Which Comes First, Cardio or Weights_ - Alex Hutchinson [60]
Nobel Prize–winning research by chemist John Vane in the 1970s showed that NSAIDs work by inhibiting the production of chemicals called prostaglandins, which regulate inflammation. But prostaglandins also play a role in the creation of collagen, the main building block of musculoskeletal tissue. The soreness and inflammation you feel a day or two after exercise is directly linked to the repairs that make your muscles stronger. In effect, taking NSAIDs to reduce this inflammation cancels out some of your adaptations to training—and indeed, studies have found that prolonged NSAID use delays the healing of bone fractures, as well as injuries to muscles, tendons, and ligaments.
Some athletes also pop NSAID pills before or during vigorous exercise, hoping to ward off later pain. In a study of ultra-marathoners at the Western States Endurance Run, researchers at Appalachian State University found that runners who took ibuprofen before and during the race didn’t finish any faster than those who abstained, and they had the same levels of perceived exertion, muscle damage, and soreness in the week following the race. More worryingly, though, blood tests of the ibuprofen users indicated higher levels of endotoxemia, a condition in which toxins leak out of the intestines into the bloodstream. This could be linked to the role of prostaglandins in forming the acid-resistant lining of your stomach and intestine (which is also why NSAID overuse can lead to stomach problems like ulcers and gastrointestinal bleeding).
All these warnings might make NSAIDs seem like dangerous pills that should be avoided at all costs. That’s not the case—they’re extremely useful when used in the right context. That means they’re not suitable for dealing with nagging, chronic problems on an ongoing basis, or for trying to prevent pain before it happens. But if you have an injury that swells and is painful even when you’re not exercising, NSAIDs, for no more than seven days, may be just what your doctor (or therapist) orders.
How long does it take to recover after a marathon or other long, intense effort?
The aches and pains that hit you in the days after an extended bout of exercise can seem worse than the competition itself. When you take part in something like a triathlon, a multi-hour hike, or a long running race, you’re subjecting your body to stress that causes damage and takes time to heal. Different systems return to normal at different rates: acute fatigue might be gone within a day or two; your immune system could be weakened for up to a week; and in some cases, muscular fatigue can linger for several weeks.
In the last few years, researchers have become concerned about the possibility that extended endurance activity could cause heart damage, since the heart has to beat unusually quickly for several hours. Several studies have found evidence of “cardiac injury” in runners after they complete a marathon, including enzymes suggesting that heart muscle has been damaged. To investigate these claims more closely, researchers at the University of Manitoba used magnetic resonance imaging to perform a detailed analysis of the hearts of participants in the Manitoba Marathon, publishing the results in the American Journal of Cardiology in 2009. They found that, despite initial evidence of damage, normal heart function resumed within a week. In other words, your heart muscles take a beating during a marathon but recover soon afterwards, just like your leg muscles.
The damage to your legs will be considerably more obvious to you, since you may have difficulty walking down stairs or even just getting out of bed the next morning. This delayed onset muscle soreness, or DOMS (see Chapter 3) tends to peak one or two days after the race and can persist for up to a week. Soreness lasting longer than a week could indicate more serious damage and should be examined by a clinician. But it’s not unusual for muscle fatigue to persist even after the soreness is gone, sometimes