Enough (N)SAID about Ibuprofen & Soreness

If I’m being honest here, it’s been a while since I’ve had a solid gym routine. But this semester I’ve been going pretty regularly, and let me tell you, I’ve felt the burn. My muscles have felt pretty sore in the 2-3 days following my workouts, so I’ve had to turn to ibuprofen a few times to relieve the pain. But even after taking ibuprofen in the morning, I’ve felt sore again by the end of the day. This got me thinking: how effective is ibuprofen at reducing muscle soreness?

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly served over-the-counter at pharmacies. Some common forms you may recognize include aspirin and ibuprofen (Motrin, Advil). NSAIDs are taken for many reasons; they reduce pain and inflammation, lower fevers, and reduce clotting action.[1,2] The typical dosage for adults who are looking to reduce mild-moderate pain is 400 mg every 4-6 hours. For adults who have pain caused by osteoarthritis, the typical prescribed dose is 1200 mg.[3] However, despite their pain reducing use, NSAIDs could yield negative side effects such as increased risk in developing nausea, stomach pains, or an ulcer.[1]

The mechanism of NSAIDs when it comes to reducing pain and inflammation is known and understood. After intense workouts, prostaglandins are produced by muscle cells. They aid in the healing process of muscle, but this often leads to inflammation, pain, and fever. Enzymes called cyclooxygenases (COX-1, COX-2) produce the prostaglandins that promote inflammation, pain, and fever. The goal of NSAIDs is to inhibit COX-1 and COX-2 from producing prostaglandins, thus decreasing the pain. However, the COX-1 enzyme is responsible for creating prostaglandins that protect the stomach lining and support platelet aggregation, so the inhibition of the enzyme is what could lead to stomach ulcers and the promotion of bleeding.[1,2,4] The science behind NSAIDs seems promising, but clinical research may prove otherwise.

Athletes commonly take NSAIDs after performing physical activity because they claim the drugs reduce pain and decrease recovery time. But here is the issue: only very few studies have been able to support this claim. Some studies have reported results that do indicate a beneficial effect, by stating NSAIDs used prophylactically mitigate exercise-induced inflammation, circulating creatine kinase levels, and muscle soreness.[5] On the other hand, these claims made by athletes lack scientific support. NSAIDs are known to treat inflammation, but many histological studies have proven that most overuse injuries are caused by tissue degeneration and not inflammation. Also, NSAIDs temporarily “mask” the pain caused by tissue degeneration or soreness. This does not ensure that muscles or tissues are actively getting healthier; it only hides the pain from the athlete. [5] Clearly, there are many different opinions about the use of NSAIDs, specifically ibuprofen, in the sports medicine field. Let’s take a look at what the “research says” about it. 

A study at the University of Saskatchewan was conducted to determine the effects of ibuprofen on muscle hypertrophy, strength, and soreness during resistance training. Participants (12 males, 6 females) trained their left and right biceps for six weeks, alternating arms on each day. The training program called for concentric curls at 70% of RM and eccentric curls at 100% of 1 RM. Every day after their training, they either received a 400 mg dose of ibuprofen or a placebo. On training days, each participant was asked to rate their soreness on a scale from 0-9. For both the placebo and ibuprofen, the participants reported soreness during the first week and that soreness decreased throughout the program to the point where participants felt no soreness in either arm during the final week. The researchers concluded that ibuprofen was not effective in reducing perceived soreness during the training. However, the researchers do not reflect on the limitations of their own study.  They had a small and uneven sample size when it came to gender and there could have been discrepancies and residual effects that came along with taking ibuprofen inconsistently. Additionally, they seemed pretty convinced by their findings, but maybe the dose they chose was not strong enough to show any reduction in soreness in a long term study.[6]

On the other hand, another study drew opposite conclusions. Researchers in Greece conducted a study to determine the effects of ibuprofen on delayed onset muscle soreness (DOMS) and muscular performance. Participants (14 men, 5 women) who have not done strength training in the last 6 months performed eccentric leg curls at 100% RM. Nine (9) subjects were given a 400 mg dose of ibuprofen every 8 hours for 48 hours after exercise, while the remaining 10 subjects received a placebo. The subjects rated their amount of soreness on a scale of 1-10 prior to exercising, 24 hours after exercising and 48 hours after exercising.  The results showed that muscle soreness was significantly lower for the ibuprofen group at both 24 hours and 48 hours after exercising. Similar to the previous study, the researchers did not evaluate the limitations of their study. The number of participants and number of each gender were low and uneven, respectively. Also, the soreness results were not discussed much in the conclusion of the paper. The researchers did not support why the soreness decreased with scientific evidence, which is what they did for the other the parameters they were testing for.[7]

Clearly, both studies came to different conclusions. However, both studies were conducted for different amounts of time, contained different exercises, and with subjects of different athletic abilities. There have been plenty of studies conducted to determine how effective ibuprofen is at reducing soreness, but each study contradicts the next. 

Overall, many studies show that ibuprofen is a short term solution to hiding muscle soreness, but it may not be effective long term. Though, I’m still going to keep on using it to treat my soreness.

Questions to consider:

  • Do you take NSAIDs to reduce your soreness after working out? How effective do you find them to be?
  • Do you think there’s a better way to measure soreness and how ibuprofen affects our muscles?
  • Do you think the length of the study has any correlation with the effectiveness of ibuprofen?

Sources: 

  1. (n.d.) Nonsteroidal Anti-inflammatory Drugs (NSAIDs). Retrieved from  https://www.medicinenet.com/nonsteroidal_antiinflammatory_drugs/article.htm#what_are_nsaids_and_how_do_they_work
  2. Tscholl, M., et al (2016). A sensible approach to the use of NSAIDs in sports medicine . Swiss Sports & Exercise Medicine , 65(2), 15–20.
  3. (n.d.) Ibuprofen (Oral Route). Retrieved from https://www.mayoclinic.org/drugs-supplements/ibuprofen-oral-route/proper-use/drg-20070602 
  4. (n.d.) What Are NSAIDs? Retrieve from https://orthoinfo.aaos.org/en/treatment/what-are-nsaids/
  5. Stuart J. Warden (2010) Prophylactic Use of NSAIDs by Athletes: A Risk/Benefit Assessment, The Physician and Sportsmedicine, 38:1, 132-138, DOI: 10.3810/ psm.2010.04.1770
  6. Krentz , J. (2008). The effects of ibuprofen on muscle hypertrophy, strength, and soreness during resistance training. Applied Physiology Nutrition and Metabolism , 33(3), 470–475. doi: 10.1139/H08-019

Rest Interval between Sets in Strength Training

This article essentially reflected on how training in certain ways can have certain effects on strength, endurance, hypertrophy and power of muscles. Looking at the exercise specifically they looked at the number of sets, reps, and rest between sets and how this effected the muscle of the athlete performing these movements.  Rest length between sets obviously being the changing variable in this study, the trials looked at acute responses and chronic adaptations of the muscles to note how the muscles were stimulated. Looking at longer rest periods such as 3-5 minutes, it was shown that an athlete could do more reps over the course of more sets, and with repeatedly doing this overall would get stronger than an athlete that had shorter resting periods, not allowing for as many reps between each set.  Similarly, longer rest periods allowed for more explosion and power from the athletes. For example, an NFL player at the combine doing the bench press will want to wait a significant amount of time between warming up, and performing the bench press to allow for optimal power and explosion to get as many reps as possible. When training with shorter rest periods, for example 30-60 seconds, this was shown to lead to more muscle hypertrophy and overall increase muscular endurance. Little rest between sets was proven to show an immediate acute reaction increasing growth hormone. This is shown to be effective in bodybuilders. Bodybuilders lift for the sole purpose of being big, tone, and proportionate. Getting this high intensity, more reps, low rest sets in for a workout will lead to more blood rushing to the muscle and allow for the muscle to grow. However, power lifters would implement the longer rest times with a heavier weight (closer to a 1 rep max, typically about 85%) because this leads overall to increased strength in the long run. Article results and full explanations –> http://rdcu.be/Hmqh

Overall I found this article very interesting. In todays day in age, I feel that so many people preach to lift heavy weight all the time with longer rest periods. I see this in the gym often, Delaware’s powerlifting team has a tendency to do multiple sets with a high weight, however they take a leisure break between sets usually for at least 5 minutes. This makes sense, this will increase strength in the long run however does not necessarily lead the powerlifters to get very big like a bodybuilder. On the other hand, a bodybuilder in the gym that I always see I will see doing lighter weight. He is a very big guy, however I will see him squatting 225 for 20 reps, and taking about a minute break between sets. This allows for him to completely fatigue his legs and allow them to grow, without him necessarily focusing on strength.

Has anyone else had similar experiences in this field? Has anyone else noticed a difference between lower reps, with a higher weight and longer rests, vs. higher reps with a shorter rest period?

Works Cited — de, B F, et al. “Rest interval between sets in strength training.” Sports medicine (Auckland, N.Z.)., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/19691365.

Other related articles —
A brief review: factors affecting the length of the rest interval between resistance exercise sets. –> https://www.ncbi.nlm.nih.gov/pubmed/17194236
The effect of different rest intervals between sets on volume components and strength gains. –> https://www.ncbi.nlm.nih.gov/pubmed/18296968

Other Relevant Websites for similar information –>
https://www.elsevier.com/solutions/embase-biomedical-research

Effects of Protein Supplements on Muscle Recovery and Performance

Many athletes and active individuals often seek the assistance of protein supplements post-exercise for a variety of reasons. Some take them in an effort to increase physical performance, while others aim to reduce muscle soreness and enhance the recovery process. However, the majority of these individuals decide to buy and consume these supplements based on marketing claims that are not backed by scientific research. This article outlines a literature study that examines the correlation between protein and the enhancement of muscular performance and recovery. The study takes into consideration healthy adults under the age of 50, and evaluates the effects of these supplements alone or in combination with carbohydrates on varying performance metrics.The results indicated that the continued use of protein supplements significantly reduced muscle damage and soreness after training sessions, and led to a particular increase in physical performance when participants were negative in nitrogen and energy balance.1 Other studies confirm the benefits of protein supplementation on muscle recovery and performance post-exercise, but at different degrees and with varying limitations.

This article relates to the course because it describes a study and application of the research process that addresses exercise-specific responses to physiological changes. Not only does it discuss and define the metabolic changes that arise from the use of protein supplements, but it also mentions the measurement of exercises and performance for comparison. It details a systematic approach to evaluating a problem through the collection of data, data processing, statistical analysis, evidence based results, and consideration of limitations.

Over the past few years, I have experimented myself with different protein supplements and exercise regimens to observe the potential effects on muscle growth and recovery. Although there are numerous factors that come into play, I agree with the claim that supplements are beneficial when used appropriately. However, diet, degree of activity, and frequency of use lead to large degrees of variation and pose a major limitation when comparing use among individuals. Regardless, much research should be carried out when deciding which protein supplement will be most successful for you and in achieving your goals.

Works Cited

[1] Pasiakos SM, Lieberman HR, McLellan TM. Effects of protein supplements on muscle damage, soreness and recovery of muscle function and physical performance: a systematic review. Sports Med. 2014 May;44(5):655-70. doi: 10.1007/s40279-013-0137-7. Review.

Single vs. Multi-Joint Exercises Effect on the Body

Resistance training has many positive health effects including but not limited to increased aerobic capacity, decrease in body fat, and increase in muscle strength. Each of these qualities were used to examine the effects of single versus multi-joint exercises in this research study. Thirty-six male participants were split into two groups to complete an 8-week resistance training program that contained either only single joint (SJ) exercises or only multi-joint (MJ) exercises. Body composition, one repetition maximum tests, and peak oxygen consumption (VO2max) were all measured at the beginning and end of the study. Statistical analysis showed that both groups improved in all categories, with those in the MJ group having significantly larger improvements in VO2max and muscle strength than those in the SJ group.

People question what type of exercises should be part of their training and learning more about the benefits of each will help to optimize training programs. This study kept total load volume the same between the groups which allows for comparison between the groups; however, in actual training programs this is often not the actual switch people would be making if changing exercise types. Other constraints of this study include that it only included male participants and they were all amateur soccer players. Therefore, further studies would be needed to conclude that the same results would hold true for other groups like professional weight lifters, non-athletes, and females.

 

Other articles on this topic:

http://caueteixeira.com/wp-content/uploads/2015/12/2015-The-effects-of-adding-single-joint-exercises-to-a-multi-joint-exercise-resistance-training-program-on-upper-body-muscle-strength-and-size-in-trained-men.pdf

https://www.researchgate.net/publication/274444663_Single_vs_Multi-Joint_Resistance_Exercises_Effects_on_Muscle_Strength_and_Hypertrophy

https://www.unm.edu/~lkravitz/Article%20folder/ExerciseOrderinRT.html

Work Cited: Paoli A, Gentil P, Moro T, Marcolin G, Bianco A. Resistance Training with Single vs. Multi-joint Exercises at Equal Total Load Volume: Effects on Body Composition, Cardiorespiratory Fitness, and Muscle Strength. Front Physiol. 2017;8:1105. doi:10.3389/fphys.2017.01105.

Traditional and Functional Workouts – Are They Really That Different?

As exercise  trends changed over recent years, the kinds of workouts individuals do have also changed. Trends like circuit workouts, high intensity interval training (HIIT), or most recently Crossfit have influenced the types of workouts people do because of the results each claim to give.Essentially these workouts can be put into two categories: Traditional or Functional workouts.

Traditional workouts or traditional strength workouts are those that use resistance training principles. These workouts are what typical gym-goers think of as “leg day” or “arm day”. They include isolating a specific group of muscles and lifting weights to maximize muscle strength usually including exercises like arm curls, leg presses, dip machines, etc. On the other hand, Functional workouts include a wide variety of exercises that mimic movements that the individual experiences in activities for daily living. A typical functional workout is harder to define since it is so subjective to the individual. For example, a functional workout for a softball player is going to be completely different from  a functional workout for a dancer.

Intuitively you would think that each type of workout out would produce different results. A traditional strength workout would increase a person’s strength while not really affecting other systems. While a functional workout would not increase a person’s strength as much and would increase their efficiency for activities faster. But what does the research really say?

First let’s look at how each workout affects aspects of the other. The article “The Effects of Resistance Training on Endurance Distance Running Performance Among Highly Trained Runners” looked to study how traditional strength workouts affects the functional running performance in runners. After a systematic review of articles, they found that resistance training has a positive effect on running pefromance [1]. This means that resistance training can be beneficial for functional activities. Another study looked at the adaptations of resistance circuit training compared to traditional strength training in resistance-trained men. It could be argued that circuit training is a form of functional training for this population and thus the study is looking at how a functional workout affects strength performance. The study found that the one rep max (1RM) increased equally for both training protocols and that circuit training was as effective as traditional strength training in improving weight lifting [2]. Interestingly each type of workout has positive effects on each other. A functional workout can improve strength abilities while traditional strength workouts can help with functional activities.

But what if the two workouts are compared to each other?

In “Functional vs. Strength Training in Adults” 101 middle aged subjects were divided into two groups (functional and strength training) that each performed 24 sessions of a training protocol twice a week. Each subject was assessed pre- and post-intervention using  Y-balance test and a Functional Movement Screen. The results showed that there were no differences in improvement between the training protocols, however functional training was less effective for women compared to men in the same group [3]. when looking at the anthropometric and motor effects of functional vs. traditional resistance training in the Tomlijanovic et al. study, there was no statistical difference between either of the anthropometric measures or the motor status variables after a five week training program [4]. There were only minor improvements in each training program that did not affect the overall results, this could have been due to the short amount of training time. Even when comparing the two workouts to each other in a non-exercise application a similar trend appears. In the study Christine Stutz-Doyle, a traditional strength workout and a functional workout were compared to study their effects on pain, strength, and functional mobility in elderly subjects with Knee osteoarthritis in hopes to improve the subjects quality of life. Interestingly there was no statistical difference in muscle strength, pain and stiffness between the two groups Although the functional workout group did increases gait velocity by the end of the study which could be attributed to the task specific training [5].

In conclusion, the gathered research states that there is no statistical difference between functional and traditional strength workouts. The results that you are going to experience from doing either are going to be relatively the same, which is rather interesting. So it is really up to personal preference of which workout you would prefer doing. Of course, it is incredibly difficult to standardize functional workouts across studies and even within studies it is difficult to control for the types of movements. A more expansive review of research studies might prove these results otherwise.

 

Further Readings:

  1. Yamamoto LM, Lopez RM, Klau JF, et al. “The Effects of Resistance Training on Endurance Distance Running Performance Among Highly Trained Runners: A Systematic Review”. Journal of Strength and Conditioning Research. 2008; 22(6): 2036-2044. DOI: 10.1519/JSC.0b013e318185f2f0. 
  2.  Alcaraz PE, Perez-Gomez J, Chavarrias M, et al. “Similarity in Adaptations to High-Resistance Circuit vs. Traditional Strength Training in Resistance-Trained Men”. Journal of Strength and Conditioning Research. 2011; 25(9):2519-27. 
  3. Matheus Pacheco, Luis Teixeira, Emerson Franchini, et al. “Functional vs. Strength Training in Adults: Specific Needs Define the Best Intervention”. International Journal of Sports Physical Therapy. 2013; 8(1): 34-43. 
  4. Tomljanovic M, Spasic M, Gabrilo G, et al. “Effects of Five Weeks of Functional vs. Traditional Resistance Training on Anthropometric and Motor Performance Variables”. Kinesiology. 2011; 43(2): 145-154.
  5.  Stutz-Doyle, Christine. “The Effects of Traditional Strengthening Exercises Versus Functional Task Training on Pain, Strength, and Functional Mobility in the 45-65 Year Old Adult with Knee Osteoarthritis”. Seton Hall University Dissertations and Thesis (ETDs). Paper 98. 2011.