Recovery 101: Intense recovery for intense activities

Orthology Union Square physical therapists Rachel Hey-Shipton and Elizabeth Melvin volunteered at the New York City Marathon this fall. Dustin Macolor, another Orthology Union Square physical therapist was a marathon finisher!

As the fall race season wraps up and preparation, training and, finally, the finish line is now behind you, it’s time to take a close look at your recovery. 

Whether you’ve crossed a marathon finish line, trekked across a mountain, or completed another challenge altogether, recovery is every bit as important as the preparation and training that got you to the starting line in the first place.

Understanding what’s going on in your body can help you understand the different aspects of a successful recovery. In this week’s blog, running expert Rachel Hey-Shipton, physical therapist at Orthology Union Square, outlines what happens during a marathon, which more than one million runners completed in 2018, and how you can plan a successful recovery afterward.

What’s happening during the race?

First, the immediate effects. You’ve been exercising and sweating for hours. You’re likely to experience dehydration and electrolyte imbalance as a result, which can cause muscle cramps and fatigue. Exercise-associated muscle cramps are one of the most common complaints we see at Orthology following a marathon, and can be extremely painful.

In the first day or so following a marathon, Delayed Onset Muscle Soreness (DOMS) sets in. While this soreness is normal, DOMS can cause pain, swelling and decreased muscle strength and impact your range of motion. It’s particularly prevalent in eccentric exercise such as downhill running.

A number of other conditions can stick with you in the days or even weeks following your race. Muscle breakdown and damage, though most prevalent in the first three days following a marathon, is still present the week after, and can be a major cause of soreness. Inflammation markers can be found in runners for days afterward, which can lead to sustained fatigue. 

Illness and injury are more likely to hit and stick with you after a race, too. After more than 50,000 steps, strain or injury just becomes more likely. As for sickness, your immunity and risk for infection can be impacted up to two weeks following your race.

Recovery 101

Clearly, running a marathon is more than just crossing the finish line. It’s important to recognize that your recovery period can last for weeks. 

The first step for any recovery is straightforward. Rest! Give yourself permission to take some time off.

Second, refuel. You’ve depleted your glycogen stores, burned an immense amount of calories and sweated out water and salts. Carbohydrates are your best bet for replenishing glycogen immediately after your run and throughout the rest of the day. Sports drinks (or pretzels or bouillon cubes often available at the finish line) are good options for replenishing your sodium level—which in turn supports good hydration and can alleviate some muscle cramps. In the days following a run, make sure you’re eating enough and focusing on balanced meals.

Proper rest and nutrition in the weeks following a race will also help support your immunity, which is a significant factor in getting back to doing the activities you love. 

Take a soak. An epsom salt bath can serve a dual purpose; A good soak is soothing, and the magnesium from epsom salts absorbed into the skin can help ease muscle cramps. Don’t have a bathtub? Try massaging magnesium oil into your sore muscles. 

Light massage in general, two or three days following your marathon can help alleviate soreness, but be sure to steer away from deep tissue or other more aggressive forms of massage. 

There’s some evidence that wearing compression socks during the first two days following a race can help stave off soreness and support functional improvement

Staying active with walks and gentle bending and straightening of your lower body joints can keep cramps at bay. Resting from running can—and should—include active movement, not just lying on the couch all day. After a week or two, your body might be ready for light running, but keep in mind that it varies based on your individual training, experience, and recovery. Listen to your body, and stop if it doesn’t feel right. 

Musculoskeletal injuries are common after the prolonged intensity of a marathon, and you’re at an even higher risk if you didn’t include cross training throughout your race preparation. Know when it’s time to bring in an expert. If you’re experiencing significant pain while resting or during certain movements, or you’re not able to walk more than a few steps, talk to your physical therapist, chiropractor or other physician.