NSAIDs Can Help Decrease Inflammation and Pain but Impact Muscle Gains

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NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen, naproxen, diclofenac, celecoxib and indomethacin can decrease pain. Take them for the shortest possible time as they can be harmful.

Should you use NSAIDs? If you must get back to work ASAP then consider the risks vs. benefits. Talk to your pharmacist and physician (MD).

NSAIDs can help decrease inflammation and pain

NSAIDs can Help Decrease Pain from:

  • Acute ligament sprain – use for < 5 days. NSAIDs reduce pain and swelling so you can return to activity faster.
  • Osteoarthritis (cartilage wear and tear)
  • Delayed onset muscle soreness. When taken for several days before muscle damaging exercise, NSAIDs may reduce soreness. Take with caution as they can wreck your strength gains (see below).
  • Muscle bruise (contusion). Short term use can decrease inflammation with no adverse effects on healing.
  • Tendonitis – reduces inflammation and helps recovery. NSAIDs may do more harm than good for chronic tendon issues.

How NSAIDs Impact your Strength Gains

  • Short-term low dose (400 mg ibuprofen) use may have no real impact on muscle strength or size.
  • Longer term, higher doses (1,200 mg ibuprofen) may compromise muscle growth and, when training was preformed with all-out max reps, strength gains were also compromised.
  • The elderly may benefit due to a decrease in inflammation from taking NSAIDs. Chronic inflammation, which is not uncommon in the elderly, impairs strength gains. NSAIDs help tame inflammation.
  • After muscle injuries, NSAIDs can help reduce strength loss, soreness and muscle markers of inflammation, particularly when lower body muscles are injured.

Why do NSAIDs Impact Training (Strength) Gains?

NSAIDs work by blocking COX enzymes. COX enzymes alter prostaglandin synthesis, mediators of inflammation and pain. Prostaglandins have other actions in the body including regulation of muscle protein metabolism. Decreases in the prostaglandin PGFare associated with decreased protein synthesis and reduced muscle fiber size. In one study, 1200 mg ibuprofen blocked protein synthesis after resistance training. Other studies show signaling responses in muscle are decreased for hours or days after resistance training when NSAIDs are used.

References:
Arthritis Res Ther 2013;15(Suppl 3):S2.
Annals of Phys and Rehab Med 2010;278-288.
Am J Sports Med 2004;32(8):1856-9.
Am J Physiol Endocrinol Metab 2002;282(3):E551-6.
Acta Physiol (Oxf) 2018;222(2).
J Physiol 2009;587(Pt 24): 5799-5800.
Am J Sports Med 2018;46(1):224-233.

 

Protein Before Bed for Greater Muscle Gains?

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protein before bedA recently published study found a protein rich snack before bedtime led to greater gains in muscle mass, strength, and type II muscle fiber size in young men participating in a resistance training program. Yet a closer look at the details of this study suggest the timing (before bed) might not matter at all.

In this study 44 young men were given a supplement containing 27.5 grams of casein and 15 grams of carbohydrate or a placebo that contained no protein, carbs or calories before they went to sleep each night for 12 weeks. They also lifted weights 3 times a week under the direction of a supervised and periodized program. The young men were instructed not to change their diet (other than the supplement). Food logs were taken to access dietary intake. Both groups consumed about 1.3 grams of protein per kg bodyweight before the study started. However, the group given the supplement consumed a total of 1.9 grams per kg bodyweight during the study while the placebo group continued eating the same amount of protein as they did before the study started – 1.3 grams per kg bodyweight. So, was it the timing of protein before bed, the total difference in protein intake or both that led to the results? We don’t know. However, the total protein intake of the placebo group was on the lower end of the recommended range (1.2 – 2.0 though higher values may be beneficial for some, especially those who are cutting calories) anyone should consume if they want to get stronger and bigger.

So what’s the bottom line?

We don’t know if consuming protein right before bed will help young, healthy and active adults make greater gains from their strength training program compared to consuming the same total amount of protein each day without a protein-rich bedtime snack.

My protein recommendation for now:

Meet your daily protein needs based on your goals first and if a pre-bedtime protein-rich snack helps you do this and sleep well at the same time, then great. If eating or drinking before bed interferes with your sleep (running to the bathroom counts as interfering) then this strategy may do more harm than good.

References:
Snijders T, Res PT,Smeets JSJ, van Vliet S, van Kranenburg J, Maase K, Kies AK, Verdijk LB, van Loon LJC. Protein Ingestion before Sleep Increases Muscle Mass and Strength Gains during Prolonged Resistance-Type Exercise Training in Healthy Young Men. J Nutr 2015.

Res PT, Groen B, Pennings B, Beelen M, Wallis GA, Gijsen, AP, Senden JM, Van Loon LJ. Protein ingestion before sleep improves postexercise overnight recovery. Med Sci Sports Exerc 2012;44:1560–1569.