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NSAIDs Interfere with Proper Training

Ibuprofen and other NSAIDs (Non Steroidal Anti-Inflammatory Drugs), taken before or after exercise, interfere with the benefits of training for fitness and athletic competition because they delay healing of damaged muscles (British Journal of Sports Medicine, August 2009). You train for sports by taking a hard workout that damages muscles and makes them feel sore. You then take easy, less intense workouts for as long as it takes for the soreness to go away. Only then should you take intense workouts again. Swimmers take hard and easy workouts every day, but athletes in virtually all other sports allow at least 48 hours between intense workouts.

Biopsies done the day after a hard workout show bleeding into the muscle fibers and disruption of the Z-bands that hold muscle fibers together. Injured muscles release healing prostaglandins that cause collagen to be laid down in muscle fibers to make them larger and stronger. They also cause pain. NSAIDs block the training effect by blocking healing prostaglandins, thus delaying recovery and collagen production. They prevent bones, muscles, tendon and ligaments from thickening and becoming stronger.

Athletes taking NSAIDs during competition are at increased risk for bleeding into their kidneys, and for intestinal bacteria to enter their bloodstreams (Brain, Behavior and Immunity, November 2006). An estimated 60 percent of athletes competing in triathlons and other endurance events take NSAIDs because they think that it will block the pain of competition. NSAIDs have not been shown to block the pain and fatigue of competing in athletic events that require endurance.


Reports from

Arthritis treatments
Lactic acid
Benign tremors


Follow-up on monitoring heart rate during exercise:

My report on the unreliable Maximum Heart Rate formula ( brought many questions on how heart rate SHOULD be used for training. Competitive athletes often use a guide called lactate threshold (LT). When you exercise, your muscles require oxygen to convert food to energy. If you exercise so intensely that you cannot get enough oxygen, lactic acid accumulates in your muscles and spills over into your bloodstream. This makes your muscles more acidic which causes terrible burning, and you to become short of breath and slow down as you struggle to get more oxygen. Your lactate threshold occurs when you exercise at the highest average heart rate you can maintain for 45-60 minutes. RoadBikeRider offers the following guidelines for cyclists; the same principles can be used in any other endurance sport.

"A good way to find your LT is to ride a fairly flat 15-mile course at a hard pace. Use a heart monitor that averages heart rate for the distance or just check it occasionally to see where HR settles.

You'll quickly find that you can maintain a certain high HR, but if you go a few beats higher you'll start panting and be unable to control your breathing. Trial and error will reveal the highest HR you can maintain for the distance. That's your LT.

Three simple exercise zones based on your LT heart rate are sufficient. These guidelines should work for most riders:
Recovery takes place about 40 beats below LT
Endurance is built on rides about 25 beats below LT
Breakthrough training is done from 10 beats below LT to about 5 beats above LT
No heart monitor? You can do just as well by monitoring your perceived exertion. For instance, recovery rides should be so easy that you barely feel the pedals. The idea is to take a 'walk' on the bike. Hard efforts, such as intervals and climbing, should be at the limit separating steady-but-labored breathing from panting and gasping. By experimenting you'll find this LT boundary."


Dear Dr. Mirkin: What can I do to prevent osteoarthritis?

Women have who very strong thigh muscles are far less likely to develop osteoarthritis of their knees (Arthritis Care & Research, August 2009). In this study, men and women over 50, with no knee pain and normal knee x rays, were tested for leg muscle strength. Two and one half years later, those with weak leg muscles had far more osteoarthritis or abnormal knee X rays. About 10 percent of people in the study developed osteoarthritis. So having strong thigh muscles may help to prevent osteoarthritis.

When your joints hurt, your doctor orders tests to find a cause, such as gout, rheumatoid arthritis and so forth. When the tests are normal, he diagnoses osteoarthritis, which means he has not been able to find a cause. More than 54 million Americans suffer from osteoarthritis. We do know what increases risk for this disease: inactivity, obesity, bone deformities from birth, joint injuries or surgery, and lack of vitamin D. Being female and getting older increase your risk also. This study gives one more reason to keep your muscles strong.


Recipe of the Week: Cuban Corn Chowder

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June 22nd, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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