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Pictured: West Ham United’s Michail Antonio lays on the ground after he picks up an injury during the Premier League match at Bournemouth in March 2017.
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS FEATURE/DR. CRAIG ROSENBLOOM - LEYTON ORIENT FC Excessive anti-inflammatory drug use in elite sports has been well documented with football having some of the highest rates of use of any sport (1)
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on-steroidal anti-inflammatory drugs (NSAIDs) are commonly used painkillers used to treat soft tissue injuries due to their anti-inflammatory and analgesic effects. Commonly used drugs in this group include but are not limited to ibuprofen, naproxen, and diclofenac. The largest data source relating to football currently available is from the FIFA World Cups. Since the 2002 World Cup any medication that has been administered by a team physician to a player 72 hours prior to a game has been recorded (2). At the last World Cup in Brazil, just over half of the 736 players present at the competition took an NSAID during the tournament. Nearly a third of all players used an NSAID prior to every match regardless of whether they played, which is roughly 7 out of the 23 players per national squad per match (3). Much higher rates of medicine use were seen in older players, and also players from the South American and Asian Confederations (3). There was no difference in
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rates of use in injured vs. non injured players, or between players participating in the match and substitutes who did not play at all (4). Looking across the game as a whole - similar rates of NSAID use were found at the 2003 and 2007 FIFA Women’s World Cup (4). In a younger population players at the 2005 and 2007 Under-17 and Under-20 World Cup tournaments, 43% of participants used an NSAID during the competition (4). Unfortunately no recent data has been published. At the FIFA Futsal World Cup between 2000 and 2012, 45.7% of players took at least one NSAID during the competition, with a quarter taking at least one NSAID prior to every game (5). Efforts have been made to try and reduce rates of NSAID use, and before the 2010 FIFA World Cup the FIFA Medical Assessment and Research Centre (F-MARC) campaigned to reduce the use of NSAIDs during the tournament. Team physicians were informed about the potential side effects, and the detrimental effects on recovery after exercise
and tissue healing (4). Despite this; rates of NSAID use per match at the 2010 World Cup increased 5% compared to 2006 (6). At the 2014 World Cup NSAIDs were the most commonly taken physician provided medication at the tournament, accounting for over 40% of all medicines taken. Diclofenac was by far the most popular NSAID accounting for 60% of use, with selective COX-2 inhibitors accounting for 16.4% (3). The medical team are an important influence given the prescription only nature of most NSAIDs. In the 2002 FIFA World Cup one country used more than one type of NSAID per player per match throughout the entire tournament (4). During a FIFA Futsal World Cup the players from two entire teams were all prescribed the same NSAID by their team physician before every game (5). Physician prescribed figures might underestimate NSAID use as this does not include any self administered medication by the players themselves (4). Data from domestic leagues is scare. In