Today on the Doc On The Run Podcast we’re talking about the only time a runner with a stress fracture should take ibuprofen.
I know ibuprofen is a very popular medication among athletes. I have seen ibuprofen on the ground on the course at every marathon and Ironman triathlon I have ever done. People are taking it when they have aches and pains, people are taking it to get through races, people take it for lots of different reasons, but I can tell you that there is only one valid reason to take ibuprofen in my mind.
This is really simple. To me, the only time a runner with a stress fracture should take ibuprofen is when you have what I call a non-skippable race. I mean a race you would rather die than miss that race. It can be lots of different things. I have a buddy who is from New York, he actually lives out here in California, and he got a slot for the New York City Marathon. Well given that he grew up in New York, that was really important to him.
For a lot of people, it’s the Boston Marathon. You try and try and try and try to qualify. Then you think you qualified, but you weren’t quite close enough. Then you try again. You finally get into the Boston Marathon. You really want to do it.
Maybe it’s Ironman Hawaii. It took me nine years to get into Ironman Hawaii, and I also would truly have rather died on the course than miss that race. I did not want to spend another nine years trying to qualify for Hawaii. So, if it’s one of those kinds of races, well I would talk with you about whether or not it’s really worth the risk of doing the race. About trying to do everything that you can to prevent and control the stresses applied to that bone, so it doesn’t get worse during the race.
If it was me, I would probably take ibuprofen to make it through the race understanding there’s a significant risk of breaking the metatarsal, but having already decided about whether or not I can accept that risk. That is the only time I would take ibuprofen.
There are research studies that have shown that taking non-steroidal anti-inflammatories disrupt the production of collagen that is part of the early phase of healing of stress fractures, and that it can change the course of remodeling of the bone and slow down the healing of the bone. I would not take ibuprofen and try hard to not take ibuprofen just because it ached a little bit.
There are lots of reasons that I would not do that. I’ve done other episodes talking about why I would not do that, about the physiology of it, the importance of your own self-analysis, and deciding how bad it hurts and you cannot do that when you’re taking ibuprofen. So, there are many reasons why not to take it. The only reason to take it is when I think that you really have to do this race and you’re trying to make it through the race.
If you’ve had a doctor tell you that you should take ibuprofen just to get rid of the aches and pains, I would be curious to know that, why did a doctor tell you to do that? Was it because you just had some normal ache and pain, or did you use it as part of your self-diagnosis process, or did a doctor tell you that it was part of your stress fracture treatment plan. I’m not going to criticize you for this, but in the comments, if you have taken ibuprofen when you had a stress fracture, I’m extremely curious to know what your reasoning was.
If a doctor told you to do it, and if they did, did they give you a clear reason on why you needed to take it? Did they imply or tell you that it was going to make the stress fracture heal faster, or is it something you decided might help this move along faster or allow you to run, or what was the reason?
If you took ibuprofen when you had a stress fracture, I would love to hear from you to know why you took it and what your reasoning was. Having said that, if you have a race like a non-skippable race that you think you might need to cancel because of a stress fracture, I will tell you that if you can ask yourself the right questions, it’s a lot easier to make an informed, thoughtful decision about whether or not you might be able to do that race or if you should really skip it.
But you have to be able to ask yourself some very, very specific questions and understand the realities about how much discomfort you really have with certain different activities and how much discomfort you have if you remove stress and strain to that one injured bone. But if you can ask yourself those questions, then you could probably fill out the stress fracture severity worksheet that I’ve created for you that you can just download and print out. It’s not a thing that you fill in line and I review it for you or something.
It’s a thing you fill out and assess yourself, and you can get that for free at www.stressfracturesecrets.com, but you have to really think about how important that race is to you, and if you’re thinking about skipping a race that’s really important to you and you’re thinking maybe I should just take ibuprofen and tough it out and go through it, maybe you should really try to do a clear self-analysis on how bad your stress fracture really is based on that worksheet I’ve made for you. Go get it right now, www.stressfracturesecrets.com.
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