to the damaged tissues (micro-tears in muscles) to supply resources to heal.
By taking anti-inflammatory drugs, you prevent the inflammation process from initiating the healing process.
Therefore, perhaps unsurprisingly, research has shown that taking ibuprofen after exercise or even before your workout can inhibit the healing of muscles, tissues, ligaments, and bones, and can delay recovery from injuries.
The Takeaway: Ibuprofen “Vitamin I” for Exercise
It can definitely be tempting to turn to vitamin I, or ibuprofen, for a quick fix when you have a niggle from running or to alleviate muscle soreness after working out.
However, while ibuprofen and NSAIDs can provide temporary pain relief and reduce inflammation from exercise, these medications actually block physiological pathways that are important for workout recovery and tissue repair.
If you’re in pain, your body is sending you a message that you need to rest or try a less intense type of exercise. Heed these signals and save the vitamin I for times when you are really sick.
If you have an ongoing injury from running or are experiencing muscle soreness that won’t go away, it’s a good idea to speak with your doctor or physical therapist for a proper diagnosis and treatment plan.
For actual vitamins, (sorry vitamin I), to look in to adding to your routine, here is our Supplements for Runners Guide.