The effect of NSAIDs such as aspirin, ibuprofen, and acetaminophen on muscle growth.
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If you are one of the many people who take a few Advil aspirin,or any other NSAID after a workout or in the days following to alleviate muscle soreness, think again! There is recent research that conclusively shows that taking NSAIDs after exercise-induced muscle damage significantly reduces levels of the prostaglandin, PGF2-α, which is intimately involved in the protein synthesis that occurs post-exercise; we work out, tear down our muscles, and the anabolic process of tissue repair and hypertrophy is dependent on levels of this prostaglandin.(1,2). It has been known for some time that maximal, prescription-level doses of NSAIDs will inhibit skeletal muscle protein synthesis, as the study in reference (2) below was performed in 1982. Most of these studies, however, utilized in-vitro systems where cultured myocytes were exposed to a stretch-stimulus to induce tissue damage and then protein synthesis was measured with-and without the presence of a high concentration of NSAID. As those of us in the field of pharmacology have (painfully) witnessed time-and time again, in-vitro systems are rarely representative of what actually occurs in-vivo. Because of this the notion that NSAID use after a workout might decrease muscular gains was passed off as an artifact of the experimental systems used; and not representative of what somebody would experience when taking over the counter doses of NSAIDs.
A group in 2001, however, using eccentric contractions in human subjects to induce muscle damage, showed that post-exercise NSAID use drastically reduced the increase in protein synthesis normally seen in response to muscle damage. This study is relevant to real workouts because the researchers used a model for muscle damage that is very similar to what what happens during a normal weight training workout and the doses of NSAIDs used in the study were normal therapeutic doses, not unlike those that most people would take for a headache or after a tough workout for soreness.(3) The results of this study were that, in the untreated subjects, post-exercise muscle protein synthesis (24 hours post-workout) increased in upwards of 76%, while subjects that received either acetaminophen or ibuprofen saw no significant increase at all. The implications of this study are huge; if you are into taking a few Advil after a tough workout to alleviate soreness, think again; you may be severely hindering your progress.
It is important to know the mechanism behind such a phenomena because it may be possible that we can use this to our advantage. NSAIDs inhibit the enzyme COX-1 and COX-2, which basically take a common substrate, arachidonic acid, and through a cascade of biochemical reactions create a number of prostaglandins. Some Prostaglandins cause inflammation and are largely responsible for the pain response we get after a workout. Reducing prostaglandin synthesis by inhibiting the COX enzyme can reduce pain and inflammation, but at the same time reduction of the specific prostaglandin, PGF2-α has a dramatic effect on the ability of muscles to hypertrophy(2,4). Intuitively, this makes sense, because inflammation is intimately involved with the healing process. Although there are certainly situations when reducing inflammation is beneficial, after a weight training workout is clearly not one of them.
The pathway is outlined below and as you can see, inhibiting COX will have the effect of reducing PGF2-α, inhibiting the ever-so-important protein synthesis that occurs to repair the muscle and allow it to hypertrophy. So there you have it, convincing evidence that NSAIDs after a workout inhibit muscle gains. The next question you may ask is: How can we use this to our advantage? (i.e. by somehow increasing PGF2-α levels). Glad you asked! This will be coming in a future post; sign up for our feed or to receive posts by email to get this cutting edge info as soon as it is published. Until then, keep training hard and continuing to learn; the day you think you know it all is the day that you stop making gains.
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