BOSTON, MA. 04/ 15 /13: BOSTON MARATHON at the finish line ( David L Ryan/Globe Staff Photo ) SECTION: SPORTS TOPIC Boston Marathon(1)
BOSTON, MA. 04/ 15 /13: BOSTON MARATHON at the finish line ( David L Ryan/Globe Staff Photo ) SECTION: SPORTS TOPIC Boston Marathon(1)
The Boston Globe

At last year’s Boston Marathon, hundreds of runners didn’t get to cross the finish line. While many people’s lives were horribly disrupted that day, on the most basic level, the runners were denied a proper cool-down after running 26.2 miles that impacted their physical recovery.

Dr. Eric Roseen, a chiropractor and expert in diagnosis and treatment of soft tissues, worked at the medical tent last year. This year, he will be back, helping runners restore their bodies after the 26.2-mile test of endurance at the Dorothy Quincy Suite in the John Hancock Building.

A runner and triathlete himself, Roseen remembers a time after an event when he saw a line at the massage and recovery tent, so he grabbed food and went to dinner, skipping some of the care he knew was good for him. He ended up developing a pain in his hip that took him a month to recover from, so he’s warning runners to learn from his own mistakes and take a cool-down as seriously as your training.

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Running a marathon impacts many parts of your body from your feet to your neck and even your brain. Review these essential steps to recovery that will help you bounce back quickly.

Step One: Walk.

Down the finish line stretch, runners probably won’t have much of a choice but to keep moving into the crowds. Dr. Roseen said walking for 15 or 20 minutes is important to help blood continue to circulate through the body and catch your breath. “A proper cool-down is just as important as a warm-up,” he said.

Allow your body the chance to come back to a regular heart rate, blood pressure, and breathing rhythm. During a marathon, blood pools in the extremities, and needs to return properly to organs in a cool down. Grab your warmth-retention blanket and keep moving.

Step Two: Hydrate.

Marathon runners lose approximately two to three pounds of water weight, which is a healthy amount. Weight gain means a runner is overhydrating. The Boston Athletic Association recommends drinking close to 32 ounces of water to replace what a runner has lost, which is approximately 12 ounces every hour. Dr. Roseen said a cup or two at each hydration station would be too much.

Signs of dehydration include feeling light-headed or dizzy, headaches, dry mouth, thirst, or a rapid heart rate. At any of these signs, it’s important to hydrate again quickly and seek medical attention.

Step Three: Eat something.

After you finally cross that finish line, your body will be crying out for calories. The Boston Marathon finish area guides runners through a few different phases before they can get to the food, though. Dr. Roseen recommends grabbing a banana or chocolate milk immediately after the race once you finally arrive at the food station.

Step Four: Get a massage.

“Stretching is good, but manual therapy stretches, where someone can help you stretch out, or a massage can limit the effects of an overuse injury at the hip, knee, ankle, or lower back,” said Dr. Roseen. “There’s a nice window after you’re finished where you can keep moving and manually work on the tissues so they get fresh blood and a chance to heal.”

Runner’s knee, muscle strains, joint pain, and shin splints are common overuse injuries that can be the most difficult to treat. A combination of stretching, massage, and icing can help to ease inflamed joints after race day. Massage services at the finish are offered before the Boston Marathon at the Hopkinton High School gymnasium and at the Dorothy Quincy Suite in the John Hancock Building.

Step Five: Make dinner plans.

One of the most important parts of recovery is restoring the calories and nutrients burned on the race. Carbohydrates, proteins, and electrolytes are essential components to a post-race meal. Dr. Roseen advises runners make reservations in the North End, or schedule a dinner at a friend’s house. But have a plan. Check out what professional dietitians recommend on our nutrition guide to the Boston Marathon. Need some recipe ideas? Bon Appetit published a great round-up of carb-loading meals you (or a very loving friend) can whip up for you post-marathon.

Step Six: Sleep.

Go.to.bed.early. “Sleep is really important for your recovery,” said Dr. Roseen, who suggested runners focus on getting eight to ten hours the nights following the race. Sleep helps the body to restore the muscles and marinate your body in all those super nutrition and vitamin-packed recovery meals.

Step Seven: Get moving.

Dr. Roseen advises that dynamic stretching and soft tissue mobilization are keys to effective recovery. So grab a tennis ball, roll over your leg muscles, and get busy with that foam roller. Signing up for a yoga class will also help you to incorporate light activity back into your routine that won’t put too much additional strain on already fatigued muscles. Check out these tips in the Work It Out, Boston video on yoga for runners.

After two or three days, Dr. Roseen said marathon runners should be able to return to normal activities. After two or three weeks, marathon runners should be able to exercise again. This is when runners should look out for pains or limitations when they are doing every day tasks.

“If your pain is limiting you from activities you can typically do, you should definitely be seeing a provider,” said Dr. Roseen. “Sometimes it’s hard to differentiate muscle soreness from something more serious that might need further evaluation like an x-ray or MRI.”

The Newton-Wellesley Hospital, in collaboration with the Boston Athletic Association, is offering two post-marathon injury clinics in April.

Looking for more marathon recovery tips? Check out funning coach Jenny Hadfield (of Runner’s World Ask Coach Jenny fame) four-week recovery schedule here.