December 18, 2018
Finishing Your Marathon
A marathon is no simple feat. It requires a significant amount of training, discipline and resolve whether it is your first attempt or you are a season marathoner. For most racers, running is more than just a hobby - it is a way of life. An outlet. So, after finishing a marathon how can you ensure you are back to running as quickly and safely as possible so as to avoid over training and preserve performance.
A Physical Therapist's Approach to Race Recovery
First to understand the rationale and timelines, I’d like to expand on the why. Why do we recommend what we do? What happens to your body after running 26.2 miles and pushing your physical limits?
Muscle soreness and fatigue is a result of microtrauma to the skeletal muscle of your body. The repetitive loading of your tissues, particularly the eccentric variety, causes a natural inflammatory process to occur that can last up to 14 days post marathon. This process leads to the expected soreness, fatigue, stiffness and reduced range of motion. This might sound terrible but this type of inflammation is good! All too often we associate inflammation as a negative, but it is our body’s natural way of healing. Other cellular changes associated with high volume aerobic activity have been studied as well. Multiple studies have shown an increase in production of creatinine kinase and elevated myoglobin levels (markers of skeletal and myocardial tissue damage). These levels can be elevated for up to a week per these studies justifying a slow ramp back up to activities as proposed below:
Week 1: Damage Control
Talking strictly from a musculoskeletal perspective the first few days are a prime time to do "feel good" techniques to promote circulation and reduce soreness. Starting with light stretching and stick/foam rolling progressing with light massage after the first 48-72 hours. By the end of the first week it is appropriate to resume light activities such as a low intensity 2-4 mile run. This is also a time to partake in light cross-training.
Week 2 : Ramping Activities
During the second week the intensity of your activities can be increased slightly. Moderate intensity cross training multiple days during the week can be of benefit to focus on foundational fitness and mobility. Light-intensity jogging for 2-3 days a week for short distances (4-6 miles) are appropriate. Symptomatic response after your activity is key during this phase as prolonged soreness beyond a day or two should indicate the intensity may be a little too much at that time.
Week 3: Returning to Training
Slowly building back up to full training volumes as tolerated. Cross training can still be a valuable adjunct to your traditionally running fitness program at this stage.
The emphasis on cross training post marathon (and beyond) is important to maintain fitness and a well-balanced physical profile. Many forms of exercise can be classified as cross training. Yoga, weight lifting, Pilates and Kinstretch (Join a Kinstretch Class) are great options to build a solid foundation and work on prerequisite mobility and strength for upcoming training. Injuries titrate down to a simple equation. If the load/stress on tissue is greater than the tissue’s capacity then an injury often occurs. If capacity is greater than the stress the chance of injury is mitigated. Cross training can be a valuable adjunct to running to build overall capacity and tissue resilience. These programs can be integral to keeping a runner healthy and competing at a high level.
Mind & Body Recovery
Finally, your muscles and joints have been through a lot but don’t forget to reboot your brain. It is essential for a successful recovery to get 7-8 hours of sleep each night and maintain a balanced diet (enjoy a few holiday treats, you’ve earned them). Simple things like meditation, spending time with family and getting ready to enjoy the holidays can do wonders for mind and spirit.
We hope you enjoy the holidays and are ready to bring on the New Year!
About the Authors
Nick Dobson, PT, DPT, FRCms
Nick holds a doctorate in physical therapy and is a certified Kinstretch instructor. He is the Center Manager at our Lake Highlands outpatient clinic.
Kendall Goldberg, MLA, ATC, LAT
Kendall is a certified athletic trainer and director of our Sports Health division, which provides athletic trainers at sporting events across North Texas. She was also the Medical Director for the 2018 Dallas Marathon.