Medicine: Pills for Pain--Not Performance

May 2, 2004
Outside Magazine
Outside magazine, July 1996

Medicine: Pills for Pain--Not Performance

By Gretchen Reynolds

"Vitamin I, vitamin K, vitamin N: that's ibuprofen, ketoprofen, naproxen. They all have little pet names," says Jenny Stone, a certified athletic trainer in charge of clinical programs for sports medicine at the U.S. Olympic Training Center in Colorado Springs, Colorado. "And I know there are athletes taking five, six, ten of them every day to get through workouts." She sighs. "This painkiller thing is out of control."

Since ibuprofen became available over the counter five years ago, many athletes have started using it as a daily supplement. Now they're stocking up on bulk-size containers, gulping painkillers like M&M's. Demand is obvious: In January a drug called Orudis KT, containing a new ingredient--ketoprofen--hit the shelves. At some point, "people decided they were some kind of performance-enhancer in a jar," Stone says. "They pop dozens of them before a workout, thinking it will allow them to avoid muscle pain." Other athletes down similar doses in what amounts to legal drug-doping, believing the pills will "thin" their blood and enhance oxygen transport.

Wishful thinking, says Stone: "The drugs don't work that way." Like aspirin, ibuprofen (the ingredient in Advil), naproxen (found in Aleve), and ketoprofen, inhibit the production of prostaglandins, typically produced when the body feels pain. But take enough of the stuff to mask the sensation during a workout and you'll be in even greater pain afterward. As for the notion that painkillers boost endurance, don't hold your breath. "What they do is increase platelet flow," Stone points out. "But that just inhibits clotting; so if you get injured, you'll bleed more."

And unlike Tylenol, which is processed in the liver, ibuprofen and its ilk are metabolized in the kidneys, and taken in continually large doses they can cause problems for those organs in athletes.

This is not to say analgesics have no place in an athlete's medicine cabinet. Indeed, Stone says that taken properly, they're safe and effective.

Good old-fashioned relief for straight pain and inflammation.
Plus: Cheap, proven, reduces swelling
Minus: Not advisable for acute injuries involving bleeding or for people with sensitive stomachs

Acetaminophen (Tylenol)
Recommended for coping with chronic aches and for injuries involving bleeding, including bruises.
Plus: Gentle on stomach
Minus: Doesn't combat inflammation; can be hard on liver

Ibuprofen (advil),
Naproxen (aleve)

Works like aspirin but it's more powerful, allowing smaller dosage for same relief.
Plus: Effectively reduces inflammation and eases severe pain
Minus: Can cause sharp stomach pain if you haven't eaten

Ketoprofen (Orudis KT)
Originally designed to combat arthritis, this is the most powerful of the prostaglandin stoppers.
Plus: Particularly effective against joint pain, such as tendinitis
Minus: Same side effects as ibuprofen/na-proxen, but less severe

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