A Look at the Literature | The Effects of Ibuprofen on Oxidative Stress, Muscle Damage, and Performance in Trail Runners by de Souza et al. (2024) | Find Your Stride | Edinburgh Podiatrist

Introduction

A remarkable number of marathon runners, up to 75%, use non-steroidal anti-inflammatory drugs (NSAIDs) during races. However, the impact of these medications on performance remains uncertain, particularly in endurance sports. This blog post summarises a randomized controlled trial conducted by de Souza et al. (2024) titled The Effects of Ibuprofen on Oxidative Stress, Muscle Damage, and Performance in Trail Runners.

Ibuprofen is a Non-steroidal anti-inflammatory drug widely used to relieve pain, reduce inflammation, and bring down a high temperature.

Study Design

The trial involved 12 male participants who were randomly assigned to one of two groups: a placebo group and an ibuprofen group (IBG). The IBG received a 400 mg ibuprofen capsule 15 minutes before their 42-km trail run and another dose five hours into the race. The trial measured various outcomes, including oxidative stress indicators and muscle performance metrics like vertical jump capability.

Key Findings

The results showed that the placebo group experienced a significant 70.1% increase in thiobarbituric acid reactive substances (TBARS), which are markers of oxidative stress (p < 0.0001; Cohen's d = 4.77). In contrast, the IBG demonstrated a more moderate 31.46% increase in sulphhydryl groups (SH), indicating less oxidative stress (p = 0.024; Cohen's d = 0.27). Additionally, the IBG showed a remarkable 55% improvement in squat jump performance (p < 0.01; Cohen's d = 1.41). However, there were no significant differences observed in muscle damage markers such as creatine kinase (CK), pace, speed, or overall finishing time between the two groups. In summary, while ibuprofen appeared to positively influence oxidative stress and muscle fatigue, it did not enhance physical performance or cause notable muscle damage.

Limitations and Future Research

Despite the promising results, the study has some limitations that should be acknowledged. The sample size of 12 participants is relatively small, and only included male trail runners, which may affect the reliability of the findings. Furthermore, the researchers did not conduct follow-up analyses 24 and 48 hours post-competition, which could provide additional insights into the long-term impact of ibuprofen on runners.

Further research is warranted to explore ibuprofen's effects on endogenous antioxidant enzymes, such as catalase, superoxide dismutase, and glutathione peroxidase. Additionally, while the study highlights the beneficial effects of ibuprofen, it is crucial to consider the potential adverse effects associated with NSAID use during races, including common gastrointestinal issues like nausea, reflux, dyspepsia, and abdominal pain, as noted in previous studies (An et al., 2020; Stamatakos et al., 2012).

Conclusion

In conclusion, this trial by de Souza et al. (2024) provides valuable insights into the impact of ibuprofen on oxidative stress and muscle performance in trail running. While it suggests a potential benefit in reducing oxidative stress, the lack of effect on physical performance and muscle damage underlines the need for further investigation into the safe and effective use of NSAIDs among marathon runners.

Find Your Stride!