Everyone talks about how NSAIDs like ibuprofen damage your heart and gut lining, but you don't hear much about the long-term negative side effects on connective tissue and injury rates.
If you're recovering from an injury, have a nagging joint that just won't heal, or feel like you are one of the unlucky "injury prone" like me, then listen up —
Your NSAID habit is killing your joints.
And could be the reason why you keep getting injured.
Studies show NSAID usage reduces collagen mass at injury sites and raises re-injury risk by more than 25% (Annals of Physical and Rehabilitation Medicine).
There's a better, more natural (and research-backed) way to optimize your recovery.
In this article, I cover:
1. nutrition principles and goals to optimize injury recovery
2. the top natural supplements for injury recovery
3. how to combine corrective exercise with supplement timing for faster recovery
Collagen structure is just as important (if not more) for long-term recovery outcomes than merely treating inflammation and pain.
It shuts down inflammation and pain. Plus your doctor is likely a big fan of using OTC anti-inflammatories. And sometimes its the only way you can continue working out. Or get through the day pain-free.
Trust me, I've been there.
A few years ago, I might as well have loaded up a PEZ dispenser so I could pop them like candy.
But it comes at a cost. You've probably heard news stories about how taking any amount of NSAIDs increases your risk of heart attack and stroke by up to 50% (in the first week of usage!).
Or that habitual NSAID usage damages your gut lining, leading to increased gut permeability (aka leaky gut syndrome).
But even with all the frightening reasons not to... most people still head straight for the pill bottle when they strain their back, tweak their knee, or develop elbow tendinitis.
Because it works (in the short term).
Not only do NSAIDs relieve pain and reduce inflammation, they can even help you get back to training and normal life sooner.
A study published in the Annals of Physical and Rehabilitation Medicine demonstrated that NSAIDs effectively relieve joint pain and reduce inflammation in the short term (7 to 14 days).
They also improve mid-term outcomes (6-12 weeks), allowing athletes to return to resume training sooner.
This is why the researchers strongly recommended avoiding NSAIDs for injuries altogether. Here's a quote from the study:
"Sports medicine physicians often treat athletes in pain with non-steroidal anti-inflammatory drugs (NSAIDs). However, there is lack of high-quality evidence to guide NSAID use. Their adverse effects have clinical relevance, and their possible negative consequences on the long-term healing process are slowly becoming more obvious.... We do not recommend their use for muscle injuries, bone fractures (also stress fractures) or chronic tendinopathy."
It's worth noting that the authors didn't base their recommendations on heart attacks or kidney disease. They focused on the healing process.
If that's not enough to convince you, consider this: NSAID usage reduces collagen mass at injury sites. Which is probably why another study found that athletes who took NSAIDs were 25% more likely to re-injure the same joint.
So NSAIDs provide short-term relief... but lead to brittle, injury-prone joints.
Not only that, NSAID usage (combined with the aging process) kick-starts a collagen degrading cycle.
And it only gets worse with time.
Is it worth it? Studies show NSAID usage delays healing time and increases chance of re-injury by up to 25%.
Most people realize in their mid-30's that their ability to recover from minor injuries has substantially dropped.
By their 40's and 50's, they realize it's been shot to hell.
This is partially due to declining production of collagen.
Collagen production slows down starting in our mid-20's — dropping by 1-2% each year.
By age 60, your ability to produce collagen has likely decreased by 50%.
When you combine the aging process, elevated inflammation levels, and a bad NSAID habit... you get a perfect recipe for collagen deficiency.
Collagen production and formation drops with age. You can't stop this process, but you can buffer it by focusing on connective tissue health and nutrition (more on that below).
During injury recovery periods, a reduction in activity leads to a reduction in collagen. Which further increases injury risk. And so the cycle continues. (conversely, resistance-focused exercise increases the rate of collagen deposition).
NSAID usage reduces collagen mass at injury sites, increasing injury rates later by up to 25%.
Chronic inflammation deteriorates collagen structures in joints. While the acute inflammation phase (3-7 days) after an injury is important for cell clean up and nutrient delivery, chronically elevated inflammation levels degrade collagen mass. Basically, if you have been dealing with sore joints for weeks, months or years — inflammation is taking a toll on your joints.
At this point, I think we can agree that taking NSAIDs just isn't worth it.
Besides, there are natural supplements that outperform ibuprofen and other NSAIDs on pain relief scores.
Not only that, they actually increase collagen mass at injury sites instead of reducing it.
So you end up with more resilient, injury-proof joints.
The catch is that only specific forms of these supplements (in specific dosages) taken at specific times are proven to bolster the injury repair process.
We'll come back to this point later.
When it comes to injury recovery, time is definitely of the essence. But it's not just about recovery time. It’s about optimizing tissue formation for strength, flexibility, and joint resilience. This is where collagen synthesis comes into play.
Collagen synthesis describes the process in which your body builds and repairs connective tissue.
It's like muscle protein synthesis, but for your joints.
Just like protein supplies the building blocks for muscle repair, collagen supplies the building blocks for connective tissue repair (and no, just taking a collagen protein powder won't do the trick).
But rarely do you hear about how collagen metabolism relates to injury recovery.
Even though studies on injured athletes and people suffering from chronic tendinosis have demonstrated a direct connection between collagen metabolism and recovery outcomes.
For example, a 12 week study of runners suffering from chronic Achilles tendinosis showed that eccentric exercise (the lowering portion) under moderately heavy loads increased the collagen synthesis rate — improving recovery time and collagen formation strength.
There are three important notes to consider based on this research:
Eccentric exercise appears to kick start collagen metabolism and turnover, helping athletes who have not been able to overcome an injury finally start the journey to full recovery.
Increased collagen synthesis (formation) speeds up recovery time.
And most importantly, improved collagen metabolism leads to more mechanically optimized collagen formations — stronger tissue that is less prone to injury and irritation in the future.
This last point deserves repeating: most injuries resurface later in life.
Either as a full-blown tear, or nagging discomfort. This can be partially attributed to the quality (or lack thereof) of the collagen tissue formation.
This is why collagen synthesis is so vital to a speedy, optimal recovery.
So, if you only took away ONE concept from this article, it would be this:
Keep reading to see exactly how you can boost collagen synthesis for shorter recovery times, stronger connective tissue formations, and injury-proof joints.
Summary & Subtext
1. NSAIDs provide short-term relief from pain and inflammation, but hinder the healing process — leading to poor connective tissue formations.
2. Leading sports medicine researchers have publicly stated that NSAIDs should NOT be used for injury recovery (i.e. researchers without conflict of interest ties to pharmaceutical companies or associated medical organizations).
3. Most people will continue to use NSAIDs for injury repair and inflammation because they simply don't know better. Or because their doctors recommend them.
4. The "Four Horsemen of Collagen Deficiency" explain why its so tough to bounce back from injuries as we age. But, there's good news.
I created SaltWrap to bring together the most practical ideas in therapeutic sports nutrition, corrective exercise, and functional fitness — with the goal of keeping you (and myself) strong, mobile and built to last.
I've worked as an A.C.E. Certified Personal Trainer, Orthopedic Exercise Specialist, and nutritional supplement formulator.
But more importantly — I've spent most of my life battling injuries, joint pain, and just being plain beat up. So I know what it's like to struggle toward fitness goals.
SaltWrap is here to push you through injuries, setbacks and perceived physical limitations. To a place beyond what you think you're capable of. Sign up here to stay in the loop.
Learn more about my best-selling injury prevention and recovery book, Built from Broken.
*These statements have not been evaluated or approved by the Food and Drug Administration.
This product is not intended to diagnose, treat, cure or prevent any disease.
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