Aches and pains
After a hard workout, many of us automatically reach for a bottle of ibuprofen, acetaminophen, or similar pain reliever to relieve the muscle soreness that we know that we’re going to be feeling the next day.
In fact, it has been estimated that over 6 million people in the United States consume these types of pain-relieving drugs every day.
The dark side of Vitamin I
So what’s the big deal?
Why should we hesitate to take something that will help us feel better and possibly get us back into the gym that much sooner?
Before we can understand the larger issue here, we must first take a quick look at how our muscles become bigger and stronger in the first place.
What doesn’t kill you makes you stronger (kind of)
First of all, the first rule of muscle growth is that in order for your muscles to become bigger and stronger, you must make them do something they have never done before.
This is the reason you need to lift weights in the first place.
After all, you can curl your arm 15 times by itself and still not encourage that muscle to become any bigger and stronger because it already has the size and strength to do what you are asking it to do.
However, if you pick up a 30-pound dumbbell and curl it 15 times, you may or may not be encouraging your muscles to grow depending on how much weight you are used to lifting.
For example, if you usually curl a 45-pound dumbbell, then you’ll likely get little muscle growth from your 30-pound dumbbell workout.
However, if you are only used to curling 20 pounds, your 30-pound curling workout, would likely be enough to encourage your muscles to grow bigger and stronger in order to deal with this heavier load in the future.
Again, you have to push your muscles to do something they have never done before (usually by the amount of weight and/or
This type of workout will cause some degree of muscle damage that your body will not only repair, but the resulting repair will become stronger than it was before.
This muscle repair process occurs as long as your body’s muscle protein synthesis (MPS) outweighs the muscle protein breakdown (MPB) process that naturally occurs as your body recycles old and damaged proteins.
Exercise stimulates both the MPS and MPB processes. However, research has found that drugs like ibuprofen and acetaminophen suppress the muscle protein synthesis response in skeletal muscle.
“The increased rate of muscle protein synthesis normally seen 24 h after high-intensity eccentric resistance exercise was [reduced] by consumption of ibuprofen and acetaminophen at over-the-counter levels. … Long-term use of these drugs may inhibit the normal hypertrophic response to resistance training.” [emphasis mine]https://www.physiology.org/doi/full/10.1152/ajpendo.00352.2001
In other words, when you take one of these drugs to prevent muscle soreness, you are preventing some degree of muscle growth as well.
Inflammation and soreness aren’t all bad.
Also, keep in mind that there is a difference between acute inflammation and chronic inflammation.
Acute inflammation is a response to tissue injury. For example, if you twist your ankle, the tissues around your ankle will often begin to swell which is your body’s natural response to flush the area with blood to remove the damaged material and at the same time deliver nutrients to start the rebuilding process.
This type of inflammation typically lasts for a few days at most, then the swelling will go down, and the body will continue the rebuilding process behind the scenes.
However, inflammation is not always something that is visible. For example, when you put in a hard workout, your muscles will likely be sore for the next day or two.
This muscle soreness is a sign of muscle damage, which (surprisingly) is a good thing because those muscles will eventually become larger and stronger.
The problem is that when you take a drug like ibuprofen or acetaminophen to either treat or prevent muscle soreness, you are suppressing your body’s inflammation response which starts the muscle repair process.
In other words, you have already done the hard work damaging your muscles during your workout, but now you are short-circuiting the muscle repair/building process by stopping your body’s natural inflammation response.
So does that mean inflammation is a good thing?
Well, that depends.
Acute inflammation, as we said above, is part of the muscle repair process that eventually results in bigger and stronger muscles. Chronic inflammation, however, is another story.
Chronic inflammation is usually not related to exercise training (except perhaps overtraining) but is often the result of stress, poor diet, poor sleep habits, or a lack of physical exercise. Chronic or long-term inflammation is damaging to almost every organ of your body, including your cardiovascular and digestion systems.
In other words, chronic inflammation is usually related to a long-term lifestyle problem, while acute inflammation is a short-term response to either injury or exercise.
Ibuprofen can also affect your hormones.
As if that’s not enough, some research has also found that drugs such as ibuprofen can significantly affect our hormones, including testosterone levels in men.
“The analgesics acetaminophen and ibuprofen have previously been shown to inhibit the postexercise response in muscles by repressing transcription However, the striking dual effect of ibuprofen observed here on both Leydig and Sertoli cells makes this NSAID the chemical compound, of all the chemical classes considered, with the broadest endocrine-disturbing properties identified so far in men.” [Emphasis mine]—https://www.pnas.org/content/115/4/E715.full
Lower testosterone levels in men have been linked to symptoms of fatigue, depression, and a loss of libido. Also, because it suppresses the muscle rebuilding process, impaired testosterone levels can lead to a reduction in muscle mass and strength as well.
The bottom line…
If you are injured, of course, you should consult your physician
Having said that, you may want to think twice before automatically using these drugs after your workouts to treat or prevent muscle soreness because research has shown that you may be short-circuiting your body’s natural muscle repair/growth response.
It also depends on your priorities. If the focus of your training is to prepare for an upcoming athletic competition, then taking pain medication so that you can continue to train is probably more important than worrying about your long-term muscle growth.
However, if you are simply someone who is looking to lose some fat and gain some muscle along the way, you may want to skip the pills to treat your muscle soreness and instead focus on other recovery methods such as getting some extra sleep, foam rolling, stretching, and massaging the affected area.
Trappe, T. A., et al. (2002). Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab, 282(3), E551-6.
Schoenfeld, Brad. (2012). The Use of Nonsteroidal Anti-Inflammatory Drugs for Exercise-Induced Muscle Damage. Sports medicine (Auckland, N.Z.). 42.
Markworth, J. F., et al. (2014). Ibuprofen treatment blunts early translational signaling responses in human skeletal muscle following resistance exercise. J Appl Physiol (1985), 117(1), 20-28.
Trappe TA, et al. Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults. Am J Physiol Regul Integr Comp Physiol. 2011;300(3)
Brewer, Christi B. (2014) Use of Analgesics for
Lilja, Mats & Mandic, et al. (2017). High‐doses of anti‐inflammatory drugs