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Ibuprofen, Tylenol, or ?

 
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racer99
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Joined: 25 Oct 2003
Posts: 122
Location: South

PostPosted: Mon Jan 16, 2006 8:40 pm GMT +0000    Post subject: Ibuprofen, Tylenol, or ? Reply with quote

Doc:
Is there a reason not to take any pain medication during long endurance events (12 hour, 6 hour races, TT, etc.)?

I have been told that it is not recommended by some, others tell me they regularly do so.

Thanks.

R99
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The Bike Doc
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Joined: 08 May 2003
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Location: Corpus Christi and Warda, Texas

PostPosted: Tue Jan 17, 2006 10:23 am GMT +0000    Post subject: Reply with quote

Racer99:

Nonsteroid anti-inflamatory drugs (NSAID) , of which Motrin belongs, have been shown to constrict blood vessels. This can lead to reduce blood flow to exercising muscles. Further NSAID can inhibit the formation of new blood vessels. New blood vessels to the muscles are formed by regular training and exercising which improves endurance. Yet the very medication taken for aches and pains, NSAID and acetaminophen (Tylenol) inhibit this desired effect. Additionally, while there are therapeutic levels in the blood of the NSAID the platelets are inhibited and a crash can lead to much bigger bruising and bleeding from cuts. Aspirin is unique in that the platelet inhibiting nature lasts one week not just several hours as is the case with Motrin and the other NSAID. For those who must take a daily aspirin to prevent blood clots they should not stop taking the asprin, the benefits then out weigh the risks.

Ibuprofen (Motrin) and acetaminophen (Tylenol) have been shown to impair muscle protein synthesis after exercise and to reduce the release of the prostaglandins that are associated with blood vessel dialation and growth. Exercise triggers the changes that lead to muscle growth and to inhibit the desirable muscle protien synthesis with medications taken after exercise is counter productive to the goals of training. I have provide links to three articles that discuss some of these issues. There are many more available if you want to do a PubMed search for them.

http://ajpendo.physiology.org/cgi/reprint/282/3/E551

http://jcem.endojournals.org/cgi/reprint/86/10/5067

http://jap.physiology.org/cgi/reprint/86/2/598

My recommendations to prevent the aches and pains of training and racing is to progressively train, increasing your intensity noi more than 10% each week and avoiding going too hard too soon to avoid percipitating an overuse injury. Additionally, daily stretching exercises should be incorperated help keep the muscles and joints limber and less prone to incuring injuries. Get the excellent book, Stretching by Bob and Jean Anderson. It is a valuable resource in teaching you the correct way to stretch.

If you must take something for aches after an event, try icing and massaging for the first couple days then switch to warm soaks and massaging for the next several days afterward. If you feel you must take a medication to relive the pain afterwards, acetaminophen probably has the lesser of the undesirable side effects on the muscle. However, if someone drinks more than two drinks (beer, wine, &/or liqour) a day even standard dose acetaminophen can be toxic to the liver.

It was good question you asked and hopefully, I have not overwhelmed you with too much information, but instead, provided you with the rational for what some might think is unusual recommendations in light of the heavy marketing of the medications in question.

Thanks,
_________________
Paul K. Nolan, MD
AKA: The Bike Doc
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racer99
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Joined: 25 Oct 2003
Posts: 122
Location: South

PostPosted: Tue Jan 17, 2006 9:41 pm GMT +0000    Post subject: Reply with quote

Thanks, Doc.
I have never used any pain meds while training or racing, just curious as to the desirability of doing so.
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