Pulled muscle treatment for those on ... - British Heart Fou...

British Heart Foundation

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Pulled muscle treatment for those on multiple heart meds.

Heartattackvictim profile image

Does anyone have any experience of treating a very bad pulled muscle through sport - shoulder in my case from golf - and is on a cocktail of heart meds. In my case aspirin, tricagelor, Ramipril, Felodopine, atorovastatin.

I've spoken to my pharmacist: I can't use heat treatment or ibuprofen or gels containing ibuprofen. I'm off to see the physio tomorrow (privately); so any experience anyone share or can point out any resources for me (I've looked to little effect!) would be gratefully accepted. Thanks, John

35 Replies

Speak to your GP, I was told it was ok on GP advice for short term use and was prescribed Piroxicam.

Thanks, will do on my next re-order of heart drugs via the (excellent) Patient Access app.

Qualipop profile image
Qualipop in reply to Gaz_chops

I also use piroxicam, sometimes called feldene gel. Is there a local private physio you could see?

I pulled one of my calves earlier in the year with about 9 weeks to recover (and finish training) for the Anglesey half marathon.

I can take ibuprofen, which helped with the first day or two, but from a lot of (I barely dare say it given recent trends) own research - including actual research papers - boosting protein intake really did seem to help.

If you think, it does make sense seeing as we need the stuff to build & maintain muscle in normal ife, so making sure there's enough when repair's needed is sensible. So swallowed my pride & bought a pack of supplement for a daily evening top-up.

Managed to get from "can't walk on it" to "careful gym work" in about 5 days and was (very gently) jogging on it within 10 days. By 4 weeks it was pretty much back to normal.

Thanks for the reply Thatwasunexpected . Food for thought.

Hi there, I’m a qualified sports massage therapist and in your case would really recommend using ice packs to reduce inflammation. The use of ice is so underrated and in my opinion works just as well as ibuprofen . Ice at regular intervals from injury for at least 48 hours then start some gentle stretching exercises. Physio will help with exercises. Good luck and hope you will be back playing golf very quickly.

Thanks Sparkies, I have used heat (seed) bags and ice packs in tandem in the past and will search out the ice packs again.

I have severe rheumatoid arthritis and received the same advice about ibuprofen etc. I looked into it and contacted my cardiologist and rheumatologist and after some discussion discovered that the systemic dosage from ibuprofen and naproxen gels is so small as to be insignificant. They both said that this is a fairly typical modern overuse of the precautionary principle. They also both said that the problem with NSAIDs comes with long term use and is probably related to fluid retention.

GrannyE profile image
GrannyE in reply to Mentdent

That is very encouraging. Thanks for that info. I too use gels with ibruprofen 10% in them in extremis. Not very often of course. The only painkiller my GP recommends for me is panadol and if really necessary paracodol and again I take those extremely rarely.

Thanks @GrannyE

Ah thanks Mentdent my pharmacist said I could ask my Dr about ibuprofen but she said it would probably be a small dose and for a limited time too.

Voltarol contains diclofenac. I would have thought that topical use of it would be OK

Thanks, richard_jw I'll certainly check this out.

Hi - I had a recent calf injury after a run and found that heat treatment infra red lamp, stretching and rest for 10 days cleared it good luck

Thanks Misstibbs I was wondering whether you did this on medical advice?

No just decades of running and injuries!

I ended up at the physio, privately, last year to get my shoulders sorted after weren't right following OHS.I can't take ibuprofen orally but OK in a gel but I'm only on warfarin.

Hope you get it sorted soon!


Thanks andy110519

I always use a hot water bottle. Laying it on the affected area. I do this over several days. Works for me.

I told the pharmacist I had used a heated seed bag. And she said not to use it again. I suppose that's why those with a heart condition aren't allowed to use a sauna too?

Better not let them know about me then. Shhhhh

No one will ever know 🤣...

I sometimes use a gel called Biofreeze - don’t know if that’s ok with your meds?

Thanks, Jocastina I have used it in the past (pre- heart attacks). I'll check it out.

Hi, am I being ignorant but don’t understand why on earth wouldn’t we be able to use a heated seed bag or hot water bottle for aches and pains 😟

I know @Calmisgood that's why I put the question out there. I'm going to double check with her because when I used it I felt ok. I'm just back from physio and had some immediate relief and when I told her what the pharmacist said she was bemused, but maybe her knowledge of the drugs cocktail was beyond her scope of knowledge? I'm booked on for two more sessions of physio: deep massage and some ultra-sound.

It’s good you put the question out there, hope you get relief soon with physio 🙂

Thanks Calmisgood - had a physio session this morning which brought immediate, if small, improvement in shoulder mobility after some deep tissue massage and ultra sound.

Physio wasn't aware of the issue related to using heat packs/wheat bags but she didn't seem totally au fait with all the meds I'm on (understandably).

Got two more sessions booked in for next week.

Spoke to BHF nurse about heat packs - a different answer to that of the pharmacist... Will ask the Dr.

I've been using heat packs and tried the opposite with the cooling gel on my shoulder. Also been seeing a pysio who has been gently massaging the area and the area has felt lots better. She gave me light exercise with a thera band.

I use ibuprofen with problem whatsoever & Im on the usual heart meds.

Thanks Glynnw That's interesting because the pharmacist was adamant that I'd need to speak to the Dr before she could issue it and said it would be low dose for a very limited time too. I've checked the ibuprofen leaflet and it seems to be a no-no for those on heart meds. Gosh, it's tricky but I do tend to bow to experts. Trouble/challenge is they don't always all agree!

It seems ibuprofen can raise BP and block the effect of aspirin if taking it.My BP is low anyway & Im not on asprin so maybe that's why it doesn't affect me

That seems to make sense (in your case);thanks Glynnw

Hi, I never ever take Ibuprofen after it raised my blood pressure through the roof a few years ago. I had very bad earache at the time. I have paroxysmal AFib discovered since that time and by dragging a runaway neighbour’s dog from the busy street had a rotator cuff impingement to my shoulder, absolute agony esp at night. I couldn’t take any of the NSAIDs because of being on anticoagulant Edoxaban. I used codeine and even Tramadol until eventually after physio and mindfulness training and months of lost sleep I was given an injection. A miracle! 6 minutes in the shoulder surgeon’s consulting room and hey presto! That was in 2017 and no pain since. I had also used heat packs, TENS machine, Voltarol gel and magnesium spray. Good luck with that shoulder. I do sympathise.

Thanks Peileen - good to hear you came through the other side! I'm certainly feeling the benefit of today's physio.

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