Get to know your drugs! A guide to bouncing back from injury

Editors note: Clay is a good friend of ours from back in the college days. You could say he knew us before we knew much of anything. He’s also a Doctor of Pharmacy, so, listen up! This info could help you bounce back from injury much faster. 

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We’ve all done it – Lifted too much, done one too many reps, ran a little too far. We’ve pulled muscles, jammed fingers, and rolled ankles. The question now becomes, “What do we do next?”

Many athletes will simply limp over to the closest medicine cabinet, say “This looks like it’ll help”, and then pop a few pills. But sometimes that doesn’t help much, or doesn’t work quickly enough for our liking.

I’m here to give you a few tips on what to do next and tell you what those few pills you just swallowed will do for you.

First, some tips…

1. Understand your injury

In order to properly treat your problem you have to know what caused it. Did you strain or pull something? Did you hyper-extend or roll a joint? Are you dehydrated and you are cramping up? Knowing this will help you (or your primary care provider if it comes to that) make a better choice on what to do next.

Get all the data you can! It’ll make your path out of injury much shorter.

2. Don’t be Superman

If you think/know you’ve hurt yourself, don’t try to power through it. You may be thinking it’ll get better or it’s just a minor hitch, but leaving an injury untreated can lead to bigger problems and more downtime later on.

If you don’t start feeling better in 3-4 days, or if you start to feel worse, make an appointment immediately to get it checked out.

3. If you don’t know, ASK!

Don’t post your injury questions on Facebook. Don’t Google it. No matter what, don’t follow someone else’s treatment plan blindly. Instead, find a trained healthcare provider and ask them what they think.

I know you have your hunches, but believe it or not, it’s best to trust someone with expertise. Chances are there is a professional in your gym. I personally get questions all the time, and I am happy to help out.

The Rest of the Story

Now that we’ve got that out of the way, let’s talk about the drugs.

When it comes to meds, most people will choose from the “Big 3”: ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol). There is a reason Tylenol is known as “the headache medicine”; that’s what it works best for. Acetaminophen works well on fever and general pain but not as well on inflammation (which is what we are going to be treating).

The max recommended dose for acetaminophen is 4000mg/day, which is two 500mg tablets every 6 hours, or two 325mg tablets every 4 hours, as needed.

Ibuprofen and naproxen are the same type of medication; the major difference is how long they work.

Ibuprofen will last about 4-6 hours; naproxen will last about 12 hours. It also may take longer for naproxen to start working compared to ibuprofen.  The max recommended dose for ibuprofen is 2400-3200mg/day; naproxen is 1500mg/day.

In my opinion, naproxen is more for chronic inflammation in conditions like arthritis, but it will work if that’s all you have. You can take two tabs or about 500mg every 12 hours as needed. Ibuprofen is the better choice for acute problems. You can take 2 (or 3 if you are really hurting) 200mg tablets every 6 hours as needed.

Take any of these with a glass of water to get them washed down and preferably with some food on your stomach. These meds are relatively safe or else you couldn’t get them without a prescription. However, no drug is without side effects.

Acetaminophen can cause liver damage if taken at high doses for a long time, but the incidence of it is pretty low. Ibuprofen and naproxen can cause stomach ulcers and intestinal bleeds, which can present as black tarry stools (Imagine what’s in your coffee filter showing up in the toilet). Again, this is usually because the meds are taken in large doses and for long periods of time. Taking them with food will help to prevent this problem.

Since you should only be taking these for a short time before seeing a physician (Tip #2), much of the risk for long term side effects is minimal.

One Last Tidbit

There have been a few studies with acetaminophen and ibuprofen looking into their effect on performance.^1-3 These studies suggest that low doses of these medications can increase endurance and stimulate muscle protein synthesis after exercise. The idea behind it is that these medications delay the inflammatory processes and the production of body heat, hereby allowing you to work out longer and allowing muscle to grow afterwards.

Now, I am not telling you to go out and dump a bottle into your next protein shake, but you could take a low dose (325mg of acetaminophen or 200mg of ibuprofen) 30 minutes to an hour before your workout to see if it makes a difference. Actual results may vary. and it’s always a good idea to check with your physician before starting this long term.

Remember, your situation is unique and nothing you read on the internet (even this post) will give you all the answers. Get your data, form a reasonable plan, and experiment wisely.

You’ll be back under the barbell in no time.

Clay

References

1. Exp Physiol. 2014 Jan;99(1):164-71. doi: 10.1113/expphysiol.2013.075275. Epub 2013 Sep 20.
2. Eur J Appl Physiol. 2014 Jan;114(1):41-8.
3. Am J Physiol Regul Integr Comp Physiol. 2007 Jun;292(6):R2241-8. Epub 2007 Feb 22.