The Right Pills to Pop

It’s hard to pinpoint what percentage of runners regularly take nonsteroidal anti-inflammatory drugs (or NSAIDs), but in 2006, David Nieman, Ph.D., of the Human Performance Lab at Appalachian State University, found that 70 percent of Western States 100-Mile Endurance Run participants took a drugstore painkiller before the event. Likewise, a 2011 study of Ironman triathletes found that nearly 60 percent had taken an anti-inflammatory in the three months leading up to the race.

“The usage we see in competitive athletes trickles down to recreational athletes,” says Bill McOarberg, M.D., founder of the Ohronic Pain Management Program at Kaiser Permanente in San Diego, California.

Runners who pop NSAIDs before a distance event hoping to boost their pain tolerance are making a big mistake, Nieman says. In another 2006 study, he gave ibuprofen (600 mg and 1,200 mg the day before and during the race, respectively) to one group of athletes and compared their performances to a group that took no meds. He found no statistical difference between the groups’ race times, muscle damage, perceived effort, or reported soreness between people who pop and people who don’t.

Of course, these meds do help runners manage aches and pains. Keep reading to see the best pill to take, and how to do that – safely.



The Pain: You twisted your ankle on a run, or you ran a hard half marathon and walking down stairs makes you wince.

The Good: Relieves swelling and aches by blocking an enzyme that creates inflammation in the body.

The Bad: Can impair kidney function, more so if taken before or during a run. (NSAIDs inhibit blood-flow to the kidneys. Kidney circulation can also be suppressed by dehydration. So a dehydrated, NSAID-using athlete’s kidneys could struggle to maintain a proper fluid and electrolyte balance.) Can cause GI distress, more so if taken pre- or midrun.

The Rx: Take 1 pill (200 mg) 2-3 hours postrun (once you’re rehydrated) for an acute injury or severe soreness. Don’t take for more than four days.


Naproxen Sodium

The Pain: You twisted your ankle on a run or you ran a hard half marathon, and you have a family history of heart disease.

The Good: Inhibits the body’s inflammatory response. Provides longer-lasting relief than ibuprofen. NSAID associated with lower heart-attack risk.

The Bad: Can impair kidney function, especially if taken before or during a run. Can cause GI distress, especially if taken before a run.

The Rx: Take 1 pill (220 mg) 2-3 hours postrun (once you’re rehydrated) to relieve an acute injury or severe soreness. Don’t take for more than four days. (Taking NSAIDs could increase muscle soreness if taken before or too soon after exercise. Ibuprofen can allow endotoxins to slip into your blood stream, which can cause cell oxidation and result in muscle soreness.)


Acetaminophen (Tylenol)

The Pain: You woke up with a killer headache and have a killer workout on tap. Or your foot hurts but you’re set on racing anyway.

The Good: Acts as an analgesic but is not an anti-inflammatory, meaning it relieves aches without impacting the stomach or kidneys.

The Bad: Can have a detrimental effect on your liver if taken frequently or in large doses.

The Rx: Take 1 regular-strength pill (325 mg) before or after a run. Skip the booze. Alcohol increases the med’s liver toxicity. Don’t take for more than four days.


Aspirin (Bayer, Excedrin)

The Pain: You are on a daily low-dose aspirin regimen prescribed by your doctor.

The Good: Anti-inflammatory that inhibits blood-clotting to protect against heart disease and stroke. Analge-sic that lessens aches and pains.

The Bad: Can cause GI distress if you’re not accustomed to it. Even a low 81 mg dose can impair your blood’s ability to clot. (NSAIDs block an enzyme that produces a layer of mucus that protects your stomach. Without it, you’re prone to nausea, diarrhea, and stomach cramps.)

The Rx: Safe before a run – if you are on a regimen. “Trail (or clutsy) runners may want to skip due to risk of bleeding. Can also worsen swelling and bruising.


Quercetin & Polyphenol

The Pain: You’re after a big goal and want to reduce the general aches and soreness that come with a long, hard training period.

The Good: Diets high in quercetin (found in onions, apples, berries) and polyphenols (found in grapes, plums, coffee) reduce inflammation in athletes.

The Bad: Supplements should be discussed with your doctor and not overdosed.

The Rx: Eat foods rich in these natural anti-inflammatories. During particularly hard training periods, you can opt to take a supplement to enhance the benefits.



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