NSAIDs and Muscle
Building
According to research published in the The Physician and
Sports Medicine, since NSAIDs are over-the-counter (OTC) medications and aren't
banned from competition by the World Anti-Doping Agency, "athletes often
self-administer these medications to prevent pain and inflammation before it
occurs. However, scientific evidence for this approach is currently lacking,
and athletes should be aware of the potential risks in using NSAIDs as a
prophylactic agent. These agents are not benign and can produce significant
side effects, including gastrointestinal and cardiovascular conditions as well
as musculoskeletal and renal side effects.
But that's not all: there are also performance side effects
for the weightlifter to consider. Drugs such as ibuprofen are classified as COX
inhibitors, and since COX (cyclooxygenase) activity is a critical component of
muscular hypertrophy, there's a clear link: Ibuprofen can inhibit muscular
hypertrophy.
In fact, previous research suggests that treatment with
ibuprofen can reduce muscle hypertrophy by almost 50 percent, which means that
taking a COX inhibitor may very well be counterproductive for muscle gains.
While these are intriguing findings, we must keep in mind
that these studies were conducted in rodent models. The research still needs to
be scrutinized since a handful of studies have also been done on humans and
have yielded conflicting results.
One of the first human studies to support the notion that
NSAIDs may blunt protein synthesis was published in the American Journal of
Physiology, Endocrinology, and Metabolism.4 Participants were given the maximal
over-the-counter dose for ibuprofen, acetaminophen, or a placebo following
10-14 sets of eccentric knee extensors.
Researchers found that rates of protein synthesis were
suppressed in groups taking the NSAIDs. Results from this study support the
earlier findings that NSAIDs may negatively influence protein metabolism in
skeletal muscle.
Research suggests that treatment with ibuprofen can reduce
muscle hypertrophy by almost 50 percent.
However, more recent research on human subjects has
demonstrated that NSAIDs do not necessarily impact muscle protein synthesis as
much as previously thought. In fact, there are several studies that have found
chronic supplementation (12 weeks) actually improved muscle strength and size.
The problem with these studies, however, is that each have
their own limitations we must consider. For example, a majority of the research
on NSAIDs as it relates to muscle protein synthesis has been done in untrained
individuals; hence, the results might yield a different outcome on athletes who
are already active and have a larger degree of muscle mass than an untrained
person.
Some of the research also looked at only older subjects with
osteoarthritis; thus, these results might not be indicative of results for
healthy, active individuals. Finally, some of these studies only looked at the
effects of NSAIDs on the acute changes in muscular hypertrophy, and these
findings may not reflect the long-term adaptations to muscular hypertrophy with
prolonged use of NSAIDs.
While there's certainly a time and place to utilize NSAIDs,
the key takeaway is that they should be used with caution, in relatively
moderate dosages, and for short periods of time.
An article published in the Critical Journal of Sport
Medicine discussed the practical management of NSAIDs in athletic injuries and
concluded that NSAIDs are not recommended in the treatment of completed
fractures, stress fractures at higher risk of nonunion, or in chronic muscle
injuries.
While the authors of the article recommended NSAIDs for the
management of acute ligament strains, muscle strains, tendinitis, and eccentric
muscle injury, they cautioned that the prescription of the NSAID should be
judicious and the length of treatment should be kept as short as possible.
NSAIDS can help with short-term pain management, but their
use should be minimized not only because of their potential long-term side
effects, but also the impact they may have on making substantial gains in
muscle mass.
Even with some conflicting research, this much is clear:
Don't reach for a bottle of ibuprofen every time you have a slight bout of
DOMS. Recognize that the inflammation you're experiencing is part of the
muscle-building process, and save NSAIDs for when you really need them.
In a nutshell, we need to keep anti-inflammatory to a
minimum to keep protein synthesis as high as possible to accumulate maximum
tissue in the shortest time possible.
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