Are Muscle Creams Worth It?

Death of N.Y. Athlete Puts Spotlight on Products That Trainers Shun

Mike Spooner smelled the distinctive aroma of muscle creams such as Bengay and Icy Hot whenever he set foot on a track. The scent, he said, was nearly everywhere -- and even more noticeable at indoor track and field meets -- as the products were used by nearly every competitor, including himself.

Spooner, an All-Met distance runner who recently completed his senior season at West Springfield High, is one of several Washington area track and field athletes who say using the wintergreen-scented liniments to treat muscle soreness is prevalent among their peers, despite the fact that team trainers do not recommend the products. Now, muscle creams have drawn attention because toxicology tests revealed last week that the April death of a 17-year-old in New York was caused by overusing such rubs.

"Anyone educated [in athletic training] in the last 25 years doesn't advise kids to use that stuff," said Jon Almquist, athletic training specialist for Fairfax County Public Schools. "The demand is due to marketing. That's the only reason why [athletic] trainers even have it."

Arielle Newman, who ran for Notre Dame Academy in Staten Island, was found dead at her home on April 3. Toxicology tests showed that her blood contained lethal amounts of methyl salicylate, an active ingredient commonly found in products such as Bengay and Icy Hot. The New York medical examiner's office reported Newman had used "topical medication to an excess," causing salicylate poisoning over time.

Alice Newman, Arielle's mother, said her daughter used different muscle creams -- often borrowed from teammates -- in between races at track meets. The coaches and athletic trainers on Arielle's team did not advise her daughter to use muscle creams, Alice Newman said.

"I asked her if she used [muscle creams] at practice, and she said no, because they don't run as fast at practice," Alice Newman said in a telephone interview. "I didn't smell it in the house. I didn't smell it on her clothes."

Despite the medical examiner's report, Alice Newman said that her daughter "wasn't using any more than the recommended" dosage.

Physicians contacted for this article said they had not heard of any other cases of salicylate poisonings connected with muscle creams.

In January, Newman's high school coach told her mother that she was not recovering from races as quickly as she had before. Shortly thereafter, Alice Newman took her daughter to the doctor, and she was prescribed two inhalers used to treat asthma patients. The inhalers did not improve Arielle's condition, Alice Newman said, and the doctors could not pinpoint any other medical problems. Medical examiners said the prescribed medications did not contribute to Arielle's death, Alice Newman said.

West Springfield's Spooner said he used muscle creams rarely, only to help soothe a tweak in his legs that was going to be a constant annoyance.

"I used it to keep my mind off that and on the race itself," Spooner said. "It may be more of a mental thing. It's not advised, and it probably only half works."

Tynita Butts, a rising junior track athlete at T.C. Williams, said she uses Bengay occasionally to treat muscle cramps. "We don't use it on a daily basis, just if our muscles are really tight. We do our warmups with all our [warmup] clothes on. It does the same thing."

The marketing appeal of muscle creams is one of the few reasons the products still are popular today, Almquist said. He said they provide little more than a placebo effect for their users.

"The chemical [in the rubs] is just an irritant to get the skin warm," Almquist said. "It doesn't do a whole lot physiologically. Physical rubbing [a muscle] is going to cause the most change."

Adults and people with darker skin complexion are at less risk, said Bernard Griesemer, a member of the American Academy of Pediatrics Council on Sports Medicine and Fitness. He said young people with sensitive skin who apply a lot of muscle cream in one application (or lesser amounts in more frequent applications) are more likely to incur problems. Newman was white.

"If you add anything to the equation, such as dehydration, high sweat rate or a fair complexion, you can get into trouble," Griesemer said.

Since young athletes are prone to both dehydration and high sweat rates, the vulnerability to salicylate poisoning will always be present if muscle creams are in use, he said.

"It's not as much of a sports issue as it is a lack of knowledge by the public on how to evaluate and how to use over-the-counter drugs and medication," said Sam Seemes, the chief executive of the U.S. Track & Field Coaches Association. "The manufacturer doesn't know the complete circumstances in which the product is being used. We, as a public, tend to push those limits."

Johnson & Johnson, which makes Bengay, released the following statement after Newman's death: "We feel it is important to remind consumers of the importance of reading the label on this and all over-the-counter medicines to ensure safe and proper use."

Alice Newman believes the labeling and directions on muscle creams need to be changed. Newman said she would like muscle creams to become prescribed medications.

Seemes, meantime, said he doubts that Newman's death will cause much change in the way muscle creams are used.

"If there is a car crash, people will slow down to look," Seemes said. "But if the traffic is clear up ahead, then they'll probably speed on up to whatever they were going before."