The Effect of Nonsteroidal Anti-Inflammatory Drugs on Recovery from Exercise-Induced Muscle Injury 2. Ibuprofen

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Abstract
Objectives: The objective was to assess the effects of two doses of the nonsteroidal anti-inflammatory drug, ibuprofen, 1600 mg and 3200 mg per day administered for six days, compared to placebo on muscle soreness, strength, swelling, and stiffness following experimentally-induced muscle injury in volunteer subjects. Methods: A one-time exercise consisting of repeated lowering of heavy loads with the elbow flexors was used to induce injury, which was manifested by soreness, swelling, stiffness, a reduction in relaxed arm angle, and a 50% loss in muscle strength from which recovery was only 50% complete in two weeks. After carrying out the exercise, subjects were randomly assigned to one of four groups, each with 20 subjects: 1. no treatment, 2. ibuprofen, 400 mg q.i.d., 3. ibuprofen, 800 mg q.i.d., or 4. placebo, q.i.d. The study was double-blind with respect to groups two, three, and four. Drug or placebo administration was begun on the day preceding the exercise. Measurements were made for two post-exercise weeks and compared to pre-exercise values. Results: In the repeated-measures analysis of variance, neither group differences nor group-by-time interactions were observed with respect to any of the variables measured. Power analysis demonstrated that differences ranging from 3% to 20% could have been detected by the methods used. Separate analysis of data from males and females also demonstrated no differences between them. The time course of stiffness, measured between elbow angles of 90° and 140°, differed from that of the relaxed arm angle, suggesting that these two parameters involve different underlying processes. Conclusions: Ibuprofen provides no detectable therapeutic benefit over a two week period following injury induced in the elbow flexors by eccentric contraction, as judged by subjective reports of muscle soreness and by objective measurements of maximum voluntary contractile strength, of muscle swelling, of muscle stiffness, or of relaxed arm angle.