Recent News and Events

by Alison McGinnis, PT, DPT, FAFS

Posted in Blog.

September 27th, 2018

What You Should Know About Using Painkillers and Anti-Inflammatories On The Run

Running is hard, especially when you’re training for an endurance race. Even without an injury, aches and pains are commonplace among runners. This leads many of us to turn to analgesics/anti-inflammatories/NSAIDs as a way to take the pain away during runs or after a hard training day to reduce soreness so we can feel better and keep on track for the next workout. In a recent study, 49% of the respondents had taken some form of analgesic (painkiller) prior to their last race.1


Although NSAIDs provide some pain relief, there are a lot of detrimental side effects on the body for both performance and recovery that are not as well known. The same study showed 93% of participants reported they were unaware of the risks associated with using analgesics with endurance events.1


In the short term, runners who used NSAIDs during a long run or race were 5x more likely to experience an adverse event during the run compared to those who didn’t take any pain reliever.2 These adverse events can include asthma exacerbation, gastrointestinal cramps and bleeding, haematuria (blood in urine), and cardiovascular events like arrhythmia and heart palpitations.2 NSAIDs can also cause hyponatremia (dangerously low sodium levels) and altered renal function during endurance activities.4 The risk of an adverse event increased linearly as the dosage increased.1


In the long term, routine use of NSAIDs can delay bone healing, decrease protein synthesis (creating new cells), and inhibit blood flow to tendons and muscles after exercise thus stunting the healing process.2,3 There is also the risk of returning too early to sport after an injury or hard workout if using NSAIDs to treat delayed onset muscle soreness, as the accompanying muscle weakness and instability is not addressed by the placebo effect of pain reduction and can create a false sense of health when returning to running. This can lead to inappropriate biomechanical stress and overuse injuries to the same tissues or to other parts of the body.2 For chronically overused tendons (tendinoses), there are characteristic degenerative changes in the tissue but in general they do not exhibit an inflammatory response.3 Therefore using anti-inflammatories to treat chronic tendinopathies is not beneficial to the healing process, but still puts the body at risk for all of the other health issues associated with their use.3


Instead, focus on other items in your recovery toolbox like compression therapy, foam rolling, or cryotherapy to speed up the healing process and reduce pain. If you anticipate that much pain during a run, it’s smart to listen to your body instead of drugging away the pain as it is trying to tell you something before you cause an injury leading to training road blocks!



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