There seems to be a growing awareness in the running community about the risks associated with routine consumption of common pain drugs.
http://www.runnersworld.com/injury-treatment/pill-problem?page=single
Possibly some relevance here to cycling. Not seen it discussed among cyclists much.
This is an interesting and important debate, based on very unfortunate incidents. I agree with many of the comments made stating that this type of report is not very useful and possibly misses a big opportunity to actually inform people.
In ultra endurance sports painkillers are often used by athletes because they can help some people keep going without the discomfort of pain and inflammation caused by simple muscle breakdown. Audax riders will tend to use them to avoid a build-up of seat, foot and knee discomfort. I don't think the drugs can mask an actual injury but they can eliminate the pain of muscle breakdown caused by ultras, they will probably lessen the chance of cramps and they can definitely help solve or avoid the seat, foot and joint issues I've just alluded to - which is why they are so popular among long distance riders.
I've certainly used ibuprofen and similar NSAIDs myself in the past for eliminating the ache of muscle breakdown in endurance events of 24 hour duration or longer. I use them more 'reactively' than 'proactively' these days, but in previous years I would take them on a dosing regime before a 24 hour event without 'waiting' to experience a problem (dosing from 4 hours before the event even started - and all through the event itself). These days I try to avoid them whenever possible and I haven't used them at all in my training in recent times. But during seriously long endurance cycling events (of 24 hours and longer duration) I've never gone through an entire event without turning to ibuprofen and/or paracetamol at some stage.
I believe they definitely work. I'm not sure of just how safe they are or are not because of a lack of meaningful scientific evidence either way, but based on a very long history of long distance runners and cyclists using them I personally do not fear a lack of safety if the drugs are used according to normal guidelines. But scientific knowledge is always the best way to make accurate evaluations on such matters and I don't feel the quoted links do justice to this debate.
The Runner's World article states clearly that the athlete had overdosed on ibuprofen (by dosing twice within the permitted single-dose period). Taking double-doses of this type of painkiller does not increase the drug effects and simply risks damaging your organs. To report that an athlete overdosed on a common non-prescription drug to the extent that it nearly killed her is not anything surprising and tells us not to overdose on the drugs - something most people are aware not to do, already. It would be far more interesting - and useful - to see the discussion focussed on using the drugs correctly (within the recommended guidelines) and to evaluate whether or not the risks of doing so are increased by the fact that an athlete is participating in a very tiring endurance event (rather than a 10k run as referred to in the article). The athlete in question was running for 24 hours and yet the article is focussed on doing what she did in an event lasting less than an hour for most people. The association is probably misplaced because the at-risk group is ultra runners, not 10k runners. Very few 10k runners use painkillers to help 'get though' the event - unless they have an injury (for which they'd probably be using the drugs normally, anyway).
Similarly, the BBC article on the death of the runner in Brighton leaves more questions than answers. If this is the first such case of these substance interactions in sporting history it would be useful if they explained how they came to this conclusion - without any previous medical research or experience of something similar having happened. To simply report the circumstances and conclude those findings resulted in his death (without an explanation of why they think this is the case) makes frustrating reading. It would help if it was established that all other causes of high potassium content in his blood had been eliminated and thus ibuprofen and sports gels definitely did it. He is certainly not the first person to take ibuprofen and sports gels together - in fact most long distance runners and long distance cyclists will have done so at some stage or other - so why is that latched onto as the definite cause of his death, when nobody else has ever been reported to have died under similar circumstances despite the combination of substances being encountered regularly? There may be very good reasons for this conclusion in the investigation - possibly based on facts - but the reporting publication has decided to completely ignore this possibility and leave us unsure.
The way the BBC article reads, it sounds more reasonable to suggest dehydration killed the runner - because without dehydration the other factors referred to are commonplace in the sport - and we all are aware dehydration can kill you. And that's what the Runner's World article seems to be stating, which I suppose makes more sense in that context. Perhaps it would be more useful to say the combination of factors makes one more susceptible to the dangerous effects of dehydration in ultra endurance sports? Regardless, it's difficult to believe that particular combination of circumstances is uncommon in endurance sports. They say the particular combination of conditions has never been shown to have caused a death before - but surely the combination itself is not uncommon?
In my view, this sort of incomplete reporting does more harm than good - because (in the case of the BBC article) it's aimed at creating 'interesting reading' for people to whom this sort of information is of no practical value (non-athletes) but it serves absolutely no purpose to the sections of the population which could actually benefit from learning about these experiences and have a genuine interest (i.e. athletes and people who may be considering taking up such fitness activities).
Unfortunately we see so many incidences of this incomplete reporting in matters related to sports and fitness training and it perpetuates the common myths and misunderstandings upon which many athletes base their decisions because there is not a lot of logical information being floated around...
