Effectively recovering from a Marathon

Following our “Shoulder injuries in swimmers” blog, we were once again asked to write some guest content for INCUS performance. INCUS is a wearable tech company who manufacture smart devices for swimmers and runners to monitor their performance economy. This time they asked INVICTA to write some content related to recovering from a marathon. Below is the full content of the blog. If you’re a runner this is a MUST READ!

What happens to the body in the 48 hours after a marathon?

Prolonged endurance running like marathon events can have a profound physiological and neurological effect on the body. Mechanically, you’ll have exercise induced muscle damage and structural microtrauma to connective tissues due to the repetitive nature of loading over a sustained period. Metabolically, this is going to lead to secondary pro-inflammatory responses and oxidative stressors especially within the lower limbs including the muscles and fascia but also the tendons and bones. For example, stress responses can be seen within the Achilles tendon for 72 hours post endurance events even without a pain response.

Naturally, markers of motor output and cognitive function are reduced, and blood markers of muscle damage and perceived soreness are elevated post event, peaking for most at 24 hours post. Your body will start the process of homeostasis (restoring equilibrium) over the subsequent 48 hours post event, with most markers returning to near baseline at 72-96 hours post.

How long would you recommend people rest completely after their marathon and why?

It really depends on the athletes training history, physical qualities, and competition goals. The recovery and management of an amateur running their first marathon compared to a seasoned professional completing consecutive long-distance events is a complete contrast. But there’s also a difference between complete rest and active recovery.

Active recovery methods post marathon have better outcomes in recovery compared to complete rest. But this active recovery should come in the form of non-running activities. If an amateur runner completes their first marathon (day 0), days +1 to 3 should comprise of active recovery to accommodate the resolution of mechanical and metabolic strains acquired during the marathon. As these deleterious effects begin to resolve from days +4 onwards, a runner may think about returning to running in a low volume, low intensity fashion. Target your next event and periodise training to gradually return back to the loading demands of the next competition.

What are the things people should not do after a marathon that could hinder their recovery?

There are four mistakes I see people do that would hinder recovery post marathon.

1. Hydration – a lack of intent to restore the volume of fluids lost with a few too many celebratory alcoholic beverages the night after. Alcohol is a diuretic and pro-inflammatory, combine that with poor water consumption and you are creating a really poor internal environment for recovery.

2. Poor Diet – too much convenience / cheat food and not enough food quality and mineral density. Obviously, it’s important to celebrate your achievements but think about balancing the scale with some good food and drink choices.

3. Poor Sleep – sleep is a primary pillar of recovery. Make sure you get enough sleep post event which might equate to a little more than your typical 8 hours but ensure this is of good quality. Smart watches and sleep apps can be helpful for this. Don’t be afraid to nap in the day if you have the luxury!

4. Returning to training – most people return to running too quickly post event and don’t schedule some time “off-feet” and a planned reintroduction back to the loads you were once running. Work closely with a running coach or trainer to periodise your return to training.

What sort of foods should people eat after running a marathon and why?

When it comes to nutrition there are three primary pillars: food quality, mineral density, and hydration.

Food quality in the form of fresh – organic produce with a balance of macronutrients; complex carbohydrates to restore glycogen stores; essential proteins for muscle repair and regeneration; healthy fats for neurological and cellular function – all of which act to restore energy balance.

Mineral density in the form of the colour and vibrancy of your food selection and the methods in which you prepare the meal. The majority of vitamins and minerals in your diet will come from fruit and vegetables but rather than a stereotypical “5-a-day” regime, opt to “eat the rainbow” with the five colours of phytonutrients (Greens, Blues/Purples, Reds, Yellow/Oranges, Whites). Add as many varieties of colours from natural food products to each meal as you can to receive a range of vitamins and minerals found in each group, e.g., handful of berries to your porridge, splash of cherry tomatoes and spinach to the bolognaise etc. Try and consume these foods in as much of their natural form as possible without overcooking and or frying with too many additional cooking agents – this literally abolishes the mineral density of the food. Good mineral density will aid your body’s ability to recover and will ensure you are not immunosuppressed post event, reducing the likelihood of cold/flu type symptoms.

Hydration – see below.

What should people drink after running a marathon and why?

Put simply…water! Isotonic drinks (e.g. Lucozade Sport, Powerade) have their place post event to begin to restore your blood sugar levels and electrolytes lost in metabolism but they should not be your primary fluid. One of these drinks serves benefit but the majority of fluid consumed should be water which is a staple to prevent further dehydration.

A good method to monitor and replace the fluids lost during a marathon would be to bring a portable weighing scale with you to the event. Pre-event, weigh-in on a flat even surface and record your weight. Post-event, repeat the weigh-out under the same conditions. The difference in weight loss pre and post is primarily water loss through perspiration. If you are 2 kilograms down in weight post event, look to restore that deficit by drinking 2 litres of water over the next few hours. The colour of your urine also serves as a quick reference guide to hydration levels, the darker the more dehydrated, aim for a clear sample.

What sort of training would you recommend post-marathon?

Days +1 to 3 post event should have the primary focus on respecting your bodies attempts to gain homeostasis, promote anti-inflammatory pathways and repairing microtrauma in the tissues. We know that complete rest is not as effective as active recovery for remedying the factors.

From an active recovery perspective, low impact activities like swimming or cycles can promote recovery but in low intensity/low volume fashions – try to accumulate 10 – 20 minutes of active recovery in each of the three days post event, your heart rate should be elevated but not to the point you are unable to maintain a conversation whilst exercising.

Movement based strategies in the gym are also a great active recovery option. For the lower body this should include movements with body weight or very low loads, focussing on moving through a full joint range of motion with slow tempo. Tissue prep work such as foam rolling and using trigger balls to ease muscle tone and stiffness can be a great preparatory adjunct to this.

Day +4 onwards post event, you might think about going on a low mileage, low speed recovery run. Interval techniques such as run – walk at a 1:1 work to rest ratio can be a good option to reintroduce you back to running and can be performed easily on a treadmill e.g., slow jog for 1 minute, walk for 1 minute for 20 minutes of moving time.

Can INVICTA help you?

Invicta Health and Performance is a physiotherapy clinic in Cheshire with practice locations in Sandbach and Holmes Chapel. We see many runners post event for treatment modalities that assist recovery from marathons. We also help patient’s pre-event through strength and conditioning to ensure they are robust enough for the demands of long-distance running. If you are a runner and need a physio in Sandbach or a physio in Holmes Chapel, then “Be Better” with Invicta and get in touch today.

Photo by Pietro Rampazzo on Unsplash