If we are practitioners of Hatha Yoga, chances are we have experienced muscle soreness and pain.

If you haven’t, then I guess you are just awesome.

We’ve all at one time or another had that fantastic practice. You know, the one where we successfully jumped back for the first time, or that one time we got our hands to the floor in pasarita (Wide-Legged Forward Bend).

And let us not forget the time we got into kapotasana (King Pigeon Pose) and stayed there. For me, these “a-ha” practices are rare.

But when they do happen I can count on two things:

1. I’m on cloud nine the rest of the day.
2. The next day’s practice and usually the one after that completely suck.

The soreness from those practices, from accessing new areas of the body, is both welcomed and hated, but also expected.

It’s all part of the package.

Just like our body was telling us to “go farther, dig deeper, we can do it” in our good feeling practice, it will also tell us to “back off, leave us alone, don’t we dare f@%&ing put our leg there” during the not-so-good feeling practice.

Our body uses soreness and pain to talk to us and protect us—it’s a good thing!

Many other bloggers, writers and teachers have written articles about pain and yoga. My favorite being “The Puzzle of Pain” by my own teacher, David Garrigues. I’m not really here to further the yoga and pain discussion.

Let’s just say that pain exists and it’s our job to listen to our body’s pain signals. What I’m interested in is if we ignore them, or worse yet, mask the pain.

As a pharmacist, my ears perk up when I hear anything drug or health care related. I’ve been surprised how much action my ears have been getting both in the Mysore room and in other yoga classes.

As it turns out, drinking coffee before practice has taken a back seat to taking or applying anti-inflammatories before (and after) practice.

There are tons of drugs available in the US market, which can enhance athletic ability and performance.

Anabolic steroids increase muscle mass and strength in bodybuilders and cross-fitters. Human growth hormone is another favorite to increase muscle mass. Erythropoietin and albuterol are favorites among cyclists, runners and swimmers to increase endurance and lung capacity.

Then there are the beta-blockers to slow the heart rate and hide anxiety, which is a favorite among archers and marksmen.

These drugs are actually more common than we think and what is even more disturbing is the number of doctors that will prescribe them for said activities. They each come with their own side effect profile and detriment to the athletes’ short and long-term health.

I never thought I would see a “yoga performance drug,” but I think that Non-Steroidal Anti-Inflammatories (NSAIDS) can now be classified as such.

Perhaps it’s because of their non-prescription, easily accessible, non-narcotic status that deems them okay to use by yoga practitioners. Regardless of the reasoning, it’s 99% of the time not a good idea to pop some NSAIDS before a yoga practice.

While there are over twenty available NSAIDS in the US, the most commonly used are ibuprofen, naproxen and ketoprofen. People love their NSAIDS. Essentially what they do is decrease inflammation resulting in decreased pain.

Very simply put, they do this by slowing down and stopping the formation of prostaglandin, one of the main chemicals that naturally occur in the body to promote inflammation by dilating blood vessels.

For the most part inflammation, while uncomfortable as it may be, is a good thing.

It’s the body’s inherent mechanism to start the healing process. It’s been proven that an injury will heal quicker in the absence of pain medications.

When taken prophylactically before an athletic event, or yoga practice, it creates an illusionary threshold for pain.

We won’t know our true physical limits so we’ll end up with more damage than if we would have not taken it, which often results in the need to take more of the NSAID to produce the same effect.

Suppressing the body’s inflammatory response cannot only result in delayed healing, but also an increase in muscle breakdown and damage (1). The main side effect of NSAIDS is gastrointestinal distress, mainly gastric ulcers (2).

A recent small study suggests that exercising and taking ibuprofen together actually increases the body’s susceptibility to gastric distress. Their conclusion was that “nonsteroidal anti-inflammatory drugs consumption by athletes is not harmless and should be discouraged (3).”

Now don’t get me wrong, NSAIDS have their rightful place.

When used to treat an acute injury or ailment they work like magic and can be a real lifesaver. But they should be used with extreme caution, and only when completely necessary (4).

Frequent use of NSAIDS also increase the risk for heart problems such as heart attack and stroke, renal filtration issues and erectile dysfunction.

Two popular NSAIDS, Vioxx and Bextra were withdrawn from the market a few years ago because of their link to severe cardiovascular events. This prompted the FDA to require pharmacists to dispense a medication guide explaining the risk of taking NSAIDS to each patient receiving one of the drugs (5).

Out of curiosity—gasp—I tried it.

Last week, for three days of practice, without having an injury, I took 400 mg of ibuprofen an hour before practice. I limited myself to primary and intermediate series. It was frightening how good I felt.

I was able to move with extreme ease and fluidity. I found myself wanting to go deeper in hip opening postures and backbends.

On the fourth day, without ibuprofen, I was so sore during practice from my previous “with NSAID” practices that I had to cut it short.

Never again will I do that. Ever.

Unless there is an active injury or legitimate reason that we explain to our teacher, there is no reason to take NSAIDS before a yoga practice to help us “push through” the pain and uncomfortableness of those challenging asanas.

Doing so makes the yoga not so yoga.

Instead of removing obstacles to help achieve “chitta vritti nirodha,” we add another one with the use of NSAIDS. If the goal of yoga is to ultimately realize Self and not separating ourselves from that, can we ever truly reach that goal by using artificial means?

Citations:
1. J Athl Train. 1997 Oct-Dec; 32(4): 350–358. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320354/)

2. Am J Gastroenterol 2009; 104:728–738; (http://s3.gi.org/physicians/guidelines/NSAIDJournalPublicationFebruary2009.pdf)

3. Med Sci Sports Exerc. 2012 Dec;44(12):2257-62. (http://www.ncbi.nlm.nih.gov/pubmed/22776871)

4. Br J Sports Med. 2009 Oct;43(11):863-5. (http://www.ncbi.nlm.nih.gov/pubmed/19546098)

5. NSAID Medication Guide (http://www.fda.gov/downloads/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm106241.pdf)

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