Ibuprofen – pain treatment in sport

Does Ibuprofen reduce the painful effects of delayed-onset muscle soreness?

A recent study carried out in Greece lends support to the use of Ibuprofen as a method for reducing the painful effects of delayed-onset muscle soreness (DOMS) that often beset athletes following an intense training session. Nineteen subjects completed the trial which took place over a three-day period. On the first day each subject completed a 1RM strength test on the hamstrings using a universal leg curl machine.

 Once an individual 1RM had been established the scientists set about inflicting muscle damage into the hamstring group. Each subject completed six sets of 10 eccentric actions (eccentric work has been shown to induce greater levels of muscle damage compared to concentric work) with a resistance of 100% of the maximal concentric strength (1RM) using the same universal leg curl machine. Each repetition lasted 10 seconds with a 10-second rest between each repetition. At the end of the exercise nine subjects were given Ibuprofen (400mg every eight hours throughout the following 48-hour period) while the other 10 subjects were given a placebo.

How they tested the muscles

A variety of measures were taken to establish the effectiveness of the administration of Ibuprofen:

  • Muscle soreness was established (before, 24 and 48 hours after the bout of eccentric exercise) using a questionnaire, with each subject rating the soreness experienced during active movements on a scale of 1-10.
  • Knee flexion range of motion (ROM) was determined using a goniometer; three measures were taken and the average value reported.
  • Maximal concentric strength was established using a universal leg-curl machine.
  • Vertical jump performance was assessed using an Ergojump platform which recorded flight time and calculated jump height.
  • Blood profiles were taken at four, six, 24 and 48 hours after the bout of eccentric exercise.
  • Creatine Kinase (CK) (indirect marker of muscle damage) and white blood cell count (linked to production of oedema in the damaged muscle, providing a mechanical stimulus for pain receptors leading to the sensation of DOMS) were measured.

The result

The study revealed that, after an intense bout of eccentric exercise, administration of Ibuprofen decreased the perception of muscle soreness and CK activity. As expected, levels of muscle soreness increased significantly following the bout of eccentric activity. However, the Ibuprofen group experienced lower levels of muscle soreness compared to the placebo group at 24 and 48 hours. Significant increases in CK were demonstrated in both groups. The placebo groups CK levels continued to rise throughout the 48-hour period while the Ibuprofen groups CK levels peaked at 24 hours and then started to decrease at 48 hours. The post-exercise response of the white blood cells was similar in both groups.

 Despite a decrease in the perception of pain and reduced levels of the markers associated with muscle damage, the research team was unable to establish any performance benefits resulting from the administration of Ibuprofen. Muscular performance of the hamstrings (maximal strength, knee flexion ROM and vertical jump performance) decreased following the eccentric-exercise session. Ibuprofen administration had no effect on the level of decline. The reduction in performance post-exercise was similar for both groups.

The results of the research reveal that intake of Ibuprofen can decrease the perception of muscle soreness induced after a bout of eccentric activity but cannot assist in restoring muscle function. Athletes will be able to continue with training although their performance, at least at maximal levels, might not be as good as expected.

(Journal of Strength and Conditioning Research Vol 17 (1) 53-59)

Nick Grantham

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