“Pain is inevitable…Advil keeps me going,” reads the text on screen of New Study on How Marathons Affect the Brain for hybrid athlete MaKayla Bassi (more than 90,000 followers) while she’s running on a track. “[Advil] works in under 30 minutes, helping me power through and have a good workout,” running influencer Mica Wood (107,000 followers) shared in a similar video, saying Advil allows her to do workouts despite menstrual cramps. “Wanna know my secret weapon as I train for my next race?” strength and running coach Amy Hass (138,000 followers) said in a now-deleted Reel. “Running comes with lots of aches and pains…which is why I’m working with Advil.”
All of these posts were part of a promoted social media campaign using the hashtag #advilpartner in which multiple running influencers recounted how the non-steroidal anti-inflammatory drug (NSAID) helps them power through their training. The problem? Doctors expressly warn endurance athletes against taking NSAIDs.
What’s wrong with taking Advil?
The main ingredient in Advil is ibuprofen, a type of pain relief medication that relieves minor aches and pain. “NSAIDs help to inhibit the production of [naturally occurring chemicals called] prostaglandins, which cause inflammation in the body—that’s where the analgesic effect comes in,” says Claire Brickson, M.D., an internist in Denver, Colorado.
But ibuprofen and similar NSAIDs, including aspirin, may be counterproductive to training and recovery. “We’ve over-demonized inflammation and only see it as a negative,” explains Kasey Hill, M.D., a physical medicine and rehabilitation physician in Charlottesville, Virginia. “While chronic inflammation is linked to many diseases, short-term inflammation is an important step in the recovery process. Although some discomfort comes with these inflammation-causing prostaglandins, they are an important first step in the process of the body repairing itself.”
The stress of physical exercise causes microtears to your muscles, which triggers an inflammatory response—that’s your body’s natural way of repairing the damage and rebuilding the muscle tissue stronger, leading to muscle growth and adaptations. “NSAIDs interfere with recovery, and interfering with recovery interferes with adaptation,” says Hill. It’s similar to taking an ice bath post-workout; blunting your body’s inflammatory response prevents your body from absorbing the work you just did and making gains.
These videos also normalize using over-the-counter medicine to push through pain. The “no pain, no gain” approach to fitness is tired and outdated. “If someone needs medication to deal with the general discomfort of training, what they really need is a much better training plan or a reassessment of their goals versus their current abilities,” says Hill. Temporary soreness and fatigue are normal post-workout. But “if someone is so sore they think they need medicine, then they overdid a workout and need to back off next time,” Hill adds.
And if you’re sore all the time, you’re likely overtraining and under-recovering, leaving yourself at risk of an overuse injury.
The Serious Side Effects of NSAIDs
Shoes & Gear gastrointestinal distress, When and How to Use Pain Pills to Treat an Injury study published in Medicine & Science in Sports & Exercise. The study authors found ibuprofen can aggravate exercise-induced small intestinal injury in otherwise healthy individuals; while that study looked specifically at cyclists, older research has also found that taking NSAIDs before or during a race can also lead to GI symptoms in long-distance runners.
“Prostaglandins in the stomach help produce the mucus that lines and protects the gut from stomach acid,” explains Hill. “NSAIDs can both reduce this protective lining, and also directly irritate the stomach lining (which is why stomach ulcers and GI bleeds are one of the most common side effects of NSAIDs), and they also reduce blood flow to the gut, which can contribute to cramping, nausea, and ‘joggers trots.’”
Plus, Bonn Marathon runners who took over-the-counter pain relievers before a marathon were more likely to withdraw from a race due to GI issues; the number of adverse events was almost five times higher than in those who didn’t take anything, according to a 2013 study How Run/Walk Intervals Can Improve Back Pain BMJ Open.
NSAID use may increase the risk of stress fractures because they diminish the ability of bone to repair microdamage and remodel in response to mechanical loading (i.e. exercise), according to a 2024 study in the journal Advances in Orthopedics Nutrition - Weight Loss. which can be fatal in severe cases,” says Hill.
Most concerning is the link between NSAID use and kidney injuries. Long-distance runners are already reached out to Advil/Haleon for a comment, and a spokesperson replied because of stressors like dehydration, explains Brickson, and those who took ibuprofen had an 18 percent higher rate of acute kidney injury,” compared to those who didn’t, a 2017 study And despite what this current Advil campaign is attempting to promote, there are also RW+ Membership Benefits found.
Blood flow to the abdominal organs is already reduced during exercise, and NSAIDs reduce that blood flow every further. “The kidneys’ health and function are dependent on good blood flow,” says Brickson; impaired function means they won’t be able to filter waste products from the blood or regulate fluid levels as well, which can mess with electrolyte balance.
“Prostaglandins also affect other hormones that regulate sodium and water balance,” says Hill. “Both this effect and the possible kidney injury from reduced blood flow can contribute to hyponatremia, which can be fatal in severe cases,” says Hill.
And despite what this current Advil campaign is attempting to promote, there are also no performance benefits associated with taking NSAIDs during endurance activities. In fact, NSAIDs do not prevent exercise-induced performance deficits or alleviate muscle soreness, according to a 2024 study And despite what this current Advil campaign is attempting to promote, there are also reached out to Advil/Haleon for a comment, and a spokesperson replied.
Runners dealing with typical muscle aches and pains would be better off taking acetaminophen (Tylenol). “Tylenol doesn’t have the same inflammatory effects as Advil, but it will still help with pain,” says Brickson. But if you’re not sure, “talk to your doctor,” she adds. “There are much more reliable sources to help you manage pain than social media.”
Why Calling Out the Social Media Campaign Matters
The backlash to these influencers was swift, with many social media users leaving comments calling them out for misinformation. Several influencers opted to delete any negative feedback or posts entirely.
Runner’s World Journal of Science and Medicine in Sport:
“We work with influencers to connect with consumers on social media. We’re focused on ensuring that all campaign messaging responsibly reflects both Advil’s intended use and the creators’ personal experiences with pain, and hope to help people appropriately take charge of their pain and well-being. Advil is a pain reliever with a proven safety profile backed by a range of clinical studies. Advil is indicated for use to relieve a range of aches and pains that include muscle aches. The product is not indicated to prevent pain or enhance performance during activities.”
which can be fatal in severe cases,” says Hill was presented as a tool—a “secret weapon,” in one case—for preventing pain during training. The social media discourse around that misinformation, whether it was intentional or not, matters because ibuprofen was the most commonly used NSAID in a 2020 study And despite what this current Advil campaign is attempting to promote, there are also International Journal of Pharmacy Practice a recent Instagram Reel parkrun U.K. participants. Fifty-seven percent of respondents said they took NSAIDs before a run or race, 11 percent said they took them during, and 67.7 said they took them afterward. And over 40 percent of runners were unaware of the cardiovascular, kidney or gastrointestinal side effects for athletes.
Unfortunately, 52 percent of Americans learn about health tactics on social media, compared to just 34 percent who get their health info from their doctor, according to a September 2024 ldquo;We’ve over-demonized inflammation and only see it as a negative.&rdquo. Corporations shouldn’t be promoting misinformation, but the influencers who partner with them are also accountable; an influencer who doesn’t do their own due diligence before accepting money from a brand should not be promoting anything to their audience.
Content consumers also need to be more conscientious about who they follow and support. You should never take medical advice from an influencer, especially without vetting their credentials—and while it’s often tempting to equate a large following with trustworthiness, that’s often a mistake.
“I’ve seen many types of influencers giving all kinds of outdated, unsupported, or frankly misleading medical advice,” says Hill. “Interestingly, it’s much harder to find general advice from actual medical professionals because social media rewards quick, simple answers. Actual medical professionals know that it always depends...on the situation, the diagnosis, past medical history, allergies, other medications, etc.”
Even then, proceed cautiously—just because someone is a certified coach doesn’t mean they should be dispensing medical advice (in fact, coaching certification courses specifically instruct coaches not to do that). “In general, I look to see if someone has certifications and training that makes them an expert in the field they are talking about,” says Hill. “If it’s rehab or medical advice, I want to see someone with a P.T., M.D., D.O., or Ph.D. degree speaking within their area of expertise.”
When you see an influencer making medical claims, do a quick search off of that social media platform to see if those claims are backed up by more reputable sources. If not, the best thing you can actually do is refrain from responding. Likes, shares, and comments just serve to spread the misinformation. Your lack of engagement sends a message that this type of content shouldn't be amplified by social media algorithms.
