You likely saw the article in the New York Times or at the very least heard about the fallout from its findings but here at the TriDoc Podcast we have a real scoop! An interview with a member of the team involved in the study that fueled the headlines. She happens to be a triathlete and proud, longtime supporter of the podcast.

Table of Contents

• Is there any science to support the use of arnica …

• Stephanie VanBebber untangles a recent study on ru …

• Episode takeaways:

  • References used for the MMB

Is there any science to support the use of arnica to relieve delayed onset muscle soreness? (DOMS)

On the Medical Mailbag, we looked at the science behind Arnica as a topical remedy.

Arnica montana is a homeopathic remedy derived from a plant in the daisy family, used topically though scientific evidence supporting its effectiveness is limited. According to the FDA and the LiverTox database, Arnica is considered unsafe for oral use and for application to broken skin due to potential toxicity and absorption risks. Side effects include skin reactions such as rash or urticaria when applied topically. Several studies have examined Arnica's effects on delayed-onset muscle soreness (DOMS), with mixed results. A 2005 study by Plezbert and Burke found no significant benefit of Arnica over placebo in reducing muscle soreness or improving muscle function. Similarly, Adkison et al. (2010) reported that topical Arnica increased muscle pain at 24 hours post-exercise and had no effect thereafter. In contrast, Pumpa et al. (2014) found a small reduction in self-reported pain at 72 hours with topical Arnica but no changes in performance or muscle damage markers. A 2022 study by Bartolomei et al. reported that a mud pack containing Arnica and menthol reduced pain and improved strength recovery, though the combined treatment makes it difficult to isolate Arnica’s specific effects. Overall, the clinical evidence for Arnica’s effectiveness in treating muscle soreness is inconsistent and limited, and the potential for side effects—particularly with oral use—raises safety concerns. In sum, our conclusion is to pass on this plant based product.

Stephanie VanBebber untangles a recent study on running and colon cancer. Should we be concerned?

About Steph according to Steph: Stephanie Van Bebber, MSc., CCRP received her BA (Economics) from Queen's University in Kingston, Canada and her MSc (Health Economics) from the University of Toronto. She has spent her career studying cancer - developing, implementing, and analyzing studies that have looked at prevention, screening, diagnosis, treatment, and survivorship. In her current role as Sr. Director at the Inova Schar Cancer Institute, Stephanie leads the clinical research team and program within the largest health system in Northern Virginia.  Working with world renowned clinicians, Stephanie is instrumental in program building - selecting, implementing, and managing projects and teams in order to offer research opportunities for patients and their families.  Stephanie's personal experience with her own husband's brain cancer and his death in 2021 give her a personal "why" for her career and also led her to find sport, in particular triathlon, as an critical outlet.  In her time outside of work, Stephanie is an endurance athlete and coach. She has qualified and competed in multiple World Championships at the Olympic and 70.3 distance, holds 2 National Championship titles in long course aquabike, and is a Virginia State champion hill climber. Her coaching is primarily, though not exclusively, focused on local athletes who receive in-person race sims and local race specific coaching in addition to 1:1 training plans. Stephanie and her son live in Northern Virginia.

Running is life, right? Well, we might need to rethink that mantra with some recent findings on ultra running and colorectal cancer. In this episode, we dug into a study that’s got the running community buzzing (and not in a good way). It turns out that three young ultra runners, all diagnosed with advanced colorectal cancer, have triggered a flurry of questions about whether the sport might carry some unexpected risks. Stephanie Van Bebber joined us to break down the findings and discuss how these revelations have implications that reach far beyond the running community. Could those long training runs be doing more than just building endurance? Are we inadvertently inviting health issues into our lives with every mile?

While it’s tempting to jump to conclusions, Stephanie reminded us that correlation doesn’t equal causation. Sure, we can run for hours, but does that mean we need to start worrying about our guts? As the study suggests, some ultra runners may exhibit higher rates of precancerous adenomas, but that doesn’t mean we all should hang up our running shoes. Instead, let’s use this as a learning opportunity. If you’re an endurance athlete, this episode is a must-listen. We chatted about the importance of screening, the need to listen to your body, and how we can learn from these findings without letting fear dictate our love for the sport.

Episode takeaways:

• Arnica offers no benefits to athletes experiencing muscle soreness (DOMS)

• Early screening for colorectal cancer can save lives, so don’t put it off!

• Ultra runners might face a higher risk of colorectal issues, but more research is needed.

• Blood in your stool is not normal, even for runners; get it checked out ASAP!

• If you’re over 45 and running, make sure to get screened regularly—your gut will thank you!

References used for the MMB

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Arnica Montana. [Updated 2023 Mar 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589897/

• Arnica is a homeopathic remedy derived from a plant in the daisy family. Can be used topically or taken orally, though scientific evidence for its effectiveness is limited in both cases.

• The FDA classifies Arnica as unsafe, warning against oral use and application to broken skin due to potential toxicity and absorption risks.

• Side effects include gastrointestinal issues when taken orally and skin reactions (e.g., rash, urticaria) when applied topically, often outweighing any claimed benefits.

Plezbert, J. A., & Burke, J. R. (2005). Effects of the homeopathic remedy arnica on attenuating symptoms of exercise-induced muscle soreness. Journal of chiropractic medicine, 4(3), 152–161. https://doi.org/10.1016/S0899-https://docs.google.com/document/d/13HrSiYmSyS4_6yta5FKmXAiKGSurMC8NNDJ3FVgAuKU/edit?usp=sharing3467(07)60124-4

• DOMS induced via arm exercises (n=20). Randomized, double-blind design compared soreness and other metrics in Arnica to placebo condition after 96 hours.

• Arnica showed no significant effect compared to placebo in reducing muscle soreness, improving muscle function, or limiting biochemical markers of muscle damage.

Pumpa, K. L., Fallon, K. E., Bensoussan, A., & Papalia, S. (2014). The effects of topical Arnica on performance, pain and muscle damage after intense eccentric exercise. European journal of sport science, 14(3), 294–300. https://doi.org/10.1080/17461391.2013.829126

• DOMS induced via a downhill running protocol (n=20, all well-trained and male). Double blind design compared pain/soreness and performance in Arnica to placebo condition after topical application immediately post-exercise and every 4 waking hours for 5 days.

• Arnica reduced self-reported muscle pain at 72 hours post-exercise but had no effect on performance or blood markers of inflammation and muscle damage.

Adkison, J. D., Bauer, D. W., & Chang, T. (2010). The effect of topical arnica on muscle pain. The Annals of pharmacotherapy, 44(10), 1579–1584. https://doi.org/10.1345/aph.1P071

• DOMS induced via calf-raise exercises (n=53). Randomized, double-blind design compared pain/soreness in Arnica to placebo condition after topical application immediately post-exercise after 24, 48, and 72 hours. 

• Arnica increased self-reported muscle pain at 24 hours post-exercise but had no effect after 48 and 72 hours. No effect on mobility, which was also rated by participants.

Bartolomei, S., Nigro, F., D'Amico, A., Cortesi, M., & Di Michele, R. (2022). Mud Pack With Menthol and Arnica Montana Accelerates Recovery Following a High-Volume Resistance Training Session for Lower Body in Trained Men. Journal of strength and conditioning research, 36(7), 1909–1915. https://doi.org/10.1519/JSC.0000000000003751

• DOMS induced via high-volume lower-body workout (n=10, all well-trained and male). Randomized crossover design compared pain/soreness in Arnica (administered via a mud pack containing menthol and Arnica montana) to placebo condition after 4 applications post-exercise (t=0 mins, 15 mins, 24 hrs, and 48 hrs).

• The arnica group described decreased muscle pain and had a faster recovery of isokinetic strength at slow speed. 

Not a subscriber to the podcast? Click here!

Support the podcast: TriDoc Podcast Patreon site

Need an endurance coach? TriDoc Coaching