How to recover after finishing a marathon

The fall marathon season has arrived. Thousands of athletes – from the fastest to those at the back of the pack – are training to take on the challenge of running 26.2 miles. If you’re one of them, you probably don’t think beyond crossing the finish line. Maybe you should.

The moments after you finish a marathon can be euphoric. But the hours and days that follow can bring a world of pain: your legs will ache, and so will your arms. Walking will be difficult; stairs – even street edges – will seem insurmountable. Your feet – and your toenails – will take a beating.

“For some people, especially novice runners, this is the most painful experience they will ever have in their lives,” says Scott Trappe, director of the Human Performance Laboratory and professor of human bioenergetics at Ball State University. “Recovery is one of the most underutilized aspects of a runner’s toolbox. You have to take it as seriously as your training.”

Running a marathon is a grueling event, especially for beginners. The greatest effect is on the muscles. Running depletes glycogen – the stored form of glucose – the muscles’ main source of energy. The prolonged pounding of legs and feet on the pavement, especially when running downhill, also causes microscopic muscle tears.

Running a marathon puts a strain on the heart, lungs and the body’s thermoregulatory system that regulates internal body temperature.

“The peak function of all of these systems is reduced for hours and at least a few days after you run a marathon,” says Michael J. Joyner, a physiologist and anesthesiologist at the Mayo Clinic in Rochester, Minnesota.

We asked sports medicine experts and some experienced marathon runners to share their tips for a successful recovery:

What’s Best for Pain Relief After a Race?

If you need to take something to relieve pain, do not take an NSAID (non-steroidal anti-inflammatory drug), but stick with acetaminophen, which doesn’t affect inflammation, said experts, who believe inflammation promotes healing.

“There is no doubt that NSAIDs disrupt some of the muscle pathways involved in muscle building, renewal and repair,” Trappe said. “If discomfort after a marathon is significant, use acetaminophen instead of the NSAID.”

“NSAIDs can interfere with the natural healing process,” says John L. Ferrell III, director of sports medicine at Regenerative Orthopedic Sports Medicine, which has several locations in the Washington area. “While they can provide temporary relief, they also carry potential risks, such as gastritis and acute kidney injury.”

What causes pain after the marathon?

For years, a buildup of lactic acid (lactate) – a chemical produced when cells break down carbohydrates – was blamed for post-marathon muscle burn and soreness. It’s also a myth, experts say.

“What you feel in your muscles is the result of pounding, microtrauma and energy depletion,” Trappe said. “Lactate is not the bad molecule everyone thinks it is. Lactate production is actually relatively low when running marathons.”

Lactic acid “probably plays a role in pain, but its role has been exaggerated,” Ferrell said.

Should you take an ice bath or a hot shower?

Some athletes sink into a tub of ice after a rough game or other intense competition. But “the emerging consensus is that warm, not cold, is better,” Joyner said. “Whether this speeds up recovery at the cellular level or just helps people feel better is an open question.”

Ferrell recommends starting with heat “because it increases blood flow,” he said. “You don’t want to suppress the inflammation right away, but once the healing process is underway, you can use ice after a few days.”

Amby Burfoot, who won the 1968 Boston Marathon and is still running it at age 78, heads straight for the hot tub.

“My body is stiff and sore, and the warm water feels very comforting,” he said. “I’m not going to do anything to strain my leg muscles for the next few weeks, so I don’t have to think about ice and anti-inflammatories and things like that.”

Should you run the day after or not?

The fastest runners often do that—their talent, training, and body type allow them to recover quickly—but for the rest of us, it’s probably not a good idea.

“Elite runners have covered many more kilometers and are also lighter,” says Trappe. Moreover, after they train for the pounding movements, the overall trauma for them is not that great, he said.

“They’re not on the job as long,” he said. “They still got beat up, but not as much compared to a four-hour recreational runner. The recovery profile is definitely different.”

Don’t underestimate the healing power of rest. Most runners should take it easy and give their bodies two to four weeks to return to normal, he added.

He and others recommend light “cross-training” activities in the days after a marathon, such as swimming, walking and easy spinning cycling.

“Enjoy your performance and go on a period of active rest, which means a modest level of physical activity and stretching until the kink in your legs returns,” Joyner said.

Burfoot, who has run about 75 marathons (he’s lost count), starts very easy recumbent, spinning and elliptical workouts a few days after the marathon.

“Nothing hard or high resistance,” he said. ‘Maybe in my second week I’ll walk three to four miles a day, then start running in the third week. I used to want to get back to training as soon as possible to get ready for the next starting line. Now my first thought is, ‘I can’t wait to start my two-week layoff.’”

Should you get a massage?

Some studies suggest that massages help, while others say the effects are inconclusive.

“It feels good, if not too aggressive, and can be a nice reward to enjoy, and it certainly has a placebo effect,” Trappe said. “It may be useful, but the verdict is still out from a scientific perspective.”

Does recovery take longer as you get older?

“The older you get, the longer it takes” to recover, Trappe said. “We are also becoming smarter and tend to respect the process more.”

Joan Benoit Samuelson, 67, won the first women’s Olympic marathon in 1984 and ran the Tokyo Marathon in March.

“You can’t run miles and expect to fully recover, whether training for or running a marathon,” she said. “Don’t set high expectations. Cross-train before and after running a marathon. Don’t think you can maintain high-mileage training weeks forever.”

What should you eat after a marathon?

Replenish your exhausted muscles with calories and fluids for the first 72 hours. Trappe recommends healthy eating – complex carbohydrates like fruits and vegetables, and products that are low in saturated fat – but he understands that not everyone will do this because “you want to reward yourself and go out for a pizza and a shake.”

Cheryl Bimler Link, 62, a retired health information technology specialist from Dublin, Ohio, said she quickly forgot about her post-marathon pain after a friend gave her a Bloody Mary in the runner’s tent.

“The tomato juice and salt settled my stomach and I felt great,” she said. “Or maybe it was the vodka.”

Connie Chan, 70, a retired college professor from Orleans, Massachusetts, who has run 33 marathons, said she eats whatever she wants for a few days, “including french fries sandwiches and maybe onion rings” — before returning to a healthy life. diet.

Mary Harada, a retired history professor from Durham, NH warns against binge eating. Decades ago, after her last marathon, she ate an entire frozen cheesecake.

“It was the dumbest thing I’ve ever done after a marathon,” she said.

How can you deal with the disappointment after the marathon?

“Post-marathon blues are real,” Trappe said. “You’ve been focused on this big goal, and now you don’t have that goal anymore.” He suggests planning something big soon afterward, like a vacation, “just to give your mind something else to do.”

Julia Kim, 65, a technology manager from Boston, spends two days swearing: never again, then signs up for a new one.

Burfoot said that these days he feels grateful and never sad after every marathon.

“I appreciate that I was able to reach another marathon finish and grateful that I still have the fitness and strength to complete 26.2 miles,” he said. “And I have high hopes that I can do it again next year.”