Why You Should Never Use Ibuprofen Again (And 8 Natural Alternatives For Joint Pain & Muscle Repair).

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Articles, Recovery

It’s now common knowledge, especially with these most recent studies on the effects of painkillers on kidney toxicity and muscle damage, that ibuprofen, Advil and any other NSAIDs absolutely wreak havoc on your liver, gut and kidneys – especially (and quite ironically considering when most exercise enthusiasts time the consumption of these anti-inflammatories) if you consume these before, during or after exercise.

Want me to prove it?

Although studies published since 2005 have investigated the safety of NSAIDs before exercise, a 2012 study entitled “Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes” turned out to be particularly upsetting, and was my first exposure to the idea that popping an ibuprofen when my knee was hurting probably wasn’t doing me any favors in the health department. In this study, nine healthy and trained men were studied on 4 different occasions: 1) taking a standard dose of 400 mg ibuprofen twice prior to a bike workout. 2) cycling without the ibuprofen; 3) taking 400 mg ibuprofen twice at rest and finally 4) resting without ibuprofen intake.

In each case, researchers measured small intestinal damage through monitoring plasma intestinal fatty acid binding protein (I-FABP). They also measured urinary excretion of special sugar probes, which can determine the amount of gastrointestinal permeability – a sign that the gut is becoming “leaky” due to damage to the gut wall and increased permeability of the gut lining.

So what did the researchers find?

While both ibuprofen consumption and working out both resulted in increased I-FABP levels (reflecting small intestinal injury), levels were higher after cycling with ibuprofen than after cycling without ibuprofen. In addition, gut permeability (“leakiness”) also increased, especially after cycling with ibuprofen – which reflected a loss of gut barrier integrity. The amount of intestinal injury from ibuprofen and gut barrier dysfunction were extremely well correlated. Based on this study, it can be concluded that exercise slightly aggravates your small intestine, and ibuprofen then turns this into a significantly more serious and risky issue.

In fact, I can’t sum it up any better than the researchers, who concluded that “NSAID consumption by athletes is not harmless and should be discouraged”.

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So what about the popular practice of taking NSAIDs before rather than during a long event like an Ironman or a marathon to “mask the pain”?

It turns out this has also been researched.

One study found that taking 400 mg ibuprofen four hours before exercise reduced the soreness, but didn’t actually prevent muscle cell injury – which is concerning since this means that the ibuprofen may mask pain, but at the same time, can lead to increased risk of injury as you push through muscle damage. In this study, researchers measured creatine kinase (CK), which is a protein that muscle cells release when they are injured.

Other studies have found that NSAID use during long events, such as a marathon or triathlon, actually decreases kidney function, which can lead to very dangerous issues during exercise, including a decreased ability to properly regulate your sodium and electrolyte status and your hydration levels. This becomes especially dangerous in the heat, in which there already a great amount of stress on the kidneys and this extra stress may create a high risk of long-term kidney damage or kidney failure. One of the most eye-opening studies on ibuprofen use during exercise occurred in research performed during the Western States trail running race, which is a popular and grueling 100-mile race.

In this study, runners were split into three groups: a group with no ibuprofen intake, a group taking 600 mg of ibuprofen one day before and on race day, and a group taking 1200 mg of ibuprofen one day before and on race day (having a group that was actually taking more ibuprofen allows researchers to see if there is a “dose response”, meaning whether a more pronounced effect is seen if more ibuprofen is given). This study found that both of the ibuprofen groups had significantly higher levels of markers for severe muscle damage, including C-reactive protein, plasma cytokine, and macrophage inflammatory protein, and this effect increased with higher amounts of ibuprofen intake.

Ironically, race time, post-workout soreness and rating of perceived exertion were not affected by taking ibuprofen – which means that…

A) ibuprofen did not help at all and;

B) ibuprofen caused significantly greater inflammation and muscle damage compared to not using it at all.

And now, as of last year, there are two more scary studies on NSAIDs.

In one of the new studies, researchers asked 89 participants in several multiday ultramarathons around the world to consume either ibuprofen or a placebo every four hours during a 50-mile stage of their race.

Afterward, they drew blood from the athletes and checked their levels of creatinine (a byproduct of the kidneys’ blood filtering process and a sign of acute kidney stress). They found that a large percentage of all the participants, about 44%, had creatinine levels high enough to indicate acute kidney injury after running 50 miles.

But the organ stress was particularly high among the runners who had taken ibuprofen – who were about 18% more likely to have an acute kidney injury compared to the racers who took a placebo. In addition, their injuries (based on creatinine levels) tended to be more severe. The researchers theorized that, by inhibiting prostaglandins, the NSAIDs prevent blood vessels from widening. Crimping blood flow to the kidneys might make it harder for those organs to filter the blood.

The second study backed this up and found that by reducing the production of prostaglandins, NSAIDs change how a body responds to muscular exertion. Researchers looked at muscle cells and tissue from mice that had experienced muscular injuries and compared the injuries to those that often develop during strenuous exercise. The tissue in the injured areas filled with a particular type of prostaglandin that plays an important role: stimulating stem cells within the muscles to begin multiplying to create new muscle cells that repair tissue damage. Afterward, tests in the mice showed that the healed muscle tissue was stronger than it had been before.

This process mimics exactly what should happen when you exercise strenuously – straining and then rebuilding muscle. But when the researchers used NSAIDs to block the production of prostaglandins, they found that fewer stem cells became active, fewer new cells were produced, and the muscle tissue (even after healing) was not as strong and supple. These findings imply that anti-inflammatory painkillers might impair your muscles’ ability to regenerate and strengthen after hard workouts.

Finally, the latest two studies that you can easily go read on your own speak for themselves – ibuprofen keeps you from gaining muscle and also increases your risk of a heart attack:

Use of anti-inflammatory drugs like ibuprofen inhibit muscle growth by 2-fold in young, healthy individuals.

Taking common non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for only a week may increase heart attack risk by as much as 50%.

So as you can see, the use of NSAIDs isn’t really a case of “jury’s out”.

Just don’t use these things. Period. With so many other natural methods out there to control pain or quell chronic inflammation, this seems to be a no-brainer. So in this article, I’ll fill you in on the potent alternatives I use to avoid dumping NSAIDs into my body, and how to enhance muscle repair and recovery with natural ibuprofen alternatives.

NSAID Alternative #1: Anything Collagen Related

Every time my wife makes bone broth from a whole chicken, which she does about once a week (her recipes are all inside her Healthy Home Workshop package, by the way), I have her leave the bones in a whole extra day, then I take the bones, put them in a cast iron skillet, dose them in extra virgin olive oil and a dollop of gelatin skimmed from the top of the bone broth, sea salt, black pepper, turmeric and Vitamin C from the squeeze of an entire fresh lemon. I then eat my way through the entire pile of bones, usually dipping them in a good stone mustard, chewing the knuckles off, sucking the marrow out and foraging the entire giant steaming hot pile of savory goodness like some kind of an ancient Viking.

Why? Simple: with this tactic, I get an enormous dose of collagen, of glycine and of gelatin. 

Studies have verified in both human and rodent models for pain, repair and absorption that a dose of collagen, at as little as 1-2g a day can produce a significant improvement in joint comfort and that subjects with the greatest joint deterioration, and with least intake of meat protein in their habitual diets, benefited the most (read that sentence again my plant-based diet friends!) On a related note, a systematic review concluded that hydrolyzed collagen has a host of positive therapeutic effects on osteoporosis and osteoarthritis, is protective of cartilage, and decreases pain.

Then there’s glycine.  Glycine is a major component of collagen and is linked to collagen synthesis and growth. Us mere humans can only synthesize 3g of glycine a day, but yet up to 12g is required to be able to satisfy all the body’s needs for collagen synthesis. Listen to this podcast by my friend Chris Masterjohn to learn why humans have this seemingly disabling deficit.

Finally, when it comes to the combination of the gelatin from the bone broth and Vitamin C from the lemon, one recent study showed a 100% increase in exercise-induced collagen synthesis with this combo. Another paper showed that Vitamin C is an essential part of skin health too, acting as both as a small molecular weight antioxidant and as a critical factor for collagen synthesis.

If you decide to forego the giant steaming pile of bones and instead simply add collagen to your smoothie (which I also do), I would challenge you to heed the advice of my friend Mark Sisson, who, a couple months ago, put me up to the task of adding about 20g of collagen twice per day to my diet, which I achieved by dumping powdered collagen into smoothies, coffees or teas. With this tactic, I noted a profound improvement in skin quality and the way my joints felt post workout. When it comes to collagen, I’d recommend Mark’s own Primal version, or the range of tasty collagen options, including “Keto Collagen” from Ancient Nutrition. By the way, for Mark’s Primal Collagen, code: BEN will save you some money. For an added boost, as my “liquid base” for most of my smoothies, I use Kettle & Fire Chicken or Beef Bone Broth. As a result, I’m getting tons of glycine, gelatin and collagen each week without necessarily needing to eat boatloads of animal protein, which may have a longevity reducing effect.

NSAID Alternative #2: Omega-3 Fatty Acids, Preferably From Fish Oil

Omega-3 fatty acids have been clearly demonstrated in multiple studies to act as an anti- inflammatory, especially when more than 1 gram is consumed. Interestingly,  fish oil has also been shown to have a mild performance boosting effects at about that same dosage of 1g, and the same study that found that also noted that “Eight-week EPA + DHA supplementation attenuates strength loss and limited ROM after exercise. The supplementation also attenuates muscle soreness and elevates cytokine level, but the effect is limited.”

Omega-3 can also increase muscle protein synthesis in a wide range of populations, and when it comes to analgesic pain-killing potential, one meta- analysis reported that omega-3 supplementation for at least 3 months can significantly alleviate inflammatory joint pain from issues such as inflammatory bowel disease, dysmenorrhea, and arthritis. Omega-3 fatty acids are also clinically proven to regulate inflammation, enhance cognition and mood, and support healthy circulatory and brain function.

However, I’ve always said that “‘taking a bad fish oil is worse than taking no fish oil at all,” and so I’m constantly on the hunt for a joint-protecting, brain-enhancing, vision-assisting fish oil that isn’t rancid, that is sustainably sourced, and that contains enough antioxidants to keep the oil stable, such as astaxanthin and antioxidant vitamins.

The fish oil I use is called “SuperEssentials Fish Oil”. I pop 12-15 of these dark, red capsules each morning, which gives me what many would consider to be a high dose of fish oil, although it’s nowhere near legendary strength coach Charles Poliquin’s mega-dose recommended intake of 30-40 grams for active athletes. This supplement contains high-quality fish oil derived from small cold-water fish, with a 1:1 balance of omega-3 fatty acids EPA and DHA (you aren’t going to find this in nearly any other fish oil that exists – especially with the addition of astaxanthin to keep it incredibly stable). In addition to fish oil, this supplement also contains another beneficial fatty acid, omega-6 gamma-linoleic acid (GLA), derived from borage seed oil, as well as a blend of antioxidants and vitamins such as Vitamin D and Vitamin A, and the antioxidant astaxanthin (which is basically the equivalent edible sunscreen that is now being researched for it’s potential anti-aging effect).

Astaxanthin, a carotenoid derived from algae, has been shown in lab studies to have potent antioxidant effects, reverse some effects of aging, improve metabolic function, and even enhance the appearance of skin and reduce the appearance of wrinkles. Numerous studies have shown the immuneskeletal, and hormonal benefits of Vitamin D and Vitamin A. Ultimately, SuperEssentials is one of the only “guilt-free fish” oils on the face of the planet and of course, it gives you zero of the dreaded fish burps. This strategy of higher dose fish oil consumption works extremely well for combatting muscle soreness and healing injuries or joint damage more quickly, especially when combined with the other methods in this article.

NSAID Alternative #3: Slather Yourself In Magnesium Lotion

In the article “Why I Slather My Body With Magnesium Oil After Every Hard Workout“, I delve into the science behind transdermal magnesium therapy, and the notoriously poor absorbability of magnesium powders and capsules compared to a topical application (here’s the latest study that shows the superiority of topical vs. oral magnesium). 

Problem is, magnesium oil makes the sheets “sticky” when you sleep, and it stings quite a bit if it touches any open wounds or cuts – and I’m certainly often covered with both due to obstacle course racing, hiking and hunting. 

Enter magnesium lotion.

The stuff I use is made by “Ancient Minerals”. It is formulated for even the most sensitive of skin and designed to deliver magnesium through the dermis, directly to the cells, where it can relax muscles and combat calcium build-up from muscle micro-tearing. Contaminants in sea waters make finding a pure magnesium source tough, so the source used in this lotion is from something called “Zechstein Minerals”, which sounds like some kind of Nazi military food but is apparently a very pure source of magnesium.

In addition to 185mg of elemental magnesium in each teaspoon, it also contains organic plant moisturizers like coconut oil and shea butter, which soothe and hydrate without leaving your skin feeling waxy or greasy. It is fragrance-free and does not contain any formaldehyde releasing preservatives.

After a tough training session or race, I simply put about a quarter size dab into my hand and put that amount on one leg, then do the same thing for the other leg, both arms, and my low back. It goes right through the skin and directly into the muscles. Not only does this approach seem to help folks who tend to get non-exercise related nighttime leg cramps, but anyone who has raced an Ironman, a Hurricane Heat, a century cycling race or any other long event knows that one thing that keeps you awake at night afterwards are your legs, abs and/or arms twitching and cramping, and this also keeps that from happening.

Finally, if you really want to take your magnesium application to the next level, you can also try the following 1-2-3 combo to drive the lotion even more deeply into the tissue. I learned this trick from former podcast guest and Tour de France recovery specialist Jeff Spencer. See the video below, in which I’m using ice, a MarcPro and magnesium lotion.

NSAID Alternative #4: Sweat & Shiver

It’s no secret that when I’m at home, I incorporate plenty of “cold thermogenesis” via cold showers in my well water and cold soaks in the tub behind my house along with infrared and sauna.

I’m so hooked on sweat and shivering (also known as “hot-cold contrast”), that when I travel to very sauna-friendly locations such as Finland or Japan, one of my favorite things to do to beat jetlag and recovery quickly from airline travel is to visit a traditional sauna or bathhouse, and partake in 45-90 minutes of heat therapy combined with cold therapy. From anti-aging to skin healing to detoxing to moving lymph fluid to massively speeding up muscle and joint recovery, there are a variety of benefits you get from this kind of “sweating and shivering”.

For those of you who think that a spa or sauna is just a place to go get your nails done, grab a massage or sit in a claustrophobic stinky wooden-slatted room with a bunch of naked or half-naked hippies, allow me to correct your misguided assumptions. For example, one of my favorite spas is in Seattle and is called Banya 5. It combines the best of Turkish hammams, Russian banyas, Finnish saunas and Japanese bathhouses. Pardon the rabbit hole for a moment because, since I’m in my Seattle hotel writing this article, this particular location is fresh on my mind. If a weekly or monthly spa visit isn’t a regular habit of yours, you are soon to realize that it should be.

The first thing inside Banya 5 is a “parilka”, which is a dry sauna made of tons of concrete and brick that generates a radiant heat that gets far hotter than traditional saunas. This deeply penetrating heat relaxes muscles and regulates breathing, and they even provide oak leaf “veniks” to perform a traditional “platza”, which basically involves whipping yourself with branches, a treatment that tones the skin and stimulates circulation.

Next, they have a Turkish steam room, in which steam brushes over fresh eucalyptus boughs to produce a nourishing, moist 113-degree heat that provides significant benefit to the skin and respiratory system. The moist heat decreases respiratory congestion to soothe, relax and ease breathing and the steam also opens skin pores to help the body expel toxins and rehydrate dry skin. I’ve always said you need to be careful with steam rooms to ensure the water being pumped in is chlorine and fluoride free, so if you decide to take up a regular spa habit, always check first to ensure a good water filtration system is being used at whichever sauna you choose.

There is also a saltwater tepid pool. This particular pool mimics the salinity of Puget Sound in Washington state, and is basically an 87-degree mineral salt bath that decreases muscle tension and increases relaxation as you are “held” in the buoyant, mineral-infused water, much like a “float tank”. Like the magnesium lotion mentioned above, the salt water also increases the absorption of minerals lost in the sweat.

Next is my favorite part: the cold plunge. The internal organs, blood, lymph and nervous system are particularly stimulated by the contrast of radiant heat and extreme cold. Cold water plunging is an important part of hydrotherapy, especially for the circulatory system, and at about 40 degrees Fahrenheit, this cold plunge is no joke. Immersion in this temperature of cold water constricts skin pores and blood vessels that have ideally first been dilated from the heat to create an invigorating pumping action of the venous system that flushes metabolic wastes and toxins.

So when I have access to heat and cold like this, what exactly is my method? A full 60 minute routine for me might look something like this:

-15 minutes dry sauna with stretches and yoga like this

-5 minutes full body immersion in extreme cold

-15 minutes steam room with deep nasal box-breathing (4 count in, 4 count hold, 4 count out, 4 count hold) 

-5 minutes full body immersion in extreme cold

-15 minutes saline pool soak with static breath holds

-5 minutes full body immersion in extreme cold

If you can hunt down a Finnish Sauna, Turkish Bath, Japanese Bathhouse or anything else like it, you must give this routine a try sometime. Finish with the cold water and a cup of hot tea or coffee, and I guarantee you’ll have a “relaxation and recovery” high, unlike anything you’ve experienced before. This is an especially potent alternative to NSAIDs for anyone who has just finished an extremely hard workout or competitive event, or just a smart and very pleasurable way to get a weekly dose of blood flow and joint repair. Of course, it can also be replicated with a home sauna and cold pool or cold tub setup, which I tell you how to setup for yourself in nitty-gritty here.

NSAID Alternative #5: Eat Sulfur-Rich Foods

Ever smell a rotten egg?

That’s a sulfur-rich food. Sulfur is one of the most abundant mineral elements in the human body, coming in at around 140 grams for the average person and is involved in hundreds of physiological processes, including the formation of the disulfide bonds that give strength and resiliency to hair and skin, taurine synthesis for proper functioning of the cardiovascular system, muscles, and the central nervous system, and perhaps most importantly for recovery, the synthesis of glutathione, one of the body’s premier endogenous antioxidants.

But you don’t need to eat rotten eggs to get sulfur.

Sulfur is found in methionine, an essential amino acid found in meat, eggs, and cheese, and it’s also found in cysteine, an amino acid found in pork, poultry, eggs, and milk. But when I’m recovering from a hard workout or race, my body simply doesn’t seem to function as well when being forced to digest complex, protein-rich foods, so I’ll often instead opt for oodles and oodles of sulfur-rich vegetables (which don’t just contain the sulfur that animal meats do, but also more potent groups called “organosulfur compounds“), along with 10-20 tablets of methionine-rich “essential amino acids“.

What qualifies as a sulfur-rich vegetable?

Any and all fibrous non-leafy green vegetables that steam well and emit that distinctive, rotten-egg-ish odor usually contain decent amounts of sulfur, including brassicas like cabbage, broccoli, cauliflower, Brussels sprouts, bok choy, and related vegetables, and alliums like onions, shallots, garlic, and leeks.

For example, a variety garlic sulfides have been shown to protect your body from peroxidative damage and increase glutathione activity in the liver.  Sulforaphane, an organosulfur compound found in broccoli, cabbage, Brussels sprouts, and cauliflower, inhibits mitochondrial permeability and reduces oxidative stress by increasing glutathione activity.

So, typically, after a hard workout, hours after a difficult race or following a long bout of air travel, you’ll often find me loading up at the salad bar located at the nearest natural grocery store I can find (I’ll often book hotels that are near a Whole Foods, Sprouts Market, etc.) for lunch and dinner (and even often for breakfast) the day after a tough event. I simply eat tons and tons of sulfur-rich vegetables combined with small amounts of anti-oxidant rich fats such as avocados, olive oil and walnuts.

A sulfur-rich salad from a salad bar like this might contain:

-Roasted cauliflower
-Roasted broccoli
-Red onions
-Roasted garlic
-Steamed cabbage
-Roasted brussels sprouts
-Avocado chunks
-Black rice noodles
Olive oil
-Chopped walnuts
-Sea salt
-Black pepper

Ahh, but wait (even if you’re not a card-carrying orthorexic)…

…what about all the canola oil in the fancy salad bars at places like Whole Foods, where I typically go to load up on these veggies if I’m traveling?

Here’s the deal: canola oil comes from a specifically bred variety of rapeseed, which is part of the mustard family along with kale, cabbage, and Brussels sprouts, and is also very high in – you guessed it – sulfur content. Rapeseed oil has been a part of traditional diets in Eastern Europe, especially Poland, India, Japan, China and Canada for thousands of years.

It’s actually a myth that all canola oil is GMO (Genetically Modified Organism). The development of canola oil predated genetic engineering by almost 20 years. Canola was bred using traditional plant breeding methods. These methods involve selecting desired traits followed by crossing these traits into existing varieties until the offspring exhibit the desired characteristics. While it is true that canola oil was not originally developed using genetic engineering methods, some forms of canola are genetically engineered today. To avoid genetically engineered canola oil, you can choose organic canola oil, which by definition would not be genetically modified, or canola oil that has been non-GMO verified.

So when you look at a grocery store like Whole Foods Market, for example, they only use non-GMO canola oil in their prepared foods they make in-house, and when it’s on the salads in the cold salad bar, it’s rarely been oxidized at extreme temperatures.

Furthermore, also a myth that all canola oil is extracted with chemical solvents. Vegetable oils can be extracted by one of two major methods: They can be expeller pressed (a mechanical process which literally squeezes the oil out of the vegetable) or solvent extracted (a chemical process whereby a solvent, usually hexane, is used to remove the oil). At Whole Foods Market, it’s all expeller pressed, non-GMO canola oil.

For low temperatures like salad and vegetables, canola is fairly heat-stable too, and yeah, although it’s not quite as good as a more stable oil, in my opinion, when I’m getting all the benefits of a big, sulfur-rich salad – especially while traveling – the pros outweigh the cons.

So there. Although I’ll readily admit that a better option is avocado oil, extra virgin olive oil or macadamia nut oil, you’ll have to drag me kicking and screaming from my occasional big-ass Whole Foods salad.

Except that pesky $27 average price tag when I weigh and pay for the darn thing.

NSAID Alternative #6: Ground & Walk

Even if I’m blistering, hobbling, limping and teeth-grittingly sore after a hard squat and deadlifting day or a race like a triathlon or a Spartan, I still go out of my way to walk (often thousands and thousands of steps) the day after a hard, muscle-damaging event.

Sure, the first few steps usually suck, bigtime, but then after that, things get easier. Blood begins to flow. Lymph fluid begins to the circulate. The heart begins to pump.

One study found that grounding yourself to the earth, or “Earthing,” might help relieve Delayed Onset Muscle Soreness (DOMS). When walking barefoot on beach sand, close to or in the water and on dewy grass, free electrons in the ground that are called “negative ions” transfer into your body through the soles of your feet. These free electrons are some of the most potent antioxidants known to man, and experiments such as those discussed in the documentary and book that my friend Dr. Mercola talks about here have shown exposure to negative ions from the ground and earth can decrease pain and inflammation, improve sleep and make your blood less viscous – all good news if you’re worried about clotting and soreness after a tough event.

In addition to the ground itself, three other potent sources of negative ions include the air your breathe when you are walking next to moving water such as waterfalls or the ocean the gases released by plants and trees and sunlight (even through the clouds) – so a walk outdoors on the beach or in a forest is actually a perfect recovery tactic.

In a recent BenGreenfieldFitness podcast, I even talked about special sandals I wear called “EarthRunners”, which are equipped with carbon lacing and carbon plugs built into the bottom of the sandal. Unlike rubber-soled shoes or sandals, this type of grounding footwear conducts negative ions from surfaces like sand, concrete, grass, roads, blacktop, etc. and straight up into your feet, while still allowing you to walk around shod (e.g. not looking like a hippie barefoot caveman).

NSAID Alternative #7: Dig Into Tissue

No matter where I am at in the world, whether the coffeemaker is in the hotel room or the lobby, whether I have to be on stage speaking in an hour or my flight arrived at 3 am the evening prior or it’s snowing, sleeting or sunny outside, I always set the chronograph on my stopwatch to 15 minutes and spend 15 minutes “making my body better”, usually using the same tried-and-true stretching or deep tissue mobilizng routines I do at home. As a matter of fact, I have a few such routines in my back pocket that I can do anytime, anywhere in the world, including:

-15 minutes yoga warriors and sun salutations

-15 minutes of ELDOA stretches

-15 minutes foam rolling and deep tissue work

-15 minutes arm swings, leg swings and calisthenics

-15 minutes walk with deep nasal breathing and box breathing

In addition to these 10-15 minutes of body care that always include some component of fascial “mashing” and mobility work, when I’m at home, at least once per week, I complete an entire metabolic mobility routine for 45-60 minutes, usually on a Wednesday morning, and often for a bonus weekend session. The video here shows exactly what I do.

I also try to get a massage like this once every one to two weeks. It sucks and it hurts but it works wonders for keeping my body aligned and moving well (and I recently came across the app “Soothe“, which easily allows me to hunt down a massage therapy just about anywhere in the US and get them to come to my condo, hotel or anywhere else).

Why do I do all this seemingly masochistic body work?

You can read my entire brain-dump on the importance of maintaining supple connective tissue and fascia here, along with the extreme importance of deep tissue work to help one recover from tough workouts or races.

But when I’m traveling or stuck in a hotel room during a conference or after a race, and since I pack light, I often don’t have access to the entire suite of medieval torture devices that I do at home.

So what do I do instead? I get creative.

-The corners of dumbbells or kettlebells at the average hotel gym can easily be used to dig into the sides of your hips or sore shoulders…

-A water bottle like a Nalgene can be wrapped in a sock or item of clothing and used as a roller for the calves, forearms, sides of hips, low back, hamstrings, hip flexors, IT band, quadriceps, etc…

-Tennis balls, softballs, and lacrosse balls can be used to dig into your neck, the back of your shoulders, your hips, etc. and golf balls are perfect for the feet…

-Rocks, the corners of park benches, flagpoles, etc. at an outdoor park setting can also be used on hips, backs, the undersides of knees and more…

So get creative. Remember Baloo the Bear from the Jungle Book cartoon, who rubbed his back incessantly on a tree? Be like that. You don’t necessarily need to pack a massage therapist and a giant foam roller in your suitcase.

NSAID Alternative #8: Use The Shotgun Approach

When I drink cow’s milk, I tend to decommission any bathroom in sight, but the same does not occur when I drink goat’s milk. I finally solved this mystery when I interviewed my friend Joe Stout, who is the chief nutrition scientist at a farm called “Mt. Capra”, just a few hours from my home in Spokane, Washington. It turns out that the size of the goat milk protein and the naturally lower amounts of lactose sugar in the milk allow it to be far more friendly to a human digestive system. Ultimately, Joe’s farm wound up being the supplier for a flagship product that my company produces: colostrum from grass-fed goats. But it turns out that you can get plenty more than just gut-friendly dairy and colostrum from these friendly critters.

For example, Joe’s farm uses extraction technology called a “refractance window drying process”, which captures fragile nutrients without harsh processing steps or extreme temperatures, and using this method, he’s able to isolate over 20 different organic electrolytes such as potassium, magnesium, sodium, calcium, and phosphorus from goat milk whey. This natural electrolyte mix – which you can think of as a goat-like Gatorade – works amazingly for hydration and for keeping joints supple.

At Kion, in a product called “Flex”, we’ve combined these natural minerals with a “shotgun formula” for muscle and joint recovery. After being fully educated on all the dangers of NSAIDs you’ve already discovered in this chapter, I wanted to be able to consume something that would promote joint comfort, mobility and flexibility, support bone health, and enhance recovery without causing any gut distress or subjecting the kidneys to the toxic byproducts of ibuprofen.

Working with Mt. Capra, the end result was Kion Flex, which, in addition to the minerals, contains the following three nutrient blends for the joints and muscles.

1. Collagen Blend:

Type II Collagen is the principal structural protein in cartilage which provides strength, flexibility and joint support. It comprises over 50% of the protein in cartilage and over 90% of articular (joint) cartilage. Studies have examined the efficacy of oral supplementation of type II collagen on moderating joint function and joint pain due to strenuous exercise in healthy subjects and have shown that collagen supplementation increased joint mobility, prolonged how long one could exercise before joint pain occurred, improved recovery speeds after exercise, and less joint pain after exercise.*

The Type II Chicken Collagen used in Kion Flex provides structural support needed for healthy joints.* It also contains Glucosamine and Chondroitin sulfates and comes from chickens free of growth hormones, antibiotics, pesticides, and insecticides. This form of collagen is a whole food concentrate that has no known side effects and provides maximum absorption. According to recent studies at Harvard University Medical School, the Type II Collagen derived from chicken cartilage can also help to strengthen the immune system.

2. FlexPro Blend:

Cherry Juice: This natural extract has been found to aid in the breakdown of uric acid crystals which deposit in joints, tendons, kidneys and connective tissue.* Studies show that consuming cherries and cherry juice daily can lessen the effects of uric acid.* Concentrated cherry juice delivers the beneficial bioactive compounds found in fresh cherries such as anthocyanidins and proanthocyanidins, without excess carbohydrates or calories.

Ginger: Possesses many strong antioxidant properties and has been shown to relieve muscular discomfort.

Turmeric: The curcumin and other natural anti-inflammatories in turmeric contain antioxidant properties that may protect your cells from free radical damage and support your body’s healthy inflammatory response. Studies have also shown that taking just 2 grams of curcumin gives pain reduction equivalent to 800 mg of ibuprofen.

White Willow Bark: The use of white willow bark for pain relief dates back to over 2400 years to the time of Hippocrates. The pain-relieving action comes from a glycoside called salicin – from which the body can naturally make salicylic acid (aspirin). This, along with the antioxidant effects of the polyphenols and flavonoids found in white willow bark, support your body’s healthy inflammatory response to exercise and may help combat muscle soreness associated with exercise.

Hyaluronic Acid: Hyaluronic acid is one of the main components of synovial fluid (joint fluid) and is the main lubricating element in synovial fluid.

Boswellia: Known by its more popular name Frankincense, boswellia has been used for hundreds of years for various ailments. It may assist with the body’s healthy response to oxidative stress and inflammation that occur from exertion.

Cetyl Myristoleate: This naturally occurring fatty acid, which I just covered in a recent podcast here, promotes joint wellness and has been researched clinically. Preliminary results of several double-blind, randomized controlled, research studies have found cetyl myristoleate effective in supporting knee function, and it has also been studied and shown to be successful for management of arthritis, autoimmune issues, cartilage support and much more.

3. Enzyme Blend

Oral enzyme therapy is a unique approach to promoting muscle and joint recovery from exercise by maintaining normal circulation and promoting a healthy immune and inflammatory response to exertion. This allows for optimal nutrient delivery and waste removal. Proteolytic enzymes in particular, including bromelain and papain, can break down dietary protein, along with soreness inducing protein-based bodies in the bloodstream, including fibrin, which is rampant in the body after a tough workout or injury. In your gut, these enzymes function as digestive aids, and in your blood – especially when consumed on an empty stomach – they act as a type of blood cleanser that can combat inflammation and support your immune system.

The enzyme blend in Kion Flex contains the following natural enzymes:

-Protease: Converts protein into polypeptides, and breaks down inflammatory byproducts.
-Bromelain: A combination of enzymes from both fruit and leaves of the pineapple plant. Also breaks down inflammatory byproducts.
-Papain: An enzyme found in papayas that breaks down fats and proteins for optimal nutrient absorption. Also breaks down inflammatory byproducts.
-Amylase: Breaks down and digests carbohydrates and inflammatory byproducts.
-Lipase: Fat digesting enzyme, and also breaks down inflammatory byproducts.
-Cellulase: Converts fiber cellulose to glucose, and breaks down inflammatory byproducts. Cellulase is not made in your body and can only be obtained from food or supplements.
-Peptidase: Breaks down proteins at different pH levels along the digestive tract and breaks down inflammatory byproducts.

In addition, Flex contains a unique ingredient: goat milk whey. This type of whey has been used for decades to promote bone density as well as relieve occasional joint discomfort, and it contributes less to allergy or autoimmune issues than other forms of whey can. One world-renowned nutritionist, Dr. Bernard Jensen, used goat milk whey as one of his go-to natural healing foods of choice for healthy joints. According to naturopath Dr. Robert H. Sorge, it can also be used as a treatment for arthritis due to the high amounts of bioorganic sodium, which the body can use to keep the joints supple and reduce inflammation (Dr. Soge notes that goats remain limber well into old age as a result of this bioorganic sodium, which is passed on in their milk and is when goat whey is made.)

Ultimately, I have never used any product – from anti-inflammatory drugs to topical lotions to any blend of natural soreness or recovery-enhancing products that beats this blend. In addition, when “stacked” with a good fish oil, the effects can be even more enhanced. A whole-food based product like Flex is, in my opinion, a must-have in the recovery toolbox of any exercise enthusiast, athlete, injured person or aging individual with beat-up joints.

Now, even though the Kion Flex bottle label instructs you to take “4-6 per day”, I personally don’t mess around. If I’m sore, I’ll often take 6 in the morning and 6 in the evening, and if I’m injured, I’ll take as many as 10 in the morning and 10 in the evening – usually on an empty stomach so the enzymes work on my muscles and not on food. When it comes to beating back soreness and accelerating recovery without the nasty side effects of NSAIDs, that “nutrient shotgun” approach is incredibly effective for me.



So…let’s review:

Anything Collagen Related

Omega-3 Fatty Acids, Preferably From Fish Oil

-Slather Yourself In Magnesium

-Sweat & Shiver

-Eat Sulfur-Rich Foods

-Ground & Walk

-Dig Into Tissue

-Use the Shotgun Approach

When you implement these methods – and especially if you combine them all into one mighty routine – you’ll bounce back much, much faster and feel much, much more happy and pain-free after a tough workout, an injury, surgery, or difficult crucibles like a Spartan race, Ironman, bike race, marathon, Crossfit WOD or anything else that seems to absolutely crush you. This translates into extra days available for training, playing sans soreness with family, knowing you’re not going to get a blood-clot flying or driving long distances after a hard training block or race, and beating back the chronic repetitive motion and inflammation-related injuries that often rear their ugly heads after your body has been through the grinder.

Do you have questions, comments or feedback about anything in this article, or your own recovery tips or natural alternatives to NSAIDs? Leave your thoughts below and I promise to reply!

Ask Ben a Podcast Question

21 thoughts on “Why You Should Never Use Ibuprofen Again (And 8 Natural Alternatives For Joint Pain & Muscle Repair).

  1. Hi Ben, your blog is nice! Thanks for sharing your thoughts regarding NSAID. This is very useful and informative blog. Thanks again, keep sharing!

  2. Jim says:

    Is Circumin considered a NSAID?

  3. SlyNate says:

    Hey Ben, the one time I tried hot/cold contrast therapy I had a really bad reaction where it felt my body was going into shock. Very painful, lots of anxiety, and nervous energy. I told a max cold shower in the winter shortly following a 45 minute 158 degree infrared sauna session. It was so bad it scared me from trying it again. Did I do something wrong?

    I can tolerate the sauna just fine and cold showers well but back to back like that really messed me up. I just want to make sure I doing this safely before proceeding again in the future.

    Thanks bro!

    1. I would focus on breathwork to control sympathetic nervous system response: https://bengreenfieldfitness.com/article/the-ulti…

  4. Megan says:

    … “even if you’re not a card-carrying orthorexic”.
    Enough with you subtle, or not so subtle jabs, at eating disorders. You insensitivity is showcased in this article as it has been in other newsletters and podcasts. You think you’re cute. You’re not. Instead, you come off as a narcissistic asshole.
    I’d encourage you to re-evaluate your methods of marketing a healthy lifestyle. Promoting clean eating is great. Mocking those who struggle is not.

  5. Tom says:

    So, do you think Epsom salt baths could be a transdermal source of magnesium and sulfur?

    Thanks for your work.

  6. Vincent says:

    Hey Ben, I get lots of muscle twitching after workouts, especially in calves and forearms. I have been checked out by the Neuro and he found nothing abnormal or alarming in various testing. Would these strategies work for this kink of benign muscle fasculations?

    1. I have some recommendations for that in this podcast: https://bengreenfieldfitness.com/podcast/nutritio… I recommend posting this to the Kion Community as well. https://Facebook.com/groups/GetKion

  7. Kate says:

    Great article Ben. With regard to bone broth & collagen, have you found any good options for people with mast cell/histamine issues? Thanks in advance, Kate

    1. I have not found either of those to be an issue much at all for people with histamine problems… Especially simply isolated collagen. There are much bigger fish to fry when it comes to histamine. Check out this podcast for more info: https://bengreenfieldfitness.com/podcast/387-how-…

  8. Nate says:

    Hey Ben
    I do alot of snowmobiling in the winter. When I get off the mtn I am pretty sore from the days adventures and falls. What would you recommend for the temp relief from the days pounding my body took?

  9. Ryan says:

    Hi Ben

    I get migraines and occasionally take excedrine migraine, which is an NSAID. Any thoughts on migraine meds without NSAID?

    Thx! Ryan

  10. Lauri says:

    How do you feel about Celebrex for arthritis joint pain, do you feel these alternative therapies work for that type of joint inflammation as well?

  11. Jonathan says:

    Let me preface that I rarely ever take pain medication, but when I do I’ve now switched my ibuprofen consumption for 3g of Kratom. Any opinions on using Kratom as an alternative to traditional painkillers. For those interested, just be aware that it can be habit forming with daily use so try to use it sparingly.

  12. Nicky says:

    I’m assuming the same no-no approach to people who are not training heavily for marathons or iron man events but just doing regular medium intensity training for health?

  13. Chris says:

    HI Ben – I’m doing an Ironman and was prescribed Ketorolac pre-race for some tendonitis in my knee. Would you recommend Kion Flex as an alternative prior to the race and how much would you take?



  14. On injury recovery, I love the use of the Marc Pro but using ice over it tells me you don’t really understand what the marc pro is doing. Ice is not helping you recover faster, it actually slows recovery from an injury. You’re using the marc pro to activate the body’s lymphatic system which is the ONLY thing that can move fluid and waste out of tissue and replace it with nutrients. Iced muscles don’t work as efficiently and ice will degrade lymphatic function, so putting ice over the marc pro is like asking your body to turn right and left at the same time. Further, you don’t want to impede the inflammatory process. Inflammation (in this case) equals tissue healing. What you do want to do is eliminate swelling and congestion and there is zero clinical evidence that icing does this, because physiologically it simply can’t. It’s impossible. Even Dr Gabe Mirkin, the guy who coined the “RICE” acronym, now teaches that icing is precisely the wrong thing to do to help injured body parts recover. Compression and elevation are great. The marc pro is fantastic. Then actively move the body part in ways that don’t generate a pain response. Then other tools you’ve talked about, like topical magnesium and essential oils. But for goodness sakes, lose the ice. If you have questions about that I strongly encourage you to connect with Gary Reinl, one of the nation’s leading experts on ice and what it doesn’t do. Feel free to email me, happy to connect you two.

    1. Yes, well aware of Gary's work. I wrote an article about it here: https://bengreenfieldfitness.com/article/fat-loss… – frankly, you can really jack up the intensity of the MarcPro with the ice on there, and yes, during that time lymphatic flow decreases, but after, and especially if you apply heat after, you get a big rush of lymph.

  15. andreas says:

    Where would you put acetaminophen and pycnogenol in this context?

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