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Steamtown Marathon Recovery

Dr. Mackarey's Health & Exercise ForumCongratulations to the close to more than 2,000 runners who finished the 23rd Annual Steamtown Marathon yesterday. Most, if not all of you, are waking up this morning with a little less jump in your step than you had yesterday.

Runners, by nature, are very active (often hyperactive) people who may have difficulty sitting and resting, even the day after a marathon. However, today should be a day of rest…you earned it! It is not wise to ignore the pain and stiffness in your muscles and joints. Therefore, I would like to offer some words of wisdom, based on science, to encourage you to adequately rest and allow your body to recover.

REST AND RECOVERY…RESPECT THE DAMAGE TO YOUR BODY:

The Effects of Running 26.2 Miles on the Body:
(RunNow.com – Jim Peskett)

Muscle-Skeletal System:

One of the most obvious effects of running a marathon is significant muscle and joint pain and stiffness. It will set in after you sit for a while and attempt to get up and move around. For most, it will be more pronounced the day after the marathon, as you get out of bed and limp to the bathroom. Studies show that the leg muscles, (especially the calf muscles) display significant inflammation and necrosis (dead tissue) in the fibers of the muscle. In other words, the trauma to the muscles is so severe that tissue damage causes muscle cells to die. Consequently, studies found that muscle strength, power and endurance is compromised and required significant time to recover… sometimes as long as 4-6 weeks!

Additionally, many runners report severe bone and joint pain following the race. Some studies report findings of microfractures or bone bruising from the repeated and prolonged pounding of the marathon. It is purported that the stress on the joints may be related to: weight and body type, running shoes, running style and mechanics. While not dangerous, again, it is important to respect the stress placed on the body and allow adequate healing…LISTEN TO YOUR BODY!

Cellular Damage:

Creatine kinase is an enzyme found in the brain, skeletal muscles and heart. It is found in elevated levels in the presence of cellular damage to these tissues, for example, following a heart attack. Similarly, significantly elevated creatine kinase levels are found in the blood of runners up to 4 days post marathon, demonstrating extensive tissue damage at the cellular level. It is important to note, that these enzyme markers are present, even if a runner does not experience muscle soreness. So, adequate rest for healing and recovery is required, regardless of soreness.

Immune System:

It is not a coincidence that the runners are more likely to contract colds and flu after intensive training or running 26.2 miles. The immune system is severely compromised after a marathon and without adequate recovery; a runner can become ill and ultimately lose more training time or will underperform.

TEN TIPS TO SPEED UP YOUR RECOVERY

(www.runnersworld.com)

1. WALK
Once you cross the finish line, keep walking…for 10-15 minutes after the race to gradually lower your heart rate and prevent a buildup of lactic acid in your traumatized muscles.

2. EAT AND DRINK
Eat small snacks in the first hour after the race and avoid a big meal for later in the day and drink 24 oz. of water for every 2 pounds of weight loss after the race.

3. RELAX
If there was ever a time to enjoy a good movie or television show, it is after the marathon. Just get up and walk around every 20- 30 minutes.

4. ELEVATE YOUR LEGS
While relaxing, elevating your legs is a good idea to improve circulation. If your traveling by car or plane for longer than one hour, wear compression socks while you elevate.

5. ROLL AND MASSAGE
Wait approximately three hours after the race before you roll out and massage your muscles. Make sure you hydrate first.

6. STRETCH
Also wait 3 hours to gently stretch your tight muscles. Be gentle because the muscles are already traumatized.

7. DO NOT RUN
The research clearly states that running too soon will slow down full recovery. Many elite runners like Paula Radcliffe take one month off after the marathon and do yoga and cross-train.

8. WEEK ONE POST-RACE
No running. Do yoga, swim, walk, etc.

9. WEEK TWO POST-RACE
If you no longer have pain, continue cross-training and gradually introduce light, soft running for 30 to 60 minutes.

10. WEEK THREE POST-RACE
Gradually increase the time, distance and speed if you are pain free.

3 MYTHS THAT PREVENT REST AND RECOVERY IN RUNNERS:

1. If I don’t have pain, then I did not damage my body and I can run again soon after the marathon.

FALSE: As stated above, enzyme levels that indicate cellular damage to the tissues are present in the post-marathon runner, even in those without significant pain.

2. Energy drinks with caffeine are the best way to reenergize my body and speed up my recovery.

FALSE: In addition to rest, drink, drink, drink – 24 ounces of water for every 2 pounds you lose after the marathon. This is based on pre and post exercise weight. You just burned 2,600 calories so avoid diet soft drinks. You need the glucose (sugar) boost. Also, don’t drink alcohol and use minimal amounts of caffeine (the equivalent of 1-2 cups of coffee). First, drink plenty of water and sports drinks (Gatorade) to prevent a diuretic like caffeine from messing up your fluid balance.

3. If I don’t run, I will lose all of my conditioning in one week.

FALSE: Studies clearly show that the VO2 Max, (the best measurement of a runner’s endurance and fitness), is unchanged after one week of inactivity. And, after two weeks, the loss is less than 6% and can be regained quickly. Moreover, it is important to remember, without adequate rest and recovery, performance is comprised, not by the loss of VO2 Max, but by muscle-skeletal tissue damage, which renders the leg muscles of the runner weaker.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.