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Health & Exercise Forum

Recovery for Marathoners

Oct 13, 2014

Dr. Mackarey's Health & Exercise ForumIf you are among the 2000 runners who finished The 19th Annual Steamtown Marathon Sunday, then you are waking up this morning with a little less jump in your step than you had yesterday. Your should probably know that if you ran a marathon before the 1908 Olympics in London, then you would have run one mile less than you did yesterday. The Royal Family was picnicking at Windsor Castle one mile further than the original for starting place of the race. For fear of insulting Royalty, the starting point was moved to accommodate them. Ironically, several runners collapsed due to unusually hot and humid weather. But, one can’t help but to place partial blame on the Royal Family for lengthening the event. If you are sore today, blame the Royal Family.

I remember quite well the euphoric feeling of finishing my first marathon. That night, however, I was exhausted. So, I went to bed early and looked forward to a fun filled day on Monday, as I took the day off to relax and enjoy my family. To my surprise, I had great difficulty getting out of bed. My feet, knees, hips, and back were very sore and stiff. My toes nails were black and feet blistered. The “recovery – the day after the marathon” was something I was not prepared for. Today, I offer some helpful suggestions to expedite your recovery:



  • Eat foods high in carbohydrates and low in fat.
  • Drink 8-12 oz of water every few hours 1-2 days before the marathon
  • Drink every 1-2 miles (at every water stop) during the marathon.
  • Use a sports drink containing a carbohydrate and sodium.
  • Take 30-60 grams of carbohydrate per hour to delay fatigue and fuel muscle contractions.


  • Drink - 24 ounces of water for every 2 pounds you lose after your workout. This is based on pre and post exercise weight. You just burned 2,600 calories so don’t drink diet soft drinks. You need the glucose (sugar) boost. Also, don’t drink alcohol. If you can’t adhere to this rule, wait several hours to have a beer. First drink plenty of water and Gatorade to prevent the diuretic from messing up your fluid balance.
  • Keep moving – Walk, don’t run immediately after you cross the line. It is important that you continue to move. Coming to a complete stop or collapse does not allow the blood in your muscles to fully circulate back to your heart. Try to walk, stop, stand intermittently for 3-5 minutes.
  • Rest – Take it easy for a few days. Let you muscles/body heal. Go home. Shower and rest in bed for 1-2 hours – even if you can’t sleep. Then, get up to eat and drink again.
  • Elevate – By elevating you legs you allow blood/fluid in you muscles to return to the heart without effort using gravity.
  • Refuel – Drink (water and sports drinks), eat carbs and snack, snack, snack. But, wait 3-4 hours for a full meal.
  • Massage – This can be an effective method of relaxing muscle spasms, cramps and mobilizing fluids from you muscles to your heart after the long run. It should be very comfortable. Wait 45-60 minutes after the race so you have ample time to drink and eat and move around a little. You may find even more benefit from massage 24-48 hours after the race to assist in the recovery of delayed onset muscle soreness from lactic acid build-up in your muscles.


  • DO NOTHING!– for 1 week after the marathon – NOTHING – no running, no long walking, no swimming, no weight training!
  • 4-6 weeks for a complete recovery – even in elite athletes
  • 6-8 weeks before beginning speed work training – even in elite athletes
  • Ease back into running
  • Studies show – even in elite athletes the damage to the body from running a marathon does not allow optimal performance for several weeks. This has been found even when the runner felt fully recovered.
  • Temperature, Humidity, and Intensity of the race significantly effect recovery time.

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:

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 The Commonwealth Medical College.