Should You Take Ibuprofen Before a Workout?

If you type "ibuprofen before a" into Google, it offers workout, race, run, and lift, and then soccer game, basketball game, and football game. On Reddit the question comes from people with a meet the next day. One 400-meter runner put it plainly: "In my mind it would help the pain but I really don't know." A sprinter wanted to know whether it would help "with not feeling your legs heavy on the last meters."

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It won't. Ibuprofen taken before exercise hasn't made anyone faster or stronger in the trials that tested it, and it doesn't reliably stop soreness afterward. The sports doctors who write guidance for athletes your age say not to take it to head off pain. The harms people warn about are mostly measured in adults running marathons and ultramarathons, though, so a single Advil before one practice is a much smaller deal than the warnings online make it sound.

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Does it make you faster or less sore?

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A 2020 meta-analysis (a study that pools the results of many earlier studies) in Sports Medicine - Open gathered 23 randomized trials of NSAIDs (non-steroidal anti-inflammatory drugs, the family that includes ibuprofen, naproxen, and aspirin) taken before exercise, covering 514 people. It found no difference in maximum performance, in how long people lasted before exhaustion, or in how much pain they felt. The authors add that the trials were small and "far from those observed in real-life practices," so what they found is that nobody has shown a benefit, which is weaker than proof that there isn't one.

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The closest match to a high school or college athlete is a trial of 20 male distance runners with an average age of about 19. Researchers made their legs sore on purpose, then gave half of them 1,200 mg of ibuprofen an hour before a treadmill run and the other half a sugar pill. Both groups ran for less time than they had before the soreness, and ibuprofen made no difference. A 2024 trial found the same thing for soreness. Twelve adults took 800 mg of ibuprofen, two other anti-inflammatories, or a placebo two hours before a hard leg-press session, and ibuprofen changed nothing: "no significant differences in muscle soreness or vertical jump."

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The International Olympic Committee's 2017 consensus on pain in elite athletes lands in almost the same place. It says NSAIDs "have no effect on sprinting, vertical jumping or endurance running performance," although it also says they "can decrease soreness," which the newer trials didn't find.

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Acetaminophen (the drug in Tylenol, which isn't an NSAID) has a slightly different record. In one double-blind trial of 13 trained cyclists, it cut a 10-mile time trial from 26 minutes 45 seconds to 26 minutes 15 seconds. That's one small study, and acetaminophen has its own dose ceiling and liver warning. The IOC's recommendation covers every painkiller anyway: "Medications should not be prescribed to athletes for pain or injury prevention."

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What the guidance for teen athletes says

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In 2020, six US sports-medicine groups, including the American College of Sports Medicine and the American Medical Society for Sports Medicine, published a joint statement on pain for team doctors who look after athletes aged 10 to 18. Its line on this question is one sentence: "NSAID agents should not be prescribed to athletes for pain or injury prevention." The American Academy of Pediatrics (the main group of US children's doctors) adds the reason from the athlete's side: "pain relief can mask important warning signs and lead to further injury," and "if athletes need to take a medicine to play, they should see a doctor."

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In a survey of 681 high school football players with an average age of 15.8, 75% had used an NSAID in the past three months and 15% used one every day. The daily users were more likely to take it before they hurt, to believe that it helped them play better, and to decide on their own when to take it, without asking an adult.

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For contact sports, the AAP handout adds that NSAIDs have "a blood-thinning effect and can increase the likelihood of bleeding after a cut, deep bruise, muscle strain, or head injury."

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What happens in your gut during exercise

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Hard exercise does some damage to the lining of your small intestine on its own, and ibuprofen weakens the same lining by shutting down the chemicals it uses to repair itself. In a 2012 trial, nine trained cyclists were tested four ways: resting, cycling, resting after two 400 mg doses of ibuprofen, and cycling after them. A blood marker that leaks out of damaged intestinal cells rose with cycling alone and with ibuprofen alone, and rose furthest with both together, to about two and a half times the resting level. A sugar test for how leaky the gut wall had become followed the same pattern. The authors concluded that NSAID use by athletes "is not harmless and should be discouraged."

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Nine people is a small study, though, and it measured markers in blood and urine rather than whether anyone got cramps or diarrhea. When researchers tested 34 runners after the 1996 Chicago Marathon, the ones who'd taken ibuprofen had a leakier gut on the same kind of sugar test. The symptoms didn't follow, though: half of the NSAID users reported gut symptoms, and so did half of the runners who took nothing, since running hard upsets plenty of stomachs on its own. A 2024 review of 30 studies on NSAIDs in marathon and ultramarathon runners found that none of the problems people worry about, gut trouble included, "had clear statistically significant links with NSAID use."

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Heat, water, and your kidneys

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NIDDK (the US government's institute for digestive and kidney diseases) says that "healthy kidneys can protect themselves" when you're low on water, and that "if you're dehydrated, NSAIDs can also keep your kidneys from protecting themselves." Its warning is that NSAIDs can "lead to acute kidney injury if you take them when you are dehydrated." The CDC's guidance on heat and medications lists NSAIDs with the risk "Kidney injury with dehydration," and the AAP handout says that "athletes who are dehydrated... should not take NSAIDs."

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The one randomized trial on this in athletes took place during 50-mile desert races. Runners took 400 mg of ibuprofen every four hours or a placebo, and at the finish line 52% of the ibuprofen group met the definition of acute kidney injury (a sudden drop in how well the kidneys filter, measured in the blood), against 34% on placebo. That difference wasn't statistically significant, so chance can't be ruled out, and a 50-mile race in the desert is a long way from a 90-minute practice. Even so, the Western States 100-mile race doesn't stock ibuprofen at its aid stations, and the London Marathon tells runners to "avoid anti-inflammatory tablets like ibuprofen, diclofenac or naproxen in the 48 hours before, during, and after the marathon."

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At shorter distances, a 2020 study tested the urine of 80 recreational runners at a 10K and a half marathon in the Netherlands. A urine marker of kidney stress rose after the half marathon, and it rose more in runners whose urine showed ibuprofen or naproxen than in runners who had taken nothing. The runners were mostly middle-aged, and the marker is an early warning sign rather than a diagnosis of injury.

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Does it kill your gains?

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The claim traces back to a 2018 trial in 31 adults aged 18 to 35. Over eight weeks of leg training, the group taking 1,200 mg of ibuprofen every day (the most the box allows) grew their thigh muscles by 3.7%, against 7.5% in a group taking a low-dose aspirin. That's daily use at the maximum for two months, which is a different thing from one pill before a lift, and the comparison group got aspirin rather than a placebo. An earlier trial in adults in their mid-60s found the opposite, with ibuprofen users gaining more muscle than people on a placebo. The 2020 consensus for teen athletes doesn't settle it either. Its one line on the subject is about recovering from injuries rather than building muscle: "no current data show that NSAIDs inhibit muscle, bone, tendon, and ligament healing in injured athletes."

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If you already hurt before practice

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The sports-medicine guidance is about taking ibuprofen to prevent pain you don't have yet. Google also suggests "ibuprofen before workout for headache," and treating a headache you already have is a different situation. Take the dose on the label and drink water with it. Skip it if you're already dehydrated or have been throwing up, which is when NIDDK and the AAP say NSAIDs are a problem for your kidneys, and think twice before a long session in the heat, which is the situation the CDC flags. For a long race or a tournament day, the London Marathon's rule of no anti-inflammatory tablets before, during, or after is the one to borrow.

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If you're taking something before every game so that you can play through the same pain, that's the case where the AAP says to see a doctor.

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