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A New Study Explores The Risks Of Ibuprofen For Endurance Runners

Taking painkillers while running long distances doubles your risk of acute kidney injury, according to new research. Runners are no strangers to pain, but we also may be too comfortable medicating with nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve some of that pain. Researchers at the Stanford University School of Medicine discovered that endurance runners who take the painkiller ibuprofen while running double their risk of acute kidney injury.

Related: 8 Items To Help You Recover After A Killer Workout

The Study

In a new study published on July 5 in Emergency Medical Journal, Stanford researchers explained that 75 percent of ultramarathoners use ibuprofen while training and racing without realizing the stress that practice causes their kidneys. The study’s lead author was Grant Lipman, MD, a clinical associate professor of emergency medicine at Stanford and director of Stanford Wilderness Medicine who has served as the medical director at numerous ultramarathons around the world. As the study explains,

“‘Running these races tends to hurt,’ said Lipman, who has served as the medical director of RacingThePlanet ultramarathon events, which are held in various parts of the world, including China, Antarctica and Chile. ‘I’ve seen firsthand how common it is for runners to take ibuprofen both before, during and after these races to relieve pain and reduce joint swelling.'”

The Results

The double blind study asked 89 runners to take ibuprofen (real or placebo) during one 50-mile leg of a 155-mile ultramarathon. Of those 89 participants, 39 had acute kidney injury after the first 50-mile section of the race, having taken one 400mg ibuprofen pill every four hours. There was an 18 percent higher rate of kidney injury among those that took the drug compared to those that didn’t. “Basically, for every five runners who took ibuprofen, there was one additional case of acute kidney injury,” Lipman was quoted as saying for the study, adding that the ibuprofen made “an impressive difference.”

The Risk For Runners

Runners that take ibuprofen before, during or after a long run are at an increased risk for kidney injury because ibuprofen decreases blood flow. Endurance runners are often dehydrated while running–especially a few hours into an ultramarathon, which is when NSAID use tends to begin. “Studies show that for most people, this acute kidney injury is usually resolved within a day or two after the race,” Lipman said in the study. “However, numbers of runners have ended up being hospitalized from renal failure.” To this point, the study mentions a 40-year-old Boulder Colorado Ironman triathlete who died from kidney failure three days after finishing his race.

An endurance runner who often used ibuprofen to regulate his own pain, Lipman was surprised by the extent of the drug’s negative impact.

The Solution

If you are an ultrarunner or endurance athlete of any kind, consider taking acetaminophen (like Tylenol) instead of ibuprofen for pain relief, and add an ice bath for good measure. Lipman himself has added both of these recommendations to his recovery routine–though he still advises moderation for acetaminophen.


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Allie Burdick

Allie Burdick

Allie is a freelance writer, athlete and mom, but not in that order. Her work has appeared in Runner's World, Triathlon Magazine and ESPNW. On her blog, VITA Train for Life, she chronicles her life as a runner/triathlete and hopes her successes and failures help to motivate and inspire others, even the over-40 crowd she somehow found herself in! The rest of her time is spent raising her twin boys with her husband in the Northeast where they live a big life! See it all on Twitter and Instagram.