7 RESEARCH ARTICLES + 5 GRAPHICS – CLICK ON IMAGE TO ENLARGE
NSAIDs – NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
→ Aspirin (ASA – acetylsalicylic acid) – Bayer
→ Ibuprofen – Advil, Motrin
→ Naproxen – Aleve
→ Diclofenac – Voltaren
→ Celecoxib – Celebrex
(1) Also called Nonsteroidal Anti-Inflammatory Agents/Analgesics (NSAIAs) or Nonsteroidal Anti-Inflammatory Medicines (NSAIMs)
(2) Provides analgesic (pain-killing) and antipyretic (fever-reducing) effects, and, in higher doses, anti-inflammatory effects
(3) Nonsteroidal distinguishes these drugs from steroids, which have a similar eicosanoid-depressing, anti-inflammatory action
(4) As analgesics, NSAIDs are unusual in that they are non-narcotic and thus are used as a non-addictive alternative to narcotics.
(5) NSAID identification on label of generic ibuprofen: OTC NSAID
(6) The most prominent members of this group, aspirin, ibuprofen and naproxen, are all available over the counter in most countries
(7) NSAIDs, particularly aspirin, may cause gastrointestinal bleeding and ulcers
→ Acetaminophen (Tylenol)
(1) Relieves mild to moderate pain from headaches, muscle aches, menstrual periods, colds, sore throats, toothaches, backaches, reactions to vaccinations (shots), and reduces fever
(2) Acetaminophen may also be used to relieve the pain of osteoarthritis (arthritis caused by the breakdown of the lining of the joints)
(3) Acetaminophen is in a class of medications called analgesics (pain relievers) and antipyretics (fever reducers)
(4) Generally not considered an NSAID because it has only little anti-inflammatory activity
(5) It treats pain mainly by blocking COX-2 mostly in the central nervous system, but not much in the rest of the body
(6) It works by changing the way the body senses pain and by cooling the body
– There are two possible explanations (at least for now)
1. NSAIDs have shown to inhibit key signaling mechanisms of muscle hypertrophy
2. Although not fully substantiated, anti-inflammatory agents may inhibit the acute inflammatory response to muscle damage that subsequently signals the regenerative healing process required for actual muscle recovery
– This acute inflammatory phase following heavy, muscle damaging exercise is linked to temporary pain/soreness, and therefore NSAIDs may be used to mitigate these effects
– However, the question is whether this strategy actually promotes muscle tissue recovery or simply the perception of recovery, i.e. pain management
– I speculate the latter being the case more so than the former since this acute inflammatory response essentially signals the subsequent processes of muscle tissue healing
– In the absence of chronic inflammation, those engaged in resistance training should not resort to NSAIDs to facilitate muscle recovery as it may inhibit growth signals and processes of tissue repair. Just rest.
7 RESEARCH ARTICLES
Duff; Chilibeck; Candow; Kontulainen, Saija A. et al
– Resistance training (RT) with ibuprofen may improve musculoskeletal health in postmenopausal women
– Determine the effect of resistance training and ibuprofen on bone and muscle properties in postmenopausal women
– 90 Participants (65 +/- 5y) training 3 days/week for 9 months
– supervised resistance training or stretching (placebo-exercise) with post-exercise ibuprofen (400 mg)
1. Ibuprofen consumed immediately after resistance training had a deleterious effect on bone mineral content at the distal radius
2. RT or ibuprofen supplementation on their own prevented bone loss.
3. RT prevented muscle density decline in the lower leg.
Dideriksen K1, Holm L2. et al
– 24 elderly men >60 yrs
1. 14 with slightly increased systemic inflammation were given Ibuprofen 1800mg/day for 1 wk
2. The remaining 10 served as healthy controls
– Elderly with slightly increased inflammation can benefit from protein and RT to stimulate muscle protein anabolism
– But, NSAID treatment added to PRO ingestion and resistance exercise did not significantly make a difference
Dideriksen K1, Boesen AP2, Kristiansen JF2, Magnusson SP2, Schjerling P2, Holm L3, Kjaer M2.
– 19 men (60-80 yrs)
1. ibuprofen (1200mg/d, Ibu)
2. or placebo (Plc).
– One lower limb was immobilized in a cast for 2 wks and retrained for 6 wks.
– Whey protein isolate was ingested (2×20g/d) throughout the whole study period.
(1) Muscle mass and strength reached beyond baseline levels after 6 wks of retraining, and NSAID did not significantly affect this
(2) Plasma inflammatory markers were unaffected by the study intervention and NSAID treatment.
Mackey AL1, Kjaer M6. et al
– Young men ingested
1. NSAID [1200 mg/d ibuprofen (IBU)
2. or placebo (PLA) daily for 2 wk before and 4 wk after an electrical stimulation-induced injury to the leg extensor muscles of one leg
– Ingestion of NSAIDs has a +ve effect during large-scale regeneration of injured skeletal muscle
Luke Vella,1,* and Aaron P. Russell1
– 16 males; 23 Yrs Old; followed lower body resistance training and were given:
1. Ibuprofen (1200mg/d)
– Ibuprofen had no effect on markers of muscle damage or muscle soreness during the first 24 h of post-exercise muscle recovery
Todd A. Trappe, Chris J. Hollon et al
– 36 individuals were randomly assigned to 1 of 3 groups:
– Each drug was administered in 3 doses/day (∼8 AM, ∼2 PM, ∼8 PM)
– Acetaminophen: 1,500 mg, 1,500 mg, 1,000 mg, 4,000 mg total
– Ibuprofen: 400 mg/dose, 1,200 mg total
(1) Placebo (67 ± 2 yr; n = 12)
(2) Acetaminophen: 64 ± 1 yr; n=11; 4000 mg/day
(3) Ibuprofen: 64 ± 1 yr; n=13; 1200 mg/day
(1) The drugs increased muscle volume and muscle strength
(2) Muscle protein content, muscle water content, and myosin heavy chain distribution were not influenced by drug consumption
Krentz JR1, Quest B, Farthing JP, Quest DW, Chilibeck PD.
– 12 males and 6 females (24 yrs) trained right and left biceps on alternate days (6 sets of 4-10 reps), 5 d x week(-1), for 6 wks
– They received:
(1) 400 mg x d(-1) ibuprofen immediately after training left or right arm
(2) and a placebo after training the opposite arm the following day
(1) Ibuprofen consumption had no effect on muscle hypertrophy and strength
(2) Muscle soreness was elevated during the first week of training only, but was not different between the ibuprofen and placebo arm