Ask The Jock Doc

There’s a big reason not to use non-steroidal anti-inflammatory medication (NSAIDS) such as ibuprofen before vigorous exercise.   Chronic use of NSAIDS has been associated with gastrointestinal complications such as ulceration, bleeding and perforation.  In less severe cases, it can cause stomach pain, heartburn, indigestion, and nausea. There is the potential for even more damage when NSAIDS are taken BEFORE a strenuous workout.  Why?   During exercise, blood flow to the gut decreases so that blood can be redistributed to the working muscles.  This causes a temporary loss of gut function and small intestinal injury.  Studies have shown that when NSAIDS are taken before exercise, it aggravates these gastrointestinal effects, even in healthy individuals.  Even more concerning is that it can impair kidney function during prolonged exercise, increasing fluid retention and the risk for hyponatremia, which can be life-threatening.

In general, it's safe to take ibuprofen after exercise as needed. Just make sure it's not taken on an empty stomach and use the lowest dose needed.

If you experience significant joint or muscle pain during or after exercise, it’s time to examine your workout or visit a sports medicine specialist. You may benefit from a biomechanical evaluation to correct deficits of strength or flexibility that cause faulty movement patterns, placing stress on your joints.

Follow the three rules of pain: If it hurts: do less of it, do it differently, or do something else! For example, if your knees bother you after running 60 minutes, but not after 40, stick with a shorter jog. Cross-training is a way to develop/maintain cardiovascular conditioning while decreasing repetitive stress on specific muscles and joints. Check your shoes: it may be time for a new pair. If your knees bother you during squats, try not going down as far, using lighter weights, or using a sled and not the floor. If you just can’t find a Plan B that works, see a sports medicine specialist who can help you figure out a safe and effective treatment plan.

Hamstring injuries occur frequently in runners with tight hamstrings or muscle imbalance. The initial treatment should include a defined period of rest, mild stretching, strengthening and local modalities such as ice. When the area is no longer painful to the touch, soft tissue massage can help break up excessive scar tissue. Despite early treatment, some hamstring injuries develop into more chronic injuries that not only last beyond 3 weeks, but become more difficult to treat.

Most athletes understand that a period of rest is required, but many return to activity too early and develop chronic injuries. “You’ve been working with a physical therapist and stretching, but one component that many athletes forget is strengthening” says Dustyn Severns, PA, ATC with UC San Diego Sports Medicine. “Many hamstring injuries occur because the hamstring muscles are not nearly as strong as the large quadriceps muscle group.”

Dustyn suggests using the following guidelines to determine when you can return to activities such as jogging/running:

1. When you have no pain with stretching, strengthening or general conditioning activities.
2. Hamstring flexibility should be equal between the injured and uninjured side.
3. Hamstring strength should be equal between the injured and injured side.
4. Hamstring strength in general should be at least 50-70% of quadriceps strength.

Start with light weights and gradually increase resistance using both concentric and eccentric contractions. When you can perform therapeutic hamstring exercises without pain, begin high intensity eccentric hamstring exercises to promote tissue remodeling and prevent re-injury. Some exercises might include the Romanian deadlift, single-leg Romanian deadlift and the hamstring drop. An athletic trainer can help you put together an effective re-conditioning program.

Ice after exercise and do a proper warm up prior to stretching or strengthening.

Be patient! Make sure that you are meeting the strength and flexibility goals as you go. As athletes, we all want to get back to our sport as soon as possible. But with hamstring injuries, getting back out there too soon can turn a month of recovery into 6 months or more! To avoid re-injury, continue your strengthening and stretching program even after you return to activity.  

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First, if you're under age 21, it’s illegal in the state of California to drink or purchase alcoholic beverages.  But read on for additional reasons specifically related to athletes and recovery:

A 12 oz beer has only 14 grams of carbohydrate. Compare this with 40 grams of carbohydrate in a can of soda, 34 grams in 8 oz lemonade, or 38 grams in a cup of grape juice. You’ll see that beer isn’t such a good recovery beverage. Alcohol's effect on total glucose levels is complex. Although it contains carbohydrates, alcohol actually interferes with glucose metabolism and will ultimately impair your body’s ability to replenish muscle glycogen stores. Drinking a lot of beer can cause you NOT to eat enough carbohydrate and protein, further reducing the amount of protein and carbohydrates available to aid in muscle recovery. This is because carbonation and fluid volume make you feel full.

In addition, alcohol is a diuretic, causing your body to lose fluid at a time when it’s critical to rehydrate!

If you drink beer on an empty stomach after a practice or competition, it will likely “go to your head” faster because it will be absorbed quickly from the stomach into your bloodstream. Alcohol affects your judgment, motor skills, coordination and reaction time. This can cause you to make poor choices and increases your risk of injury off the field. You’d hate to have to sit out the season because you sprained your ankle or broke an arm falling down the stairs at a party.

Alcohol can also interfere with normal sleep quality, disrupting REM sleep and affecting your ability to think or train properly the next day.

So what should you drink or eat after a game? Drink at least 20 oz of fluid for every pound of weight lost during the competition. Remember the three Rs: Refuel, Rehydrate and Rest. Your body stores glycogen best in the first two hours after exercise. So choose non-alcoholic beverages and high carb foods that you enjoy, with some protein for muscle repair. Chocolate milk is a great recovery beverage with carbs, protein and fluid all in one package!

If you’re partying with your high school teammates, be a leader and choose soda pop, cranberry juice and seltzer, or ice-cold water as you enjoy pretzels and pizza (good carb choices).

You're right! Effective December 2012, the FDA is requiring that ALL sunscreens be "broad spectrum. That means they protect your skin from both UVA and UVB rays. UVB rays can cause sunburn, while exposure to UVA rays increases your risk for skin cancer and early skin aging. Sunscreens may no longer advertise a sunscreen protection factor greater than 50+ SPF because there's inadequate research showing that higher levels provide superior sun protection. A sunscreen with an SPF of 15 or less can help prevent sunburn, but is not guaranteed to prevent early skin aging or skin cancer, so cannot be classified as broad spectrum.

Sunscreens can no longer use the terms "waterproof" or "sweatproof". Instead, they may be labeled as "water resistant" for 40 or 80 minutes depending on the results of laboratory tests.

Since sunscreens can wear off, it's important to re-apply at least every 3 hours. If you're an athlete, this might mean re-apply at halftime or in between matches. If you're surfing or swimming, have sunscreen on hand when you get out of the water. Use a cream, lotion or gel with an SPF of at least 30 to receive adequate protection.

You may have heard concerns that using sunscreen will compromise your vitamin D status, but studies haven't found this to be true.

One out of 5 Americans will develop skin cancer in their lifetime. Your risk increases with a higher history of sun exposure. If you want beautiful, wrinkle-free skin, along with a healthy body, early sun protection is critical.