Background… then question.
So I finished my first IM this weekend at St George… that was friggen gnarly.
On Friday morning before the race, my back popped out. Happens a few times a year, I’m 47 years old, used to it. Usually takes about 2-3 days of bedrest for me to be back up and moving. This time, I didn’t have the luxury of 2-3 days. So Friday I laid in bed all day and popped Cyclobenzaprines and a BUNCH of Ibuprofen. I was slightly hunched, but able to walk at 4:30am race day, so popped more Ibuprofen and decided to go for it. A few more before the race to get me thru the swim (which was a challenge that day), then some more onto the bike, and also at T2 so I could do the marathon upright.
So during the marathon, I had some pretty severe leg cramps. Nothing like I’ve had before. I took plenty of SaltTabs and e-lyte drink on the ride. Didn’t matter, my legs were just cramping majorly which kind-of ruined my run time… don’t get me wrong. I was ecstatic to finish and hear Reilly call my name :^)
Question… Does anyone have any expertise in medicines which would help explain this? Does Ibuprofen screw up your musculature? Screw up your sodium balance in muscles?
If so, what would have been a better option for me to manage strong lower back pain on race day???
I woke up the morning of the Boston Marathon with severe neck spasms. It had happened to me a few years earlier and the only thing that seemed to help was the cyclobenzaprine. I still had pills left from the earlier prescription and decided to take half a pill because I was worried about how a muscle relaxer would affect my running. Worst of both worlds. My neck still hurt and running was very difficult. I hit that halfway point on pace, but I knew I was working way too hard for what should have been comfortable at that point. Around mile 16, my legs starting cramping. They were the worst cramps I have ever had. I couldn’t even stand up.
I’ll be curious to hear the medical explanation, but I’m 100% convinced that my cramps were caused by the muscle relaxers. I was in great shape leading up to that race and I was just debilitated. I did wind up finishing–just not quickly.
I can’t comment on the muscle cramps, but from working at the NYC Marathon for the last couple of years I can tell you that is not recommended during endurance events. It can cause acute kidney failure, especially in volume depleted (dehydrated) athletes. They only give out acetaminophen along the marathon course and at all tents.
I would be careful taking ibuprofen in the future, and if you’re going to substitute with acetaminophen for pain relief remember <3.0g total dose in any 24h period.
I’ve trained several times on ibuprofen, and it seems to actually help on my long rides (assuming the red wine the night before wasn’t helpful)…have never had to race on it, though took it most of the week before the race. It is known to have an effect on sodium balance.
The course and exertion required to complete it with the winds, the climbs, and the extended overall time from the wind and the waves, likely caused a bunch of people to cramp on the run Saturday…in fact I saw one AG winner walking up the last incline before the downhill finish (he was exactly one loop ahead of me), and I’m guessing he was cramping or pre-cramping
Dr in the medical tent at Kona told me that taking NSAIDS the day before or during the race can make it more likely to get hyponetremia (low blood pressure from low sodium concentration in the blood). TOO much water can also cause this along with not enough salt. So, my guess is that the NSAIDS helped to cause your cramping.
Thanks all for the info.
Hopefully there’s no “next time” and I don’t have a back shut-down the day before a race again. Sounds like if I do though, the Ibuprofen I was pumping in was the wrong way to go.
And interesting about the other racer who had cramps taking the cyclobenzaprine. I just knew my musculature and overall “system” was a little fubar’d during the race.
Main thing though even if my time sucked, I finished IMSG and it was one Bad Mutha to knock out!
Dr in the medical tent at Kona told me that taking NSAIDS the day before or during the race can make it more likely to get hyponetremia (low blood pressure from low sodium concentration in the blood). TOO much water can also cause this along with not enough salt. So, my guess is that the NSAIDS helped to cause your cramping.
This. It isn’t that NSAIDS cause renal failure in a direct manner, but they can affect electrolyte balance so that the kidneys are not able to filter as well. Add to that the lack of volume to dilute the waste products from the body, the potential for cardiac dysrhythmias and it just is a bad idea period.
The cells tend to take in more potassium when serum sodium levels get low in an effort to cause more sodium to enter the cell and create balance. NSAIDS mess with that. I avoid them like the plague if I am a week out from a race and try to just hydrate and move post race to prevent soreness. I will tend to ice areas that are sore and rest if I need to. Tylenol is a better option if there is pain involved. At least until the hydration status returns to normal.
I had a ready reserve bag at mile 40 of my first 50 mile run last month. It contained two vicodin. I was beyond hurting at that point and so I popped one of them at the aid station. My pace picked up after about 15 minutes and miles 47-50 (uphill out of a canyon) were some of my best all day. The downside is that I trashed my quads and IT band because I couldn’t feel them and my recovery has taken twice as long as I had planned.
I am a big believer in Tylenol at long races. Like anything else - if you’re smart about what you are doing
it is perfectly valid. Just don’t take them by the handful.
I usually take 1 Aleve (Naproxin Sodium) when I wake up on race day. Doc can’t tell me any reason not to
and it seems to keep the gremlins away.
I usually pop a pair of Tylenol Rapid Release tabs about mile 20 of the marathon (open or IM) and I find it really
helps with the leg pain (for me it is quads and hip flexors). I also know many ultra marathoners who
swear by Ibuprofen during the events. I think I’ve done it once or twice - but I seem to get all I need from the
Tylenol.
I rarely take any NSAID’s otherwise… even after a long run a prefer a foam roller session and a cold beer.
Hey adventureboy, congrats on finishing a tough race made even tougher by your circumstances.
If you want to get into the nitty gritty about your question, this would be a good resource from the American Medical Athletic Association journal
Hey adventureboy, congrats on finishing a tough race made even tougher by your circumstances.
If you want to get into the nitty gritty about your question, this would be a good resource from the American Medical Athletic Association journal
Hey, I only took one of them! and it was stuffed in a sausage my friend brought me from Spain. I really had no idea it was in there. Oh, and i didn’t really take it, my chimera brother inside me did.
