The idea of popping a few painkillers before an Ironman is becoming commonplace. One study showed that as many as 60% of triathletes were taking medication such as Ibuprofen before or during races, and Ironman recently announced Aleve – “the pain relief brand trusted by millions” – as a new sponsor for its 2019 world championship in Hawaii on 12 October.
The partnership would imply there’s little risk to using artificial assistance to help see you through what is, after all, billed as the hardest one-day event on the planet. If it reduces discomfort and is promoted by the biggest brand in the sport, what could possibly be amiss?
Plenty, according to the backlash from both medical professionals, and professional and amateur athletes, who believe the drugs’ side effects – to fatal levels in extremis – are not being disclosed to an unwitting endurance sport community.
“There is a high risk of adverse effects to multiple organ systems including gastro-intestinal, kidney and cardiovascular,” says Craig Rosenbloom, a sports and exercise medicine doctor, who has conducted a review into the research on non-steroidal anti-inflammatory drugs (NSAIDs) in relation to endurance events. “Fatal effects include hyponatraemia (low salt levels in the blood), kidney failure, stroke, and heart attack.”
Britain’s multiple Ironman champion Lucy Gossage underlined that sentiment on Twitter: “I think it’s ludicrous to have a non-steroidal anti-inflammatory drug sponsoring Ironman. The message this is sending out is wrong on so many levels.”
Aleve is the brand name for naproxen, an NSAID sold over-the-counter in the USA, but mainly available on prescription in the UK. Rosenbloom cautions that its purported benefits of pain prevention and injury treatment are not backed up by evidence, and stresses that Aleve’s half-life can be up to 17 hours – compared to 2hrs for Ibuprofen – thereby extending its health risk potential.
Ironically, this “last all day” message is billed as a benefit by Lisa Tecklenburg of Bayer, the global drug company that produces Aleve. “When people hear ‘Ironman,’ they know that it stands for overcoming obstacles to reach the pinnacle of performance,” Tecklenburg says. “Aches and pains can be obstacles as well.”
And herein lies the nub of the issue. Aches and pains resulting from a 3.8km swim, 180km bike and 42.2km run, are a normal reaction from a stressed body due to exercise.
They are our cue for when to push on and when to ease back and allow for adaptation. Viewing them as obstacles to be removed by numbing the discomfort shows no sense of listening to our bodies’ warning signs, so it’s little wonder trying this shortcut has health consequences. Some ultra events already ban NSAIDs due to the health risks, and although largely unenforceable, it at least sends out the right message.