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Marathon Recovery and Physical Therapy
by ACE Physical Therapy and Sports Medicine Institute, Arlington, VA


Over 30,000 runners will participate in the race in this weekend’s Marine Corp Marathon.  Training for such a grueling event can take six months or more. Runners focus on finishing the race, but they should also prepare for marathon recovery. The amount of running required for training and completing a race impacts the body dramatically. Proper preparation can reduce the severity of the post-race symptoms.

The entire body is involved when someone runs greater than 26 miles at one time!  The musculoskeletal system takes the biggest beating and some of it can be kept to a minimum with proper training.  Unfortunately, if someone has not trained properly at this time, they would be much better off not running the race.  For those who did take the time and put in the effort to get their bodies ready for the grueling effects of a marathon they can reduce the severity of the symptoms that are sure to occur due to the damage to their musculoskeletal system.  These people might experience some of the common symptoms or all of them depending on their conditioning and race day environment.  Some of the more common injuries or conditions to the musculoskeletal system include strained muscles, tendinitis, muscle damage at the micro level (DOMS), sprains of various joints and compressive reactions to the cumulative pounding that occurs when the foot hits the ground thousands of times during training and running a marathon.

Post-race activity and treatment can help to reduce the severity of the symptoms that can occur after a marathon.  The post-race ritual should begin immediately after crossing the finish line or whenever the runners stops running.  The process of rehabilitating your body following a marathon can be broken into 3 time periods.  Immediately following the race, 1-2 weeks after marathon, and the return to a regular running routine.   

Immediately After Race. Following the race you, should continue to walk and move.  Your legs will feel fatigued and your feet will hurt.  You might have developed blisters and if there was a lot of downhill running your toenails might be a mess.  While these minor injuries will need attention at some point, your immediate concerns include getting warm while re-hydrating and re-fueling your depleted system.  Change into dry clothing and begin drinking water and sports drinks to replenish the electrolytes that you sweated out during the race. You also need to begin to re-fuel your system with carbohydrates and proteins. Eat something easily digestible and possibly in liquid form. Your appetite will be suppressed anyway, so don’t attempt to eat a big meal immediately following the race.

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Week One and Two Post-Race. The first 7-10 days following your race is a critical time for your body to recover.  You will need to curb your desire to exercise aggressively or run. You should stay active, but it must be very low intensity level exercise and preferably cross training and not running. It is not uncommon for elite runners to take up to 2 weeks (or more) off from running following a race.  The body will not become deconditioned in a couple of days following your race if you don’t exercise and run.  The benefit of resting your joints and muscles is far greater than any concern of becoming deconditioned if you take several days off from a regular running routine.

Post-marathon activity is extremely important in preventing long lasting injuries.  The amount of rest that your body will require to fully recover will be surprising to most people.  You will have to respect the fatigue, lethargy, and aches and pains that are present or you might make the situation worse.  This is one time when more exercise is definitely going to be the wrong choice to make. Take it easy for several weeks and “listen” to your body.  You will not lose your conditioning if you take a few weeks off, and your body will greatly benefit and fully recover from the grueling activity marathon race.

Should you suffer an injury during the preparation or actual running of the marathon you should seek the treatment of a Physical Therapist that specializes in orthopaedic/sport rehabilitation.  The therapist can educate you and treat your symptoms, enabling you to return to your desired workout schedule. You can visit the Physical Therapist without a doctor’s prescription, but call your insurance and inquire about the need of a referral from your general practitioner.

Running a marathon is a grueling event that requires a tremendous amount of preparation.  If the preparatory phase is performed correctly, the marathon runner can usually prevent any severe injuries but they will have to maintain a post-race routine prior to their return to a normal running regimen.

Tid Bits of Info.

  • DOMS stands for Delayed Onset Muscle Soreness and is related to swelling of individual muscle cells.
  • Runners who trained by running 30+ miles per week for 4 months averaged approximately 4-hour marathon times.
  • Total Marathon distance: 26 miles and 385 yards or 42.195 Kilometers.
  • Greater than 500 marathons are run each year around the world.
  • If you injure yourself while training for or running a marathon, seek the advice and treatment of a sports/orthopaedic Physical Therapist.

The author, ACE Physical Therapy & Sports Medicine Institute, operates Physical Therapy Clinics in Arlington, Alexandria, Falls Church / Merrifield, Fairfax / FairOaks, Herndon / Reston, Lansdowne / Leesburg, Tysons Corner / Vienna in Northern VA. If it Hurts, See a PT First!

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