Running/Walking With Anti-Inflammatories and Tylenol

*Contributed by Dr. Darrin Bright. Medical Director for MIT & OhioHealth Max Sports Endurance Academy

I often receive questions regarding the use of anti-inflammatories (Advil, Motrin, Aleve, ibuprofen) and acetaminophen (Tylenol). It seems like a simple solution to the common aches and pains associated with running and walking. However, as with anything in medicine, we must always consider the medical evidence to determine the risks and benefits of popping a few pills before a run.

Anti-Inflammatories   Let's focus on anti-inflammatories first. Unfortunately anti-inflammatories were developed during a time in medicine when manufacturers did not have to prove the efficacy or benefit. In the sports medicine community, we largely consider anti-inflammatories a misnomer. There are very few studies documenting any anti-inflammatory effects with over-the-counter anti-inflammatories. There are very good studies documenting that anti-inflammatories can help with pain relief. However, these benefits do not come without risks. Anti-inflammatories are associated with irritation of the lining of the gastrointestinal system. This can lead to stomach ulcers with thousands of people dying every year from bleeding ulcers associated with anti-inflammatory use.

Anti-inflammatory use is also associated with kidney damage. This is especially important for endurance athletes as the combination of dehydration and anti-inflammatories is a double whammy for the kidneys. As a medical director for many large endurance events, I strongly discourage anti-inflammatory use on race day due to the potential for adverse medical events.

Tylenol   On the course at the Capital City Half Marathon, Emerald City Half Marathon, and Columbus Marathon you won't find ibuprofen; you will only find Tylenol.  Tylenol is an effective pain reliever.  Like all medicines, however, there are some risks.  Exceeding the recommended dosage can lead to liver damage.  Individuals with pre-existing liver problems should not take Tylenol.  However, it is not associated with ulcers or kidney damage.  For these reasons, it is a much safer alternative for endurance athletes. 

In summary I would recommend always asking yourself why you need the medication.  I feel it is bad practice to routinely take a medication "just in case I get sore after the run."  If you do have some aches or pains after a run, try an ice bath.  There is very good literature documenting the pain relieving properties and anti-inflammatory effects of ice baths after activity.  There aren't any lasting side effects associated with ice baths (aside from the occasional shiver).  If you feel you need to take something to help with the discomfort I would suggest reaching for the Tylenol first.  Avoid anti-inflammatories on race days. If you do take anti-inflammatories before or after a workout make sure you are well hydrated and do not take them on an empty stomach.

Happy Running and Walking!