#818 Should I take NSAIDs for a non-union in a runner? - DOC

#818 Should I take NSAIDs for a non-union in a runner?

Should a runner take non-steroidal anti-inflammatory medications for a non-union? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



If you have a metatarsal non-union where you actually broke it, and it started to heal, and then kind of quit healing and just got a bunch of scar tissue between the ends of the bone and your doctor’s letting you run on it, the question is, should I take non-steroidal  anti-inflammatory drugs or NSAIDs? And these are things like ibuprofen, naproxen, medications that are not steroids, but they stop inflammation and many runners take them for all kinds of aches and pains after training.

The question is, is it a good idea or not? Well, that depends. You can take those medications if your doctor says it’s good idea, but there are a couple of reasons I wouldn’t. A couple of real specific reasons. There’s a lot of conflicting information about this. This is my opinion based on what I know from research and extrapolating that to these particular circumstances.

So, here’s the first thing. First thing is, is there are some studies that show that some non-steroidal  ant-inflammatories, not specifically the ones I mentioned, but there are studies that show that they actually slow healing of tendon to bone junctions. So, where the tendon actually connects to the bone itself, it can slow the healing of injured injuries to the tendon where it’s attaching to the bone.

Why does that matter? Well, the way I think about it related to non-unions is this, you have a bone, you have a big cable of collagen, and it’s trying to attach to the bone and heal. And if we know that some non-steroidal  anti-inflammatory drugs actually slow down that attachment process, your goal of the non-union, if you’re not going to get it to turn into bone is to get it to become stable, to get a bunch of scar tissue or collagen to actually attach the two pieces of bone so that it becomes stable.

Well, the tendon has all collagen, the way the collagen attaches to the bone and the tendon, I believe is pretty much the same way as the collagen attaches the two pieces of bone together creating sort of a ligament like structure. But if it slows down healing and tendon to bone junctions to me, it just seems to follow that it might actually slow down healing of the non-union scar tissue that can make it stable enough that you might be able to continue running.

The other reason, the second reason that I would not recommend people take non-steroidal  anti-inflammatories is that it can actually limit your most important tool that you have to decide whether or not it’s safe for you to advance your activity or not and that is your pain level. So, your pain level is the crucial piece. You have to be able to track and monitor your pain to decide whether or not you can keep ramping up activity and keep maintaining your running fitness.

That is a thing I walk you through in the fast track challenges. The thing also laid out for you in the running injury roadmap that I wrote. It’s a book that you can get for free. You can even get access to the Fast Track challenge too but you have to be able to assess your pain and if you’re taking ibuprofen or you’re taking naproxen and it decreases your ability to sense the pain because of movement of the non-union, that’s counterproductive.

You don’t want to just beat it up. You want to be able to figure out how to get it to heal enough that it becomes stable enough that you can actually run on it. So, those are the two reasons why I think that you should not take non-steroidal  anti-inflammatories if you have a non-union.

Let’s say there is one circumstance where I would recommend you do it, that’s if you’re doing a particular race that took you a long time to qualify and you know that it might make it worst, your doctor said it’s okay for you to run the race but you want to get through it without a ton of pain, that might be a way to do it. But that’s about the only time that it would make sense to me.

If you liked this episode, please like it, please subscribe. Check out the running injury roadmap. You can get your copy for free at www.docontherun.com/roadmap. So, go check it out and I’ll see you there.