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Joint pain is a common issue in experienced bodybuilders, or even novices, who start out too hard. Relief via treatment with NSAID’s (non sterodial anti inflammitory drugs - or painkillers) is a popular alternative, but most individuals concede that use of NSAID’s over the long term is not ideal. New research has come to light, which might convince even the most stubborn bodybuilder to look for a natural alternative to NSAID’s. Emerging research over the last decade suggests NSAID’s may actually impair the very thing that all bodybuilders hold dear, namely, muscle gain.

Reduced Muscle Protein Synthesis with Painkillers

In the case of young, healthy individuals, there is accumulating evidence for a negative effect of NSAIDs on skeletal muscle adaptation to physical training1-7. NSAIDs have been reported to attenuate the increase in muscle protein synthesis in young men after an acute bout of resistance exercise1-3. Additionally, muscle satellite cell activity – a fancy name for a process which facilitates muscle hypertrophy, is negatively regulated by NSAIDs after an acute bout of resistance exercise4 or endurance exercise in humans5. In rats, NSAIDs have been reported to severely blunt skeletal muscle hypertrophy after a period of muscle overload6, 7.

Glucosamine and NSAIDs

But the studies mentioned above were in an acute model, where subjects were infused with NSAIDs for several hours before the exercise intervention. So subjects had more NSAIDs in their system than say the average bodybuilder using NSAIDs for temporary joint pain relief. For this reason, another group of researchers from the Institute of Sports Medicine at the University of Copenhagen did a study of patients with osteoarthritis of the knee. Each patient was subjected to a 12-week strength-training program and given either NSAIDs, glucosamine or a placebo. Each group experienced similar increases in muscle mass, but only the groups receiving the NSAIDs and glucosamine exhibited an increase in muscle strength. However, there was no significant difference in strength between the NSAID and glucosamine groups. In attempting to explain why the group receiving NSAIDs did not show a significant decrease in muscle hypertrophy, the authors said that they could not rule out the possibility that long-term NSAID use has a negative effect on muscle hypertrophy following resistance training8.

Glucosamine Superior to Ibuprofen for Cartilage Preservation

However another study published by the same researchers a year earlier (2010) showed that glucosamine was superior to ibuprofen in improving a marker of cartilage turnover. The study subjects were patients with osteoarthritis of the knee who completed a 12-week resistance training program. These findings alone are reason enough for the average bodybuilder to consider using a glucosamine supplement to prevent long-term cartilage degradation9.

NSAIDs Inhibit Recovery

Another study has shown that use of NSAIDs may abolish the exercise-induced adaptive increase in collagen synthesis in human tendons. Fifteen healthy youngsters received either a standard dose of NSAIDs for 7 days or placebo and then completed a prolonged bout of running (36km), which served as the stimulus for heightened collagen turnover. Runners receiving NSAIDs exhibited a total blunting of the adaptive increase in collagen synthesis in the patella tendon seen in the placebo group in response to the prolonged exercise10. So apart from possibly inhibiting muscle protein synthesis, NSAIDs can inhibit your body’s natural collagen remodelling process in response to exercise.

Glucosamine for Joint & Muscle Insurance

In summary, there is certainly evidence in human and animal models that heavy use of NSAIDs can attenuate muscle mass and strength gains. However we are still waiting for conclusive evidence that long term use will do the same in humans. Nonetheless, research also tells us that NSAIDs can increase cartilage breakdown and inhibit collagen resynthesis, which are both important to avoid if you want to maximise your longevity in the gym. To preserve your precious muscle, cartilage and tendons, it is worth considering a glucosamine supplement if you haven’t already.

1. Weinheimer EM, Jemiolo B, Carroll CC, et al. Resistance exercise and cyclooxygenase (COX) expression in human skeletal muscle: implications for COX-inhibiting drugs and protein synthesis. Am J Physiol Regul Integr Comp Physiol. 2007;292:R2241-R2248.
2. Trappe TA, White F, Lambert CP, Cesar D, Hellerstein M, Evans WJ. Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab. 2002;282:E551-E556.
3. Trappe TA, Fluckey JD, White F, Lambert CP, Evans WJ. Skeletal muscle PGF(2)(alpha) and PGE(2) in response to eccentric resistance exercise: influence of ibuprofen acetaminophen. J Clin Endocrinol Metab. 2001;86:5067-5070.
4. Mikkelsen UR, Langberg H, Helmark IC, et al. Local NSAID infusion inhibits satellite cell proliferation in human skeletal muscle after eccentric exercise. J Appl Physiol. 2009;107:1600-1611.
5. Mackey AL, Kjaer M, Dandanell S, et al. The influence of anti-inflammatory medication on exercise-induced myogenic precursor cell responses in humans. J Appl Physiol. 2007;103:425-431.
6. Soltow QA, Betters JL, Sellman JE, Lira VA, Long JH, Criswell DS. Ibuprofen inhibits skeletal muscle hypertrophy in rats. Med Sci Sports Exerc. 2006;38:840-846.
7. Bondesen BA, Mills ST, Pavlath GK. The COX-2 pathway regulates growth of atrophied muscle via multiple mechanisms. Am J Physiol Cell Physiol. 2006;290:C1651-C1659.
8. Petersen SG, Beyer N, Hansen M, et al. Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil. 2011;92(8):1185-1193.
9. Petersen SG, Saxne T, Heinegard D, et al. Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training. Osteoarthritis Cartilage. 2010;18(1):34-40.
10. Christensen B, Dandanell S, Kjaer M, Langberg H. Effect of anti-inflammatory medication on the running-induced rise in patella tendon collagen synthesis in humans. J Appl Physiol. 2011;110:137–141.

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