“Eight?”

“Yeah, usually. Eight”

“And then what happens ?”

“Well, I feel okay. I mean, I can ski.”

“And if you don’t take it?”

“Can’t ski at all. Back hurts too much.”

This was a conversation I had with a prospective client. He loved to snow ski but had so much back pain and stiffness during and after skiing that his only solution, in his mind, was Advil.

Eight Advil.

If you have an achy knee, back, shoulder, whatever, and you know that if, for example, you spend the morning on the slopes, even the green runs, that you’ll be paying for it later, doesn’t it seem reasonable to take something like Advil, Motrin, or Aleve before you ski to prevent the fallout after?

So, to stay active and feel more alive, you’re better off ignoring what your body is saying and instead take a drug?

I know. Who wants to hurt?

What About IbuProfen (Advil, Motrin) Before a Run?

So, maybe you’ve heard somewhere or read somewhere that taking Ibuprofen before you run or even during a longer run helps shoo the pain away. If your knees or hips or back normally hurt when you run, a little Ibuprofen can be like magic. How bad can that be for you? After all, you can buy it in any grocery store or drug store.

As it turns out, pretty bad.

Researchers examined the blood of runners who took Ibuprofen before and during a long, endurance race and compared the findings to runners who did not take the drug.

They discovered some disturbing things:

1. Biologic markers of inflammation and increased immune system response were higher in the drug group than in runners who had not taken the drug.
2. Signs of mild kidney impairment in the drug group.
3. Low-level endotoxemia, a condition in which bacteria leak from the colon into the bloodstream, was found in the runners who took Ibuprofen.
4. Runners had no more or less pain than the group who did not take the drug.

You’re taxing your kidneys, leaking bacteria from your gut, and don’t have any less pain than the group who skipped the drug.

In addition, Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, can interfere with the bodies natural healing response. Injuries to tendons, bones, cartilage, and ligaments can take longer to heal and heal less completely with chronic use of NSAIDs.

There’s a time and place for NSAIDs though. For acute injuries, pain relief, and short term use, NSAIDs can be helpful and relatively safe (some people still have gastrointestinal side effects). When you’re using the drug to allow you to do something like go for a run is where you run (pardon the pun) into trouble.

What to Do Instead of Always Reaching for Advil

Know and respect your limits. If you know your knee hurts when you play tennis, you don’t have to give up tennis necessarily but you do need to know how long you can play and not injure yourself. Most physical activities with respect to joints have a time and load relationship. You might, for example, be able to play 20 minutes and have no symptoms or problems later. But 25 or 30 minutes may be enough to push you over the edge. If you stay under your limit, avoid injuring and re-injuring yourself, you can gradually increase the time.

Build your capacity. A lot of people wait too long to start training for events like snow skiing and end up under-trained. This is one reason why they hurt or get injured. Training has to be a lifestyle; not a stop gap measure to boost your capacity for a one time event. If you make training a regular part of your life, your overall capacity and ability will go up so you’ll have “more in the tank” when you go skiing, hiking, or do something else you enjoy.

Train your body outside of your activity or sport. My friend, Heidi Armstrong, who was one of only 45 female racers out of 905 athletes to finish the Leadville 100, credits her ability to get off the bike without significant neck, back or leg pain, as most racers experienced in that race, from the kind of training she does off the bike. And most competitive athletes know that their sport alone isn’t enough to make them truly fit. When all of your body is more fit, the loads you experience during a physical activity are more evenly distributed which leads to fewer aches and pains.

Prime before prime time. Priming is a version of “warming up” that includes both easy to moderate low impact motions (stationery bike, elliptical, rowing, etc) and a sequence of movements to “wake up” your joints and muscles. Joints that tend to be achy or stiff usually need some priming before you go out and play tennis or ski or other activity. Here’s an example:

Eat to win. One of the best things you can do to help your joints is to follow a mindful diet. And, if you’re at all sensitive to gluten, removing it from your diet can help as well. Recent studies have shown that some people may have non-celiac disease gluten sensitivity and if so, that may trigger a systemic immune response which can keep joints irritated.

Add glucosamine and chondroitin sulfate. If you’ve read or listened to any of the mainstream media, you’ve probably also have heard that neither of these supplements are effective for people with osteoarthritis or joint pains.

The media latched onto an article published in Arthritis & Rheumatism in 2008 and declared that the supplements were ineffective even though the lead author, Allen Sawitzke, said that the study had significant limitations, like a small sample size, and that the study couldn’t determine whether glucosamine and chondroitin are effective for patients with arthritis. Sawitzke also admitted that the study needed a better method for measuring the joint space. Some critics have argued that the method used was not sensitive enough to detect meaningful change.

Chondroitin Sulfate is a disease modifying agent for osteoarthritis. It slows the progression of the disease and deterioration of the joint cartilage. If you have osteoarthritis and have clearance from your doctor (people who have diabetes, are allergic to shellfish or take blood thinners need to visit with their doctor first), you should be taking at least 800 mg of Chondroitin Sulfate for at least two years. This is how long it takes for the supplement to slow the deterioration of the cartilage and the disease modifying effects are independent of symptoms. So, take it even if you feel fine.

Get Help. Sometimes you need professional guidance and programming to get you out of the Advil trap. You’ll need someone who understands joint healing, biomechanics, exercise physiology, and a little psychology too.

The Bottom Line

The good news is that with focus, commitment and consistency, you can do a lot to change your situation when it comes to various joint aches and pains and reduce or eliminate the need for drugs like Motrin and Advil.

• Adjust your activity to stay below the pain threshold.
• Build your capacity.
• Train outside of the activity or sport.
• Use a priming before your training or activity.
• Eat to win and include supplements.
• Get help.

photo credit: Brandon Milner via photopin cc