Kelly is brilliant coach and a wonderful friend. It was an honor to train with him when I lived in San Francisco. You should subscribe to the SFCF Blog for more of his (and Adrian's) posts. Very smart guys.

Damn man, 1 more thing i need t ocorrect thanks to crossfit. i sure am going to miss advil! Love the kettle bell work in the rain. Hope it doesn't slip.

Merle
Crossfit USA

Thanks Kelly
I guess that leaves only Vitamins T&V (tequila,vodka)for pain relief.
Crossfit at 53 years old gotta have something for pain.

Definitely respect Kelly, but I don't think you can take a all or nothing stance on the subject. There was a recent study by the Human Performance Laboratory at Ball State University:

"All subjects participated in three months of weight training, 15-20 minute sessions conducted in the Human Performance Laboratory three times per week. The researchers knew from their own and other studies that training at this intensity and for this time period would significantly increase muscle mass and strength. They expected the placebo group to show such increases, as its members did, but they were surprised to find that the groups using either ibuprofen or acetaminophen did even better. An earlier study from the laboratory, measuring muscle metabolism (or more precisely, muscle protein synthesis, the mechanism through which new protein is added to muscle), had looked at changes over a 24 hour period. This "acute" study found that both ibuprofen and acetaminophen had a negative impact, by blocking a specific enzyme cyclooxygenase, commonly referred to as COX.

But that study looked at only one day. Over three months, says Dr. Trappe, the chronic consumption of ibuprofen or acetaminophen during resistance training appears to have induced intramuscular changes that enhance the metabolic response to resistance exercise, allowing the body to add substantially more new protein to muscle."

The liver damage issue is real. My buddy's wife died in her late 30's - was up to 10+ advil a day for chronic back pain. Yes, excessive, but not uncommon: 3-4 in the morning, afternoon & evening.

Regarding the question of affiliate competition, objections turn into whining when:

1. you're the only one complaining
2. you've made friends and members uncomfortable about discussing the competition
3. you disappear from the community after the competition
4. the winners become shy or nervous about celebrating victory
5. you neglect to mention your own missteps, e.g., overtraining, working out between competition wods, cavalier approach to the competiton, etc.

Anthony,

Interesting stuff. Could you post up a link to the complete study?

Surpassing the ordinary. Awesome job Carson, Charles, and everyone from CrossFit Cedar Park in the Epic Challenge. The storm didn't slow anybody down!

Kelly is in a close race with my husband for title of "coolest guy on the planet" in my eyes. I freaking love K-Star and everything he write or says. A wizard with words! :-)

Hey AB,
I couldn't agree with you more. There rarely absolutes. However there are a couple of points to certainly consider.

I'm not a medical doctor (just a doctor of physio), and don't even want to have the anti-inflamm discussion with my patients as it extends beyond my area of training and experience but, I nearly do everyday because people are chronically self treating with the meds. So here goes.

1) Ibu is fantastic at treating specific soft tissue injuries like a swollen bursa for example.
If you are unsure, ask your doc. Your PT will say, compression, arnica, Ice, fish oil etc.

2) There is an overwhelming pile of literature supporting the blunted healing effects of NSAIDS. (not to mention the all too common and very serious GI bleeds these drugs may induce). Many times people will return to sport/activity having dealt with the pain associated with the swelling, but have not fully healed ligaments and tendons. They are actually pre-disposing themselves to further injury. Sounds like chronic heel cord ruptures that were treated with Ibu for a long time no? Or chronic sprained ankles. Or Rotator cuff tears...etc.
This is not debatable. The best ortho clinics in the world do not advocate NSAIDS post surgery or for chronic arthritis. Their clinical (black box) real world experiences of failed/limited surgical outcomes (allograph transplants (ACL, miniscus, etc) support the literature on this.

3) Ibu is often substituted for Ice. So lazy. How many ice you got?

4) The ball state study:
How many folks? Untrained? Ages 18-22?
Mostly male? Typical of big university performance studies. Did they look at tendon strength, ligament strength? They were looking at protein synthesis. It is possible that this untrained uber male group was able to train harder from not having pain inhibition. Is the implication that we don't have to worry about NSAID use down stream (connective tissue health etc) Put up the research link and let's look at it. Clearly the tylenol and ibu are in a different category. Any other studies? I'm not a researcher, my training is just to be a careful consumer of research. I love that you are going to the research on this. But, as crossfit knows we must take the exercise physiology research and carefully match it up with real world results.

5) Most importantly. People are way way to cavalier about popping ibu for a little discomfort. We are pushing the margins of human performance. The small details are really going to start to matter.

Important discussion. Please keep posting your thoughts and research.

Steve--Vitamin T always is safe. And paleo.

kstar

"Bask in your soreness!Brag about it at work as your friends help you get up off the toilet."

Hahaha I love this guy!

6. You neglect to mention your relationship to a competitor who did not make it.
7. The only people who support your arguments come from a single place.
8. Standards of excellence must be lowered to accomodate you.

Kelly, I completely forgot to check this, my apologies.

The two major points you brought up in your original article (please correct if I misunderstood):
1) ibuprofen makes tendons & ligaments weaker
2) ibuprofen stops muscles from getting stronger

Based on the BSU study there is evidence that ibuprofen makes muscles stronger. Unfortunately I could not find the full study online - and you're right in that all studies are going to be flawed. But it works both ways, especially considering the study you referenced (Piroxicam) didn't deal with ibuprofen. So my original point was that #2 needs more research and debate in order to make a claim one way or another.

Your article discusses how tendons and ligaments don't repair properly if an athlete is hurt and takes ibuprofen, but there's no discussion on whether ibuprofen itself causes healthy tendons and ligaments to weaken.

I'm always looking to learn and you're a wealth of knowledge - any info you have would be greatly appreciated.