DO YOU THINK IBUPROFEN WILL HELP YOU WITH ULTRA? IT'S THE OPPOSITE

Oh, you won't like this post 😅

I know most of you are on painkillers. Ibuprofen in your pocket, ketonal in your drop bag, "just in case." Don't pretend you're not.

But you need to know what you are really doing to your body.

The International Society of Sports Nutrition (ISSN) and the UTMB organizers are blunt: nonsteroidal anti-inflammatory drugs (NSAIDs) during ultras are a game of Russian roulette. UTMB has gone a step further and introduced a complete ban, 24 hours before the start and during the race. Will they be detected in tests? Disqualification. End of discussion.

Why so harsh?

❌YOUR KIDNEYS ARE ALREADY AT THE LIMIT.

During an ultra, your kidneys are already working at peak efficiency. Dehydration, reduced blood flow, metabolic stress. And you add ibuprofen, which further strains them.

The result? Acute kidney injury. Not theoretical. Real. UTMB Medical Director Dr. Patrick Basset puts it bluntly: under conditions of prolonged exertion, NSAIDs can be toxic to the kidneys and lead to rhabdomyolysis, or muscle breakdown. Combined with dehydration and hypoxia at altitude, this poses a direct threat to life.

❌HYPONATREMIA? NSAIDs MAKE IT WORSE.

I've already written about hyponatremia, or dangerously low blood sodium levels. NSAIDs can contribute to its development by affecting the kidneys and causing fluid retention. So, if you drink water, your sodium levels drop, and medications worsen the situation.

❌YOUR INTESTINES ARE ALREADY BLEEDING. NSAIDs ARE ADDING FUEL TO THE FIRE.

Gastrointestinal bleeding is a common problem among long-distance runners. NSAIDs increase this risk by damaging the lining of the stomach and intestines. In ultramarathons, where the intestines are already at their limits, this can lead to serious complications.

☝️🤓BUT THEY DO HELP WITH PAIN?

This is where the trap is.

Pain is a warning signal. Your body says, "Hey, something's wrong. Slow down. Be careful." When you mask that signal with ibuprofen, you keep running despite the injury. You're making the injury worse. What could have been a week off turns into months of rehabilitation.

UTMB calls it "legal doping." Not because it improves performance. But because it allows you to run despite signals telling you to stop.

☝️🤓WHY DOESN'T WADA PROHIBIT IT, BUT UTMB DOES?

WADA focuses on substances that artificially enhance performance. NSAIDs don't do that. They won't make you faster. They'll make you run despite the pain that should stop you.

UTMB takes a different approach. It focuses on safety in extreme mountain conditions. Long duration, altitude, dehydration, cold, and heat all dramatically increase NSAID toxicity.

☝️🤓WHAT DOES THIS MEAN?

I'm not here to scare you. I'm here to give you the information you need to make an informed decision.

Ibuprofen before takeoff "just in case"? A risk that's not worth it.

Ketonal at kilometer 60 because "I won't make it otherwise"? Consider whether reaching the finish line is worth the potential kidney failure.

Pain that requires pain medication is pain that's telling you something important. Maybe you should listen instead of silencing it.

😡PATO-INFLUENCER

You'll often hear famous people on podcasts and Facebook describing how they "run" and that it's to make their dreams come true, or that they run with an injury and otherwise wouldn't have completed that dream 500 km race.

Listen, I'll be honest: this is not OK. 😤

First of all, let them do drugs if they have to. It's their health, it's their business. I sympathize with their choices. But the worst part is that you take inspiration from it.

When someone with a good reach says "I took four ibuprofens and made it to the finish line" and suddenly it sounds like a strategy and not like the confession of a man who risked his kidneys for a medal.

Secondly, don't run with injuries. Why? Consider whether you have a healthy relationship with sport. Is this one run worth months of rehabilitation?

Who is worth listening to? Ego?

Are you a bit carried away? Bravo! Is it worth putting bodily destruction on a pedestal?

✅HOW TO AVOID IBUPROFEN? BUILD A SYSTEM THAT DOESN'T NEED IT.

Now that you know that ibuprofen on ultra is Russian roulette with your kidneys, the question arises: what can you do instead? How can you run 100 km without ending up with your hand in the medicine cabinet?

The answer is simple. And that's precisely why most people don't use it.

✅PILLAR ONE: FEED YOUR MUSCLES BEFORE THEY SCREAM

Ultra pain often doesn't come out of nowhere. It stems from months of neglect.

If you don't provide your body with enough protein, your muscles can't keep up with repairing micro-tears. You train, you break down fibers, and they have no way to rebuild. And so it goes, week after week. And then you wonder why everything hurts by the 60th kilometer.

How much protein? 1.6 to 2.5 grams per kilogram of body weight per day. Not "about that much." Not "I try to eat a lot of chicken." A specific number that you consciously achieve.

Plus energy. Sufficient calories. Because if you chronically eat too little relative to how much you train, you develop RED-S syndrome, or relative energy deficiency in sport.

And RED-S isn't just fatigue. It's weakened bones. It's stress fractures. It's injuries that "came out of nowhere," but you've actually been building up to them for months.

✅PILLAR TWO: PREPARE YOUR TISSUES BEFORE YOU DESTROY THEM

Muscles adapt quickly. Tendons and ligaments take months.

If you increase your training volume too quickly, your muscles keep up, but your connective tissues lag behind. And suddenly you have Achilles tendinitis. Or runner's knee. Or something else that requires ibuprofen just to leave the house.

The solution? Gradually increase the load. Boring, I know. But effective.

And strength training. Yes, I know you prefer running. We all prefer running. But stable joints are joints that don't ache at the 80th kilometer. Strong glutes are knees that hold the axis. A strong core is a back that doesn't scream after 15 hours on your feet.

Lauersen studied 26,000 athletes. Strength training reduces injuries by 70%. Seventy percent. And you still don't do squats because "you don't have time."

✅PILLAR THREE: HAVE A PLAN AT THE START, NOT A FIRST AID KIT

Hydration. Sodium. Two things that determine whether your muscles will work or cramp in agony.

Painful cramps during an ultramarathon are often not an injury. They could be electrolyte imbalances. I say "may" because science isn't 100% sure where the cramps come from. Too little sodium, too much water, or vice versa. And instead of reaching for a painkiller, all I had to do was drink some isotonic drink with salt.

But something else is most important. Accepting that pain is information.

If pain forces you to change your running technique, it's not the time to resort to ibuprofen. It's the time to slow down. Or to stop exerting yourself. Because masking the pain with medication allows you to run longer, but it also allows you to worsen the injury, which will take months to heal.

One run is not worth the permanent damage to your health. No run is worth the permanent damage to your health.

✅SUMMARY

Don't want to reach for ibuprofen? Build a system that doesn't need it.

Fuel your muscles with protein and energy. Give your tissues time to adapt. Strengthen your joints. Replenish your electrolytes along the way. And learn to listen to pain instead of suppressing it.

It's not sexy. It doesn't sound like a master secret. But it works.

And leave the ibuprofen at home. Where it belongs.