Marathon Monday: How to recover after running 26.2 miles

Chicago Marathon 2014

About 41,000 runners participated in the Bank of America Chicago Marathon on Sunday. Well-trained or not, most of the field is likely contending with aches, pains and stiffness that can make even the smallest set of stairs feel like mountains.

Whether it’s a runner’s first marathon or their 50th, covering 26.2 miles requires recovery time so the body can heal from the stress and strain that’s produced by hours of pounding pavement. University of Chicago Medicine sports medicine specialist Ryan Hudson, MD, worked in the medical tent at the Chicago Marathon finish line on Sunday and has spent years providing medical support at endurance races. We asked him to answer several questions about marathon recovery and pass along his best tips.

Here’s what he had to say.

UChicagoMed: Why do marathon runners need recovery time?

Ryan Hudson, MD

Ryan Hudson: The big picture is to recover from the emotional and physical stress that’s placed on someone when they’re running. The recovery period is important to allow inflammation to subside and muscles to repair and rebuild and to restore hydration status and have your body replenish energy stores.

I think another part of recovery is getting through something called delayed-onset muscle soreness – DOMS – which strikes a lot of people when they’re doing a major physical task. This is muscle soreness that develops one to three days after the event. We used to think it was due to lactic acid build up, but now we know it’s a part of the side effect of the repair process of microscopic muscle damage.

UCM: While every athlete is different, how long does marathon recovery typically take?

RH: If you ask different people, you’ll probably get a lot of different answers. There’s nothing textbook. My recommendation is one day of rest for every five miles. So I say about a week is a general time to not do any significant exercise.

Muscle soreness tends to last three to five days. You want that to subside before you put your muscles through another big stress.

What are best things runners can do to make sure they’re recovering properly?

I advise small walks for the first few days after a marathon. Cool baths or even ice baths can be helpful for recovery. Sitting in a bath that’s about 50 degrees for 10 minutes might help speed muscle recovery and inflammation reduction. But be careful not to make water too cold or sit in the bath too long. You don’t want to overdo this treatment and cause hypothermia. The other thing is diet. You want to eat lots of lean protein to build up the muscles again, as well as a diet with carbs to build up the carb stores and replenish glycogen, which is present in the muscle and liver.

And lastly, you want to be sure to hydrate so you can wash out the toxins from the muscle use and replenish what you lost from sweating.

What are some of the biggest mistakes people make when they’re in recovery mode?

I think it’s a mistake to take ibuprofen too soon. I tell people to wait 24 hours to take ibuprofen. It can really impact our body’s electrolytes and it can be hard on the kidneys if you’re dehydrated. Acetaminophen, which is generic Tylenol, would be a good alternative for muscle pain.

Meanwhile, massages are great. But I tell people to get gentle massages. The muscles have already been disrupted, so you don’t want to do more damage on top of that.

How do you know when it’s time to get back out there?

As a general rule, I tell people to wait until they’re ready to go back and then give it one extra day to give them a safety margin. That often helps to make sure they’re truly ready to return to running and get back into things.

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