#417 Is this treatment bad for runners? - DOC

#417 Is this treatment bad for runners?

Today on the Doc on the Run podcast, we’re talking about whether or not this treatment is bad for runners.


This episode comes from a telemedicine call where I was speaking with a runner who had an over-training injury and she wanted a second opinion. And the reason she called was that she went to see a doctor and the doctor recommended a specific treatment for her.

So she went home and she started doing some online research, and she started thinking that maybe this treatment might actually be bad for her as a runner. And so, she scheduled this consultation and she wanted to double check and find out whether or not this treatment might be bad for her.

Now, the specific problem and the specific treatment doesn’t matter. The reason for that is that it had some very, very bad news. Every single treatment we as physicians recommend has some part of it that’s bad for you. And you may think that’s a little silly, but it’s actually true. Everything in medicine is about risk versus benefit and so, we take every treatment that we offer to a patient that we recommend to someone who has an injury or an illness and we have to decide, is this treatment actually going to make the person better as a whole, or could potentially make them worse?

Let’s think about a couple of really simple examples, say antibiotics. You get strep throat and the doctor recommends a medication called azithromycin or a Z-Pak, and they tell you need to take this antibiotic and it will make your throat better. Well, why wouldn’t you take that all the time? Well, that’s really simple. You wouldn’t take it all the time because the chronic antibiotics that you use in your body is going to actually get rid of a lot of very healthy bacteria that you need in your system. It can also, of course, lead to antibiotic resistance where you can get infections that actually won’t be treated effectively by those antibiotics in the future. So that’s just a couple of reasons you wouldn’t want to do that all the time.

In addition to that antibiotics, many of them, when you take them, they’re actually kind of hard on your kidneys, so you could get kidney problems or kidney failure or kidney disease. And obviously you don’t want to do that either. So it might be okay for you and better in that scenario to take it for a short period of time, but not a long period of time. Same thing’s true for ibuprofen. A lot of us know that ibuprofen can make you feel better if you have soreness, musculoskeletal injuries, over-training injuries, it can make you feel a lot better. A lot of people also will take it when they’re racing, because it makes them not hurt as much during the event. That is very, very risky.

I was at IRONMAN Texas one year, and the announcer brought somebody up on stage who was trying to do the race again, and he had actually had kidney failure a couple of different years. I, of course, immediately wondered whether or not he was taking ibuprofen during the race that could have led to kidney failure, as a consequence of taking ibuprofen, getting dehydrated, and then having the relative concentration of the ibuprofen go up in his bloodstream to what’s basically a toxic dose to your kidneys.

So everything that we do, all the treatments we do, are harmful to you. If a doctor says, “Just stop running,” you may think, well, that’s not really harmful. Well, it definitely is harmful to you as a runner. So if you’re a runner and you just stop running, you will lose your neuromuscular connections. You will get weaker. You will get stiffer. You’ll develop disuse osteopenia, where the bones actually start to get weaker and become more prone to stress fractures later.

Everything has risk. So you always need to think about you as a runner. And when you go to a doctor and they offer a treatment, you want to actually tell them what your main goal is, and then ask them whether or not this treatment could actually make it impossible for you to accomplish that goal. That’s really the key.


Go to https://www.docontherun.com/fasttrack/ and grab your seat now. I’ll see you in the training.