Sunday, December 30, 2012

Goal Completion for Triathletes, Thanks From Dr. Post


Thanks to you, the readers, from this author.

First, I want to thank all of you who:
                                                           A) Sent me positive feedback on my piece on Ironman.com during Ironman Championship week in Kona, "What's in a Wristband?" I very much agree that it captures the feeling, the wonder, the absolute joy you experience as you exit the King Kam Hotel, or any IM race registration really, with this new jewelry on your wrist.  (www.ironman.com search wrist band)


                                                          
                                                            B) read my From the Pier posts on Ironman.com during Hawaii Ironman week.  I've received a good deal of positive feedback from that and hope to be privileged to contribute further to Ironman.com in 2013.

                                                            C) followed me on Twitter. To go from nowhere, zero followers, to over 700 followers in just a couple months makes me want to redouble my efforts.
 for 2013.
                                                             D) took the time out of your busy lives to read this blog.  I'm at almost 12,000 hits per month and growing steadily thanks to you.  Who says a blog can't be fun?


Ironman support from your kids.  Can anything be better? Nope.

Below is a piece by motivational speaker Jim Rohn.  It's particularly well suited to the triathlete as he/she is planning the upcoming year.
__________________________________________________________________

What goals did you set at the start of this year? Have you accomplished them? Personal development legend Jim Rohn says it's ok if you haven't yet achieved your goals. The more important question to ask is if you've started.

“The real value in setting goals is not in their achievement. The acquisition of the things you want is strictly secondary. The major reason for setting goals is to compel you to become the person it takes to achieve them,” Rohn says. Say you want to be a millionaire. The greatest value to becoming one is actually not the million dollars. (Seriously!) “The greatest value is in the skills, knowledge, discipline and leadership qualities you’ll develop in reaching that elevated status,” Rohn says.

"Answer this question: What kind of person will you have to become to get all you want?

Write down the kinds of skills you’ll need to develop and the knowledge you’ll need to gain. Your answers might give you some new goals for your personal development. Work on your goals. Your ability will grow to match your dreams. This is the magic of goal setting. The more you work on your goals, the more new opportunities will present themselves to you,” Rohn says.
You can make big changes in your life. “You can make startling changes you can’t even conceive of right now, if you just give yourself half a chance.”

Sounds good doesn't it?

____________________________________________________________________

I think as triathletes, this is what we do as we prepare for the upcoming season.

Here's wishing you racing and training success, hopefully smart and injury free, in 2013.

Hope you never see the inside of this tent in 2013

Goal Setting 2013, Thanks To The Readers

Thanks to you, the readers, from this author.



First, I want to thank all of you who:

                                                           A) Sent me positive feedback on my piece on Ironman.com during Ironman Championship week in Kona, "What's in a Wristband?" I very much agree that it captures the feeling, the wonder, the absolute joy you experience as you exit the King Kam Hotel, or any IM race registration really, with this new jewelry on your wrist.  (www.ironman.com search wrist band)







                                                             B) read my From the Pier posts on Ironman.com during Hawaii Ironman week.  I've received a good deal of positive feedback from that and hope to be privileged to contribute further to Ironman.com in 2013.

                                                             C) followed me on Twitter. To go from nowhere, zero followers, to over 700 followers in just a couple months makes me want to redouble my efforts for 2013.                                        

                                                             D) took the time out of your busy lives to read this blog.  I'm at almost 12,000 hits per month and growing steadily thanks to you.  Who says a blog can't be fun?


















Ironman support from your kids.  Can anything be better? Nope.


 Below is a piece by motivational speaker Jim Rohn.  It's particularly well suited to the triathlete as he/she is planning the upcoming year.

__________________________________________________________________

 What goals did you set at the start of this year? Have you accomplished them? Personal development legend Jim Rohn says it's ok if you haven't yet achieved your goals. The more important question to ask is if you've started.

 “The real value in setting goals is not in their achievement. The acquisition of the things you want is strictly secondary. The major reason for setting goals is to compel you to become the person it takes to achieve them,” Rohn says. Say you want to be a millionaire. The greatest value to becoming one is actually not the million dollars. (Seriously!) “The greatest value is in the skills, knowledge, discipline and leadership qualities you’ll develop in reaching that elevated status,” Rohn says.

"Answer this question: What kind of person will you have to become to get all you want?

Write down the kinds of skills you’ll need to develop and the knowledge you’ll need to gain. Your answers might give you some new goals for your personal development. Work on your goals. Your ability will grow to match your dreams. This is the magic of goal setting. The more you work on your goals, the more new opportunities will present themselves to you,” Rohn says.

You can make big changes in your life. “You can make startling changes you can’t even conceive of right now, if you just give yourself half a chance.”

 Sounds good doesn't it?

 ____________________________________________________________________

 I think as triathletes, this is what we do as we prepare for the upcoming season.

 Here's wishing you racing and training success, hopefully smart and injury free, in 2013.
















Hope you never see the inside of this tent in 2013



Sunday, December 23, 2012

Transitions - How To Be the Fastest - It's Easy

"Oh yeah, life goes on, long after the thrill of living is gone."
                                                                             John Mellencamp

Speedy Transitions begin well before you set up in one.

This may be short on words since I had right elbow surgery Wednesday (and am typing left handed)  but the content will be great.


In a recent blog, I mentioned that the ability to be the fastest in your age group at transitioning is simply a matter of learning and practice. I very strongly believe this.  It's not hard to accomplish. This will be where the learning part is, and the practice will be your homework. I used to be terrible at this part of triathlon but was encouraged by my coach, for 4 weeks before my first race of the season, to spend at least an hour per week working out the details of the many recommendations on how to cut transition times.  I had to find the ones that worked best for me. Most things you read/hear are pretty good but it's up to you to separate the wheat from the chaff.

I set up a transition area in my driveway and am long past wondering if my neighbors think I'm nuts walking around the front yard in my wet suit.  And, I'm no longer concerned when they watch my only semi successful attempts at the "flying squirrel" bike mount and inevitable subsequent moan or profanity.*

But I got better. A lot better! And after any local tri, I look as intently at the T1 and T2 splits as all the other numbers.  And you know what?  I almost always have the fastest transition splits in my age group (now if I could just push those pedals a little faster.)  It's only a matter of time until you do too!  I'm just certain of it.
___________________________________________

This first video is a good start at swim to bike.

http://www.youtube.com/watch?v=rKWHELY0qxw

And now a couple minutes of bike to run.

http://www.youtube.com/watch?v=Ya6HxuE_x58


And the Big Enchilada, the one that made me the transitioner I am today.

http://www.youtube.com/watch?v=brHcsqKM_mo

* The "flying squirell" flying bike mount has been, well, discarded.

Monday, December 17, 2012

Hyponatremia (Low Sodium) in Triathlon


"Water, water, everywhere nor any drop to drink."
                                                                                 Rime of the Ancient Mariner




Exertional Hyponatremia

For the last twenty-five or so years we’ve been aware of a condition known as E.A.H., E.H., or

Exercise Associated Hyponatremia.  It's now generally known as Exertional Hyponatremia.  Briefly it’s a condition associated with endurance athletic racing be it triathlons, marathons and even longer events where the body's sodium level is diluted to such a degree that sufferers can seize and die.  Although it’s occurrence  is incompletely understood, the primary common factor is fluid intake before, during, and after racing be they water or sports drinks.  That's correct, sports drinks as well.  Some athletes, women more than men for some reason, can be predisposed to the development of severe, even life threatening hyponatremia.  Several recent deaths in endurance sports have been attributed to EH, interestingly two in doctors.

In short, while it's difficult to drink too little, you can definitely drink too much.  In other words, everything you learned growing up about drink, drink, drink, drink at poolside, drink at every aid station, is probably incorrect to some degree. 

It wasn’t that long ago that we were taught to “tank up,” To begin fluid loading the night before your event (which, if you’re a Masters male racer may lead to more frequent nocturnal tips to the facilities, less sleep, and possibly a poorer performance.)  How often have you read that we should sip from our water bottles frequently the hour or so before race start and have a big pee just before the gun?  You were good to go, no pun intended, like a sponge that held absolutely as much fluid as possible.

Some athletes consume so much fluid that they actually gain weight before or even during the event.  In the early days of Ironman, when the event was still held on Oahu, race inventor John Collins would actually weigh competitors at race start and at points during the competition.  Perhaps an increase in competitor weight would have been picked up in 1978-79.  Even though athletes heading toward hyponatremia perspire, compared to their fluid intake, their fluid losses cannot keep up with the intake.  Their serum sodium decreases to a dangerous, potentially fatal level, as the racer may experience fluid in their lungs, fluid on the brain, and even convulse and die.
 
Symptoms seem to overlap with symptoms of dehydration to a degree: decreased urine output, nausea and/or vomiting, a bloated feeling, headache confusing race medical personnel who would encourage further oral fluids or intravenous fluids.  This would, of course, be the opposite of what's needed and the situation would worsen.
 
Remember this.  Just because you feel well as you cross the finish line, the cessation of exercise can aid the sudden absorption the the water in your stomach further lowering serum sodium.  Something to remain vigilant for in the early post-race period. 
 
I've seen data presented where about 10% of marathoners and 18% of iron distance triathletes have this to some degree.  Yes, 18% of iron distance athletes where obviously most survive...but there are some close calls.  Our kidneys can handle about a liter an hour, over that and the sodium balance begins to shift.
 
Risk factors include: excessive drinking during the event, elderly, NSAID consumption (they stimulate anti-diuretic hormone retaining water), low body weight, female, greater than 4 hour competition, and extreme temperatures.  Obviously prevention is the best solution by adequate pre-race salt in the diet, a heat acclimation period, an understanding of this illness by the athlete and medical crew, etc.
 
So if next your work out or race meets the above conditions, just be aware that this could be you...or me...and that an understanding of how to both stay out of trouble and what to do if you might be headed that way are your best bet. 
 
If you'd like to read a little more, Doug Casa, Phd. runs the Korey Stringer Institute at UConn where he and his staff have done a great deal to further our knowledge.  You might start off with this
 
 

Wednesday, December 12, 2012

Being Afraid....Being Injured...You?


"Do the conditions you encounter exceed your abilities?



Although we as triathletes push pretty hard sometimes, we’re rarely outside our comfort zone in other than a physical sense.  I've previously briefly described hiking the John Muir Trail with my son Ben a couple years ago. This was a six day journey through wooded areas, over many creeks and streams, as well as some fairly steep mountain trails culminating in standing atop Mount Whitney, the highest peak in the lower 48, with it’s seeming 100 mile view.

On the third day, our longest, after traversing some pretty difficult to navigate terrain (since we were so early in the season and didn’t have the benefit of hikers before us marking the correct trail), we crossed one particular river and unbeknownst to us, were off the trail. Way off the trail. We tried to back track to a known point, but we were lost. Lost in billions of acres of land…with no GPS…no cell service…no plan “B”, no nothing. The only way out of this was to think our way out. And, yes, we were at least a little afraid (although maybe the bears and mountain lions were a little afraid of us too. Maybe.  Uh, maybe not.)

It’s times like this that occasionally you don’t think terribly rationally. Like during the run in an iron distance race. In the former, although you have a tent and food for a week, you don’t know where you are. And, the in latter, you’ve trained for this for an awfully long time but are rapidly running out of energy and ideas at the same time. You may have to…oh, don’t even think it…walk! And walk a lot.  But for us it was one of those times that, with no other option, no chance for help from any outside source, that with a little luck, you “just do it.” You take the information you do have, think the problem through such as you might have done in a college course, and you’ll likely find your way back to the trail. With great relief I might add.

Injuries to the triathlete can follow a similar path. One can have a physical problem, seek help from a friend, an internet forum or local medical professional. It's position where you're no longer in control and for some be down right scary!  But in the end, you know vastly more about your recent athletic experience than any physician. This would include the specific training load your body has seen including any overload situations, one of the most common sources of injury in my experience.  And with just a little help from the medical community pointing you in the right direction, you and your care giver can frequently come up with the right diagnosis. Like being lost in the woods, you think the problem through. And from this diagnosis, like the route though the woods, the route back to your training normalcy is revealed like the yellow brick road.
 
So, next time you find yourself injured, think it through. Use your available resources, especially your own brain, and sometimes you’ll surprise yourself. I’ve seen it happen.

Good luck.

Sunday, December 9, 2012

Ibuprofen: Not For Daily Use!



"I'd take any risk to tie back the hands of time." 
                                                                                Too Much Time On My Hands, Styx

"Prophylactic" or daily use of Ibuprofen by triathletes is not without risk.

Why am I the last one to find out about things? Why didn't I know that in some circles upwards of half of the endurance athletic community takes ibuprofen nearly every day? I did a podcast recently where this was one of the items we discussed as some triathletes, known in marketing circles as early adopters, seek to diminish post exercise muscle soreness with this drug.  A review of the literature will not consistently support the position that exercise induced muscle soreness is indeed reduced with NSAID therapy (nor that it's desirable.)  Conversely, it's been determined that these medications may actually hinder the act of muscle regeneration - read this as muscle repair.  And the logic behind NSAID administration so that the athlete can race through a serious injury makes no sense to this physician.
However, if you have an injury, and feel that an NSAID like ibuprofen or Aleve is appropriate, follow the package directions and have at it as part of your injury care regimen. Otherwise, when taken pre-workout, ibuprofen can have negative influences on one's gastrointestinal system.  You already know that with exercise comes a shunting of blood from the intestinal tract to the exercising muscles.  The combination of exercise and ibuprofen can lead to a leaking of the cells which line the colon.  A study quoted by the New York Times highlighted the work  of Dr. Kim van Wijik who also noted, "More immediately, if less graphically, the absorption could be compromised, especially after exercise, which could affect the ability of tired muscles to resupply themselves with fuel and regenerate."

When used for maximum effectiveness, and minimizing the potential for adverse effects, according to the Alliance for Rational Use of NSAIDs, "...the lowest effective dose for the shortest period of time to achieve therapeutic effect." 
So if you take the time to review this situation, you'll agree with Dr. van Wijik when you read that it's clear that, "ibuprofen consumption by athletes is not harmless and should be strongly discouraged."



Ibuprofen. Not for Daily Use.

"I'd take any risk to tie back the hands of time." 


                                                                                Too Much Time On My Hands, Styx


 "Prophylactic" or daily use of Ibuprofen by triathletes is not without risk. 




Why am I the last one to find out about things? Why didn't I know that in some circles upwards of half of the endurance athletic community takes ibuprofen nearly every day? I did a podcast recently where this was one of the items we discussed as some triathletes, known in marketing circles as early adopters, seek to diminish post exercise muscle soreness with this drug.  A review of the literature will not consistently support the position that exercise induced muscle soreness is indeed reduced with NSAID therapy (nor that it's desirable.)  Conversely, it's been determined that these medications may actually hinder the act of muscle regeneration - read this as muscle repair.  And the logic behind NSAID administration so that the athlete can race through a serious injury makes no sense to this physician.




However, if you have an injury, and feel that an NSAID like ibuprofen or Aleve is appropriate, follow the package directions and have at it as part of your injury care regimen. Otherwise, when taken pre-workout, ibuprofen can have negative influences on one's gastrointestinal system.  You already know that with exercise comes a shunting of blood from the intestinal tract to the exercising muscles.  The combination of exercise and ibuprofen can lead to a leaking of the cells which line the colon.  A study quoted by the New York Times highlighted the work  of Dr. Kim van Wijik who also noted, "More immediately, if less graphically, the absorption could be compromised, especially after exercise, which could affect the ability of tired muscles to resupply themselves with fuel and regenerate."


 When used for maximum effectiveness, and minimizing the potential for adverse effects, according to the Alliance for Rational Use of NSAIDs, "...the lowest effective dose for the shortest period of time to achieve therapeutic effect." 




So if you take the time to review this situation, you'll agree with Dr. van Wijik when you read that it's clear that, "ibuprofen consumption by athletes is not harmless and should be strongly discouraged."







Tuesday, December 4, 2012

When Do You Say, "I've Had Enough Triathlon" and Retire?

"Eckhardt, think about the future!"   Jack Nicholson, The Joker, Batman













 One of Nicholson's best lines in the film Batman!  But then, to one degree or another, don't we all think about the future?  Some more of us than others?

 There comes a time when we need to move on.  Triathlon becomes a less significant factor in life, less of a priority, and training becomes more an obligation than a challenge.  That early morning swim is a burden, not an opportunity to work on a race limiter.

________________________________________

 The sword of time will piece our skin,

It doesn't hurt when it begins,

But as it works its way on in,

The pain grows stronger, watch it grin.    

                                                   Suicide is Painless, Johnny Mandel. M*A*S*H, the movie

_______________________________________

 I know a number of people who were in triathlon for a short while and out.  On to something else.  It was a fling, an accomplishment, but not a lifestyle.  They didn't own a power meter, never found out the answer to a question on Slowtwitch. They weren't certain of the date of the World Championship in Hawaii. (It is in Honolulu, right?)  In fact, they had more on their plates than triathlon. Work, family, hobbies, other passions, etc. were all part of the game and while important, tri didn't take front and center stage.

 Not so for the woman I met on Friday,16 hours before race start in Kona this year. This was bike check in, on the pier, for what would be her 40th, that's right, fortieth IM distance race.  I'm no Psychiatrist but in discussing the importance of triathlon in her life, the word addiction would have to enter the conversation somewhere.

 But eventually, the luster grows dull and we want to, or have to in many cases secondary to chronic or recurrent injury, pass the torch.  And you know what, it's OK.  It really is.

 "Cal" is one of the best triathletes in our area.  Like a fool, I let him talk me into a workout at the pool a couple years ago, something different he said, just for fun (Cal's kind of fun obviously.) We'd swim 100 y, jump out on to the pool deck and do ten push ups, and be back in our lane to push off for the next 100.  Can we do it on 2:00? Yes.   Can we do it 1:50? Yes, Cal we can.  I think we needed a funeral home consult after that work out.

 But, Cal's life has gotten more complex lately as his kids have gotten older and entered wrestling, travel wrestling, Cal's moved away from tri despite having the ability to run a half IM sub 4:30 in the very competitive 45-49 year old age group.  (I'm certain that some of you read this as discarding a gift that you, or I for that matter, will never have.  I feel your pain!) In short, your day will come, and when it does, it'll be just fine.  Honestly. I saw that day a while back, and it's just fine.
















The race is run, how did you fair?




_________________________________________________________________________



What's in a name?  Quicker Ankle sprain recovery.

 I had an athlete asking me about taking a drug called Voltaren, recently shown in gel form to significantly improve swelling and function following an ankle sprain ("At day 5, treatment satisfaction was "good" to "excellent" in almost 90% of "Voltaren" group but only "good" or "very good" in 23% of placebo patients.*"



But many people know this drug by a different name.  Many different names as a matter of fact. All one needs is to follow this drug to Wikipedia to get some idea of the scope of this issue.  Below are the "other" names of this single medication:

TRADE NAMES


Trade names include:




  • Aclonac Emulsi Gel

  • A-fenac (Bangladesh)

  • Neofenac (Bangladesh)

  • Anuva

  • Abitren

  • Acteric (Costa Rica)

  • Arthrotec (combination with misoprostol)

  • Artifen (Pakistan Abbott Laboratories LTD)

  • Befol

  • Berifen

  • Betaren

  • Bufenac Forte

  • Cambia

  • Cataflam

  • Catafast

  • Caflam (Pakistan)

  • Clafen

  • Clofast

  • Clonac

  • Dedolor

  • Deflamat

  • Deflox

  • Diclac

  • Diclo M (India & Myanmar) V.I.P Pharma

  • Dicloberl

  • Diclobene

  • Diclo-Denk (Germany)

  • Diclofenac

  • Diclofenac-Asteria (USA and Korea)

  • Diclofenaco Normon (Spain)

  • Diclofenacum

  • Dicloflam (South Africa)

  • Dicloflex

  • Diclogem

  • Diclogesic (Jordan and Romania)

  • Diclohexal

  • Diclomex (Finland)

  • Dicloran (Malaysia)

  • Diclowin Plus (India)

  • Diclon

  • Diclopar (Tanzania)

  • Diclotab (Laos)

  • Diklofenak T Actavis (Sweden)

  • Difen

  • Difenac (Venezuela)

  • Difene

  • Dinac (Nepal)

  • Dioxaflex (Latin America, Central America)

  • Disflam K (diclofenac potassium, Central America)

  • Dolex

  • Dolphin (Egypt)

  • Dolmina (Czech Republic)

  • Dyloject

  • Feloran

  • Fenac (diclofenac potassium, Australia)

  • Flamrase

  • Flector Patch

  • Flogozan (Mexico)

  • Idinac (India)

  • Immunagel (India)

  • Kemoren (Indonesia)

  • Klodifen

  • Modifenac

  • Morbidic (India)

  • Motifene

  • Naklofen

  • Neopyrazon (United Laboratories, ASIA)

  • Oflam

  • Olfen

  • Ortofen

  • Phlogin - Diclofenac Sodium (Pakistan)

  • Panamor

  • Parazone-DP (combination of Paracetamol & Diclofenac Potassium)

  • Pennsaid

  • Pritaren

  • Rapidus

  • Rapten-K

  • Reactin (India)

  • Rhumalgan

  • Rofenac (Middle East)

  • Rufenal

  • Safeguard (combination with misoprostol)

  • Sandoz (diclofenac sodium, Australia)

  • Solaraze

  • Seradic (India)

  • Topac

  • Trabona

  • Tratul (Austria, Romania, Moldova)

  • Uno

  • Veltex CR (South Africa)

  • Vetagesic

  • Voldic

  • Volini (India)

  • Volfenac (Thailand)

  • Voltaflam (India)

  • Voltaren (Argentina, Australia, Turkey)

  • Voltaren Emulgel (Australia, Canada)

  • Voltarol

  • Voltarol Emulgel

  • Voltarol Pain-eze

  • Voltfast

  • Voren (Taiwan)

  • Voltral (UK, Pakistan)

  • Votrex

  • Vostar

  • Votalin (China)

  • Voveran

  • Vurdon

  • Zipsor

  • Zolterol


 *Unfortunately, the study was from Germany using a strength not available universally.


Sunday, December 2, 2012

When Do You Say, "I've Had Enough Triathlon" and Retire?

"Eckhardt, think about the future!"   Jack Nicholson, The Joker, Batman



One of Nicholson's best lines in the film Batman!  But then, to one degree or another, don't we all think about the future?  Some more of us than others?

There comes a time when we need to move on.  Triathlon becomes a less significant factor in life, less of a priority, and training becomes more an obligation than a challenge.  That early morning swim is a burden, not an opportunity to work on a race limiter.
________________________________________

The sword of time will piece our skin,
It doesn't hurt when it begins,
But as it works its way on in,
The pain grows stronger, watch it grin.    
                                                   Suicide is Painless, Johnny Mandel. M*A*S*H, the movie
_______________________________________

I know a number of people who were in triathlon for a short while and out.  On to something else.  It was a fling, an accomplishment, but not a lifestyle.  They didn't own a power meter, never found out the answer to a question on Slowtwitch. They weren't certain of the date of the World Championship in Hawaii. (It is in Honolulu, right?)  In fact, they had more on their plates than triathlon. Work, family, hobbies, other passions, etc. were all part of the game and while important, tri didn't take front and center stage.

Not so for the woman I met on Friday,16 hours before race start in Kona this year. This was bike check in, on the pier, for what would be her 40th, that's right, fortieth IM distance race.  I'm no Psychiatrist but in discussing the importance of triathlon in her life, the word addiction would have to enter the conversation somewhere.

But eventually, the luster grows dull and we want to, or have to in many cases secondary to chronic or recurrent injury, pass the torch.  And you know what, it's OK.  It really is.

"Cal" is one of the best triathletes in our area.  Like a fool, I let him talk me into a workout at the pool a couple years ago, something different he said, just for fun (Cal's kind of fun obviously.) We'd swim 100 y, jump out on to the pool deck and do ten push ups, and be back in our lane to push off for the next 100.  Can we do it on 2:00? Yes.   Can we do it 1:50? Yes, Cal we can.  I think we needed a funeral home consult after that work out.

But, Cal's life has gotten more complex lately as his kids have gotten older and entered wrestling, travel wrestling, Cal's moved away from tri despite having the ability to run a half IM sub 4:30 in the very competitive 45-49 year old age group.  (I'm certain that some of you read this as discarding a gift that you, or I for that matter, will never have.  I feel your pain!) In short, your day will come, and when it does, it'll be just fine.  Honestly. I saw that day a while back, and it's just fine.

The race is run, how did you fair?

_________________________________________________________________________
What's in a name?  Quicker Ankle sprain recovery.

I had an athlete asking me about taking a drug called Voltaren, recently shown in gel form to significantly improve swelling and function following an ankle sprain ("At day 5, treatment satisfaction was "good" to "excellent" in almost 90% of "Voltaren" group but only "good" or "very good" in 23% of placebo patients.*"

But many people know this drug by a different name.  Many different names as a matter of fact. All one needs is to follow this drug to Wikipedia to get some idea of the scope of this issue.  Below are the "other" names of this single medication:


Trade names

Trade names include:
  • Aclonac Emulsi Gel
  • A-fenac (Bangladesh)
  • Neofenac (Bangladesh)
  • Anuva
  • Abitren
  • Acteric (Costa Rica)
  • Arthrotec (combination with misoprostol)
  • Artifen (Pakistan Abbott Laboratories LTD)
  • Befol
  • Berifen
  • Betaren
  • Bufenac Forte
  • Cambia
  • Cataflam
  • Catafast
  • Caflam (Pakistan)
  • Clafen
  • Clofast
  • Clonac
  • Dedolor
  • Deflamat
  • Deflox
  • Diclac
  • Diclo M (India & Myanmar) V.I.P Pharma
  • Dicloberl
  • Diclobene
  • Diclo-Denk (Germany)
  • Diclofenac
  • Diclofenac-Asteria (USA and Korea)
  • Diclofenaco Normon (Spain)
  • Diclofenacum
  • Dicloflam (South Africa)
  • Dicloflex
  • Diclogem
  • Diclogesic (Jordan and Romania)
  • Diclohexal
  • Diclomex (Finland)
  • Dicloran (Malaysia)
  • Diclowin Plus (India)
  • Diclon
  • Diclopar (Tanzania)
  • Diclotab (Laos)
  • Diklofenak T Actavis (Sweden)
  • Difen
  • Difenac (Venezuela)
  • Difene
  • Dinac (Nepal)
  • Dioxaflex (Latin America, Central America)
  • Disflam K (diclofenac potassium, Central America)
  • Dolex
  • Dolphin (Egypt)
  • Dolmina (Czech Republic)
  • Dyloject
  • Feloran
  • Fenac (diclofenac potassium, Australia)
  • Flamrase
  • Flector Patch
  • Flogozan (Mexico)
  • Idinac (India)
  • Immunagel (India)
  • Kemoren (Indonesia)
  • Klodifen
  • Modifenac
  • Morbidic (India)
  • Motifene
  • Naklofen
  • Neopyrazon (United Laboratories, ASIA)
  • Oflam
  • Olfen
  • Ortofen
  • Phlogin - Diclofenac Sodium (Pakistan)
  • Panamor
  • Parazone-DP (combination of Paracetamol & Diclofenac Potassium)
  • Pennsaid
  • Pritaren
  • Rapidus
  • Rapten-K
  • Reactin (India)
  • Rhumalgan
  • Rofenac (Middle East)
  • Rufenal
  • Safeguard (combination with misoprostol)
  • Sandoz (diclofenac sodium, Australia)
  • Solaraze
  • Seradic (India)
  • Topac
  • Trabona
  • Tratul (Austria, Romania, Moldova)
  • Uno
  • Veltex CR (South Africa)
  • Vetagesic
  • Voldic
  • Volini (India)
  • Volfenac (Thailand)
  • Voltaflam (India)
  • Voltaren (Argentina, Australia, Turkey)
  • Voltaren Emulgel (Australia, Canada)
  • Voltarol
  • Voltarol Emulgel
  • Voltarol Pain-eze
  • Voltfast
  • Voren (Taiwan)
  • Voltral (UK, Pakistan)
  • Votrex
  • Vostar
  • Votalin (China)
  • Voveran
  • Vurdon
  • Zipsor
  • Zolterol

*Unfortunately, the study was from Germany using a strength not available universally.