Pain is important to ensure that the escalation of (re)training is not so fast that the tissue is damaged. Taking painkillers removes this important control mechanism, increasing the risk of injury and relapse. Painkillers should therefore generally only be used during breaks in training.
Simple analgesics (painkillers)
Indication. Analgesics (painkillers) can be used to a limited extent to reduce pain in minor injuries where there is no risk of aggravating the injury with continued sports activity (e.g. bleeding under nails, skin abrasions, etc.). All types of painkillers can, of course, be used if sporting activity ceases. Due to the modest side effects, paracetamol is recommended.
Mechanism of action. Paracetamol has both analgesic (analgesic) and temperature-lowering (antipyretic) effects. The mechanism of action is partly unknown. 90% is absorbed from the intestine after tablet ingestion and the maximum concentration of paracetamol in the blood is reached after ½-1 hour after tablet ingestion. The duration is 4-6 hours. Only 60% is absorbed after suppositories.
Side effects. Paracetamol in the usual dose has no significant side effects. However, even small overdoses can cause serious liver damage.
Contraindications. Painkillers should never be used to allow an athlete to continue an activity that carries the risk of aggravating the injury. Paracetamol and other painkillers with a temperature-lowering effect should never be used to lower the body temperature of athletes with an elevated temperature before sports activity. Severe viral infections can invade the heart muscle and cause myocarditis. The risk of myocarditis increases with vigorous physical activity during viral infections and deaths have been reported in young, healthy athletes in such situations. Temperature elevation is indicative of infection and all sports activity should be stopped and temperature normalised before resuming sports activity.
Dose. 1 gram of paracetamol 3-4 times daily.
Conclusion. Paracetamol can be used by athletes who need painkillers during injury breaks, and should only be used in exceptional circumstances during continued sporting activity.
