An expert guide to recovering from a marathon


Ashley Wilson, a sports rehabilitation physiotherapist at Isokinetic London, lays out the most effective strategies for recovering from a long-distance run

The London Marathon is a major event within the sporting calendar, drawing participants from a variety of backgrounds, including thousands who have never previously attempted anything quite so physically demanding. For them, the glory of crossing the finishing line is soon met with the realities of the physical response to that extreme distance. This leads to an important question: what is the best way to recover? To answer, let’s forget about the fancy equipment and focus on what is easily accessible.

Sleep is probably the most important element of recovery. Poor sleep quality after long-distance exercise may result in a reduction of cognitive function, fluctuations in mood, alterations in inflammatory markers and a rise in the perception of pain. Sleep deprivation may be more prominent given that athletes often have difficulty optimising sleep prior to important competitions, which adds to the potential for greater fatigue post-competition. Some helpful tips on optimising sleep include:

— Keep your bedroom cool, dark and quiet
— Avoid using screens prior to sleep
— Avoid over-hydration too close to sleep
— Begin sleep routines approximately 30 minutes before bedtime
— Utilise relaxation and breathing techniques

Ashley Wilson of Isokinetic London

Ashley Wilson of Isokinetic London

Runners will often perform a significant ‘carb loading’ phase in the lead up to the race, to allow for adequate storage of fuel to complete the event. Some runners may have trained with a low carbohydrate diet and utilised fat-rich foods as their primary fuel source, and in these conditions a high carbohydrate diet post-run may not be required. But for most runners, it is necessary to increase the intake of high carbohydrate and protein-rich foods post-race to restore depleted fuel sources and aid repair. Appropriate rehydration is also important to minimise the potential for increased fatigue. Weigh yourself before and after the race and expect to replenish 1.25-1.5 litres of fluid for every 1kg lost in body weight. Sodium-rich foods may also aid rehydration as part of the post-race diet.

Static stretching is often a go-to technique as part of the traditional ‘warm down’ after exercise, despite there being limited evidence of it having a positive effect on physiological and psychological response after exhausting bouts of exercises. Often, the increasing stiffness felt after a marathon gives runners the sense that they need to sustain long periods of static stretching, and giving in to this urge doesn’t appear to have any detrimental effects on subsequent performance, but if you wish to stretch, you should consider a mix between static and dynamic stretches and keep within tolerable levels of discomfort.

As a strategy that has been utilised over many centuries, massage has the potential for improving perceived recovery. This psychological benefit is also met with some research that suggests that, when combined with the utilisation of compressive garments, massage may have the potential to reduce soreness and increase subsequent physical exercise performance. The perception of recovery it offers may be a powerful tool for many runners after the marathon, given that for so many it will be their first big competition. Utilising self-massage devices such as a massage gun or foam roller are likely to be less effective on recovery but may be useful in reducing joint-related discomfort or stiffness.

Active recovery
Now this may seem like an impossible task for some, but moderate levels of aerobic exercise can be useful in removing metabolites after a marathon. Examples may include aquatic-based exercise or cycling, where continuous exercise is performed to help restore normal muscle function. To generate the largest gain, the best timing for active recovery is in the immediate aftermath of the exercise (within 10-20 minutes). Evidence in favour of active recovery hours or days after the event is limited.

Pain relief
Often, an unfortunate consequence of a long event like the marathon is the potential for post-race pain. In less fortunate circumstances, a runner may experience an injury, in which case they should seek medical attention to determine its severity and set a course of management. More often, though, the pain is just the presence of delayed onset muscle soreness (DOMS) which typically lasts for 24-72 hours but may last for as long as a week in the inexperience marathon runner. One of the main strategies for managing post-race soreness is the application of ice. Ice gives a strong perception of pain reduction, although this is limited to the short term. When applying ice to muscles, an ideal strategy would be to utilise cryotherapy-type equipment, where all or part of the body is contained within a chamber or compressive iced sleeve. Additionally, a TENS device presents a good option for the relief of joint-related discomfort. The reduction in pain will allow for a faster restoration of function and thus improve general wellbeing, but pain-relieving strategies are often short lived and should be used in combination with the other strategies above.

The good news is that the best strategies for recovery remain the most inexpensive options, namely sleep and nutrition. Other strategies, such as cryotherapy, massage, compression garments and TENS, may provide some aid, particularly for those runners who have chronically high training loads and are most affected by pain and fatigue post-race, but they should be seen rather as adjuncts as opposed to primary methods.