Hospital for Special Surgery physical therapist offers marathon recovery tips

Close to 47,000 runners have spent the past several months training for the ING New York City Marathon. Once they have completed the race and achieved their goals, there are measures they can take to facilitate recovery, decrease post-race discomfort, and return to running without injury.

Eating immediately after the marathon, icing sore muscles, and having a gentle massage are only a few of the tips that Michael Silverman, PT, MSPT, physical therapist from the Rehabilitation Department at Hospital for Special Surgery in New York, offers runners who cross the finish line.

"Marathoners have to pay close attention to their bodies so they don't injure themselves," says Silverman." Training should have provided runners with a good idea of how their body works. Runners should take everything they've learned in that time and apply it to taking proper care of their body after the marathon—they will feel better, faster."

The following are marathon recovery tips from Silverman on ways to bounce back from a marathon:

•Replenish. Immediately after the race, you are given an ING New York City Marathon Recovery Bag presented by Hospital for Special Surgery containing foods and fluids. While you are waiting around, being ushered out of the park, consume the entire bag. This will immediately replenish salt, and add some quick carbohydrates and nutrients.

•Rehydrate. After months of training a lot of runners just want to party when they finish the race. That is fine, but be smart about it. Hydrating is very important. If you consume alcohol it will only further dehydrate you. Making a smart ratio, 2:1, or 3:1 glasses of water per alcoholic beverage will help you from causing harm.

•Rejuvenate. Sitting down after all of those hours of running is a shock to the body. As much as you want to just sit down after the race, it's important to keep moving!

•Eating the day after is just as important. Try to stay away from enormous meals. Eat small amounts of nutrient-rich foods every 2 hours. Good meals could be steak, sweet potatoes and broccoli. Berries, chocolate or yogurt parfaits are good desserts. Chicken stir fry with loads of vegetables is an excellent lunch.

•Ice your muscles often. If you are having severe muscle pain during the race, immediately go to the medical tent to ice your muscles. After returning home from the
race, ice your muscles with ice packs or (preferably) an ice bath. Ice baths soothe microscopic muscle damage and inflammation. Sit in a 54-60-degree (Fahrenheit) ice bath for 6-12 minutes. 30-60 minutes afterward, take a warm shower.

•Stretch correctly after the race. After finishing the race, walk for 10-15 minutes and perform very light stretching. During the next day, perform light stretching and a light warm-up (biking or a warm shower).

•Get a massage a few days after the race. Use caution during the first 48 hours after the race, as your muscles are very sensitive. If you get a massage, schedule it for a few days after the race. Make sure it is a flushing (light) massage and be sure the therapist knows that you just ran a marathon.

•Perform low-impact, low-intensity exercise after the race. Only start exercising when you are feeling ready. This can take up to a month. Cycling, the elliptical, and exercises in the pool (swimming, underwater running) are ideal.

•Wait 5-7 days after the race before running again. Begin with decreased intensity on soft surfaces and don't run more than 25 percent of your peak weekly mileage. A good rule of thumb is: perform one week of reduced intensity training for every hour.

"Feeling sore after a marathon is normal; but pain and swelling are the body's ways of indicating that something is wrong," says Brian Halpern, M.D., a primary care sports medicine physician at Hospital for Special Surgery and author of Men's Health Best Sports Medicine Handbook. "The best way to handle almost every sports injury is the RICE method, which stands for Rest, Ice, Compression and Elevation."