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[[Delayed Onset Muscle Soreness]] (DOMS) generally occurs between 24 and 72 hours after unusual or severe exercise, especially eccentric exercise like downhill running. NSAIDS have been shown to increase the pain of DOMS, though they may delay its onset<ref name="DomsNsaids"/>, and NSAIDS may also impair healing from DOMS<ref name="um"/>.
=NSAIDs and Intestinal Damage=
As little as one hour of intense cycling can result in indications of small intestinal damage<ref name="van Wijck-2011"/>. This is believed to be due to the redirection of blood away from the digestive system and towards the active muscles. These markers are significantly higher if 400mg ibuprofen is taken before the exercise<ref name="VAN Wijck-2012"/>. The marker used is Plasma Intestinal Fatty Acid Binding Protein which is an early marker of intestinal necrosis<ref name="Vermeulen Windsant-2012"/>.
[[File:Ibuprofen and GI damage.jpg|none|thumb|500px|The level of a marker of intestinal damage during and after 60 minutes of cycling at 70% [[VO2max|V̇O<sub>2</sub>max]].]]
<ref name="VAN Wijck-2012"> {{Cite journal | last1 = VAN Wijck | first1 = K. | last2 = Lenaerts | first2 = K. | last3 = VAN Bijnen | first3 = AA. | last4 = Boonen | first4 = B. | last5 = VAN Loon | first5 = LJ. | last6 = Dejong | first6 = CH. | last7 = Buurman | first7 = WA. | title = Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes. | journal = Med Sci Sports Exerc | volume = 44 | issue = 12 | pages = 2257-62 | month = Dec | year = 2012 | doi = 10.1249/MSS.0b013e318265dd3d | PMID = 22776871 }}</ref>
<ref name="van Wijck-2011"> {{Cite journal | last1 = van Wijck | first1 = K. | last2 = Lenaerts | first2 = K. | last3 = van Loon | first3 = LJ. | last4 = Peters | first4 = WH. | last5 = Buurman | first5 = WA. | last6 = Dejong | first6 = CH. | title = Exercise-induced splanchnic hypoperfusion results in gut dysfunction in healthy men. | journal = PLoS One | volume = 6 | issue = 7 | pages = e22366 | month = | year = 2011 | doi = 10.1371/journal.pone.0022366 | PMID = 21811592 }}</ref>
<ref name="Vermeulen Windsant-2012"> {{Cite journal | last1 = Vermeulen Windsant | first1 = IC. | last2 = Hellenthal | first2 = FA. | last3 = Derikx | first3 = JP. | last4 = Prins | first4 = MH. | last5 = Buurman | first5 = WA. | last6 = Jacobs | first6 = MJ. | last7 = Schurink | first7 = GW. | title = Circulating intestinal fatty acid-binding protein as an early marker of intestinal necrosis after aortic surgery: a prospective observational cohort study. | journal = Ann Surg | volume = 255 | issue = 4 | pages = 796-803 | month = Apr | year = 2012 | doi = 10.1097/SLA.0b013e31824b1e16 | PMID = 22367448 }}</ref>
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