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Should I Take a Pain Reliever Before or During a Marathon?


Updated June 10, 2014

Portland Marathon Finish Line Full Size

Portland Marathon Finish Line

Wendy Bumgardner ©

Question: Should I Take a Pain Reliever Before or During a Marathon?

Marathon runners and walkers often want to take pain relievers before or during a marathon. Which are the safest to take?

Answer: The expert physician panel at the 2005 Marathon Directors College advised to avoid pain relievers before and during a marathon.

Marathon Problems with NSAIDS

The most common over-the-counter non-steroidal anti-inflammatories are ibuprofen (Advil) and naproxyn sodium (Aleve). They have two effects: pain relief and prevention of inflammation. They can cause nausea and they decrease kidney perfusion. If you plan to use these drugs before or during the marathon, you should be using them on your longest training runs or walks to see if can tolerate them and whether they have ill effects on you.
The Facts on NSAIDS

Marathon Problems with Acetaminophen (Tylenol)

Acetaminophen has two effects: pain relief and fever reduction. It can be toxic to the liver when you are overheated and at oxidative stress, as when running or walking a marathon. Some people get nausea from acetaminophen.
Problems with Acetaminophen

Marathon Problems with Aspirin

Aspirin has two effects: pain relief and fever reduction. It also inhibits the ability of the blood to clot effectively in most people. This can result in in bleeding more if you have an injury, and experts suspect you have more micro-bleeding and burst capillaries from the 26.2 miles of pounding your feet and legs take during a marathon. Many people experience nausea and even gastric bleeding from aspirin.
About Aspirin


While presented with humor, the panel noted that beer provided hydration, carbohydrates, salts, and pain relief when taken during the marathon. In fact, it was prescribed by one physician as a quick remedy for muscle cramps. Personally, I can attest to the amazing restorative qualities of Belgian beer in the final mile of the Blankenberge Two-Days Walk. Portland Marathon Race Director Les Smith experimented with beer as his sole hydration during a marathon and the results were "When I finished, I was looped." It was noted that beer decreases athletic performance, "It was a slow marathon."

Bottom Line: Try Nothing New on Race Day

It is best to avoid pain relievers before or during the marathon. Use your long training days to experiment with how you feel running or walking without any pain relief, and what effects you have if you resort to using pain relievers. As always, Try Nothing New on Race Day.

SOURCE: Marathon Directors' College. Meeting hall, Portland, OR. 06 OCT 2005.


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