Can You Workout on Pain Medication?

I’ll put my hand up here and tell you that I’ve occasionally taken pain meds to help me get through long runs in particular even though I don’t think it’s a great idea. I’ll also bet that if you’re a long time exerciser you’ve done it too. If you’re a new runner starting out you might be dealing with aches and pains like shin splints maybe you’ve already thought about it. It might be a controversial opinion but I don’t think it’s a great idea to take even over the counter pain meds to get through a workout for some obvious reasons and some not so obvious reasons. I also think that if you’re doing this more than a handful of times a year it very well could be a sign you’re taking exercise to far and it might be becoming an addiction for you. Plus we’ll look at what science has to say in the form of peer reviewed articles along the way.

You can’t listen to your body

This is sort of a catch all for a lot of the other more specific concerns we’ll talk about in just a minute. I do lots of things like cycling, swimming, paddling and yoga but most often I’m running. As a runner it can be hard to be as tuned into out bodies as we should be. It’s a sport where little twinges and aches can be expected and it’s hard to tell if those are serious in the moment to start with. Add to this the fact that we’re sometimes on plan and we feel like we have to keep going no matter what and we runners as a group can be bad for ignoring things. Adding pain pills to get through a tough workout can easily become a recipe for disaster. But that can be deeper than you’re originally thinking so read on.

Missed dehydration

One issue you might not have thought of is the warning signs of dehydration. Some of the symptoms of moderate dehydration can be masked by pain medications. Things like headaches, muscle soreness, tingling, cramps and nausea. For me I know the first warning sign is always a headache developing when I need to hydrate. If you’re taking pain medication for a sore knee say, you might miss these early warning signs and that can get dangerous real fast!

Dependency vs habits

No I’m not saying you’re about to develop a naproxen dependency that will eventually cost you everything and lead to rehab. The thing is once we find a crutch that works we sometimes tend to stick with it. Take me and KT tape for example. I’ve done all the PT exercises for my sore knee and even run a few 10k’s without it when I had to but I generally tape up for every run. Probably not a big deal but the idea of skipping this step does freak me out a bit. If you start dosing up for long runs it might well become a habit and then you’ll feel like you NEED to do it. Not a huge deal but one hot day or when a new injury is developing elsewhere you might miss something your body is trying to tell you. Make sure if you go this route you put a hard end point on it!

Liver and kidney damage

Tylenol (or acetaminophen) can cause liver damage in large doses. The effects of this can be amplified by vigorous exercise. While other anti-inflammatory medications like IBprofin, aspirin and Naproxen can cause kidney damage. Ditto for the exercise making it worse thing. In fact more ultra runners have detectable renal damage after a race if they are taking Advil compared to those that took a placebo. The more often you take it or the more rigorous the exercise the more of a chance you’ll have a problem down the line. Officially it’s a bad idea however if you insist there is a general consensus that Tylenol is the safer bet among race directors. Just make sure you look at everything else you might be taking because the active ingredient is present in many other medications like cold and flu stuff, sleep aids and medicated lemon drinks among other things. People do regularly overdose on acetaminophen accidentally by taking it in multiple medications without knowing, so be careful!

Also think carefully about taking anti-inflammatory medications after tough workouts. Inflammation does hurt but its also important in healing and the recovery process. It doesn’t always deserve the bad wrap it gets. Studies show that athletes who take these medications after a workout to deal with soreness don’t recover as well as those that do not. If healthy subjects took advil after running 36km they showed less collagen production in their knee-caps than those that did not. So taking these medications can prevent your body from actually getting stronger in some cases. Also there isn’t much point in taking them right after a workout as a means of preventing soreness since there is usually a day or so delay before you actually get sore. After the fact try your best to embrace the ‘hurts so good’ attitude if you can. Things like a walk, stretching, an epsom salt bath or yoga are probably more effective anyway so think about that the next time you think about taking a pill post workout!

What about the stronger stuff?

I’m just going to say don’t do it. If the over the counter stuff isn’t cutting it you’re not ready to return to exercise yet for so many reasons. A lot of these medications are habit forming so using them more often to workout increases your frequency of use and therefore your risk. If you need the stronger stuff your injury clearly hasn’t healed enough to be back out there yet. Finally these drugs can have mind altering effects and that’s not what you need when you’re pushing hard. Just don’t do it!

My tips if you’re going to do it anyway

1. Ask your doctor first!
2. Take the minimum does required – If half a pill will work start there. 
3. Start with Tylenol – Of all the over the counter meds it’s the safest to run on in that it has the fewest possible and least likely complications.
4. Prevention is better than treatment – Do physio exercises for your specific injury and take care of chronic issues, rest up for long or hard workouts.
5. Put up with the minor stuff – While there is no reason to suffer generally, considering the risks minor aches and pains or those that are getting better might not call for medication after all. Time will help.
6. If you can, wait to start or ideally take it after – If it’s only the last few miles that hurt take your pills a bit before you start to feel it or just take it after your workout if you really need it then.
7. Over the counter stuff only – Being on serious enough pain meds might mean you can’t do certain activities at all. This is twofold one if your medication makes you loopy it’s harder to stay safe using heavy equipment or running around moving cars. Two if your pain is serious enough to need a prescription maybe you shouldn’t be working out.
8. If you’re pain isn’t running related pick another day or treat that first – Just say you’re taking meds to workout because of something like a headache or cramps could you not just do it another day? If not take the pain pills for that issue, let them leave your system, do what they should and go later.
9. If you’re not improving or getting worse still with your issue take a break from your activities – When I’ve taking pain pills for running related pain it’s been while I’m in the upswing and taking active steps to rehab it otherwise.
10. Consider using a targeted pain cream like voltaren instead – It’s not as powerful and will only target your known issue.

Time to fess up

Do I tell other runners to skip the pain meds when running? Yes. Have I done it myself? Also yes. However I don’t make it a habit and I take all my other advice too. I don’t worry about it if I’m taking something for cramps or the rare headache. But I usually wait a few hours until I’m feeling better to start. Last year when I was half training towards the beginning my knee wasn’t exactly sore but it wasn’t not sore at all either if that makes sense. I was doing all the PT I needed to but for the odd long run I did pop a naproxen before heading out the door. So yes by the time I was taking something my knee was well and good on the mend. What I don’t do is take a pill to keep me running. I’ve also let go of all my goals for a whole season when injury rears its ugly head, there’s always next year right?

Now I do the hard work year round to stay well and so should you! I know that even a basic level of inconsistency will cause my runner’s knee to flare up so no matter what I get out there once a week, yes even in February even in the snow and even when I’m busy. I know that it’s no fun and sometimes legitimately terrible but that’s what makes it possible for the fun months. I also know that I’ll have flare ups as my milage increases from those once or twice a week runs in the winter up to five a week when I’m training for a running race in the spring. So before that milage increases in late February or early March I start doing my knee exercises everyday before it even starts to hurt! I stay ahead of it. For me cross-training is easy, I love to paddle, ride my bike at every opportunity, swim most weeks in the winter and most nights in the summer and really the work I do everyday is cross-training for me. I also love to catch a yoga class when I can. But for the most part it’s not something that just happens staying well takes work. If you’re ever even considering taking pain medication to deal with an injury before working out you’re not doing the real hard work you should be!

So am I way off base here? Do you take pain meds to get through a tough workout or race? I’ve heard it’s common practice among marathon runners for the big day and part of me really does get that. Why do you think it’s a no go or no big deal?