By Dev K. Mishra, M.D., President, Sideline Sports Doc
For better or worse, the professional athlete who claims that he’s no role model for kids is inescapably a role model. So what are we to make of recent data that a very high percentage of professional soccer players at the 2010 World Cup regularly required pregame pain relieving medication in order to play? Does that practice make its way down to the youth level?
Answer: absolutely yes.
Let’s start with a key definition. What we are talking about here is principally legal use of medications such as over the counter pills like Ibuprofen (brand names such as Motrin or Advil). These are anti-inflammatory medications that also have pain-relieving effects. I haven’t come across any published studies on pregame pain medication in young athletes but by the definition above I do know it’s extremely common. I don’t know of a teenage high level club sport player or high school athlete who hasn’t taken some anti-inflammatory medication at least a few times in their playing career to help them feel better and perform better through a game.
Going back to the report of the 2010 World Cup a study published in the British Journal of Sports Medicine showed that “During the tournament 71.7% of all players took medication, and 60.3% (444 of 736 players) took painkilling agents at least once. Over a third of players (39.0%) took a painkilling agent before every game.” Interestingly, the study also found that teams from North and South America had higher percentages of pain relieving medication usage than teams from other geographies. There was no speculation as to why.
Speaking from the North American perspective I can tell you that the most common medication used pregame is an injectable anti-inflammatory medication called Toradol. Toradol works quickly and is extremely effective. It is also legal when prescribed by a qualified physician. The medication is commonly used for muscle strains, contusions, stable sprains, and tendonitis. Toradol use is very common in most American professional sports. The World Cup report was no surprise to me except for the fact that physicians from some parts of the world weren’t using it as much.
Occasional use when medically indicated and properly supervised is fine. The dilemma comes in when an athlete needs medication repeatedly in order to play. All medications have potential side effects that can add up with repeated use. Additionally, continually using medications to play may be masking a larger problem that can harm the athlete permanently if not corrected.
My recommendation for young athletes is that occasional use of low dose anti-inflammatory medication such as Ibuprofen for soreness or strains is probably fine. But if you find that you can’t play at all without medication and find yourself taking it every time you suit up that is a big indication that you could have a major issue. I generally advise any athlete who is not getting better after 3-5 days to seek consultation from a sports medicine physician.