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You’ve been training for months, and now the finish line of the Boston Marathon is in sight.
But what comes after the race? We turned to experts at six local hospitals for advice on how to recover from running a marathon. From when you should start running again to what you should absolutely avoid doing after you cross the finish line on Marathon Monday, below are the steps doctors and physical therapists say you should take after you complete the storied 26.2-mile race from Hopkinton to Boston.
Immediately after you finish the race on Marathon Monday, John-Paul Hezel, a sports medicine physician at BIDMC, recommends putting on warm clothes or making use of the reflective blankets that will be handed out by race officials and medical staff.
“The body will cool down, and it’s important to keep blood circulating to all tissues,” he said. “Hydrate with water and electrolytes — chocolate milk is as good as Gatorade or other sports drinks — and be sure to eat in the first hour or so after the race. Carbs, protein, healthy fat — all are very important for short- and long-term recovery.”
Hezel said that he recommends going for heat after the strenuous exercise over cold — like an ice bath — and he said in the days after the race “activity is critical.”
He recommends cross-training with swimming, low-resistance biking, or even long walks to help your body recover.
“Some very light soft tissue mobilization with foam rolling and gentle massage can also aid the process,” Hezel said. “Low-weight or bodyweight strength training should be a part of the recovery program just as it should be prior to the race. Lay off heavy weights for a couple weeks.”
Douglas Comeau, medical director of Boston University Sports Medicine and a family medicine physician at BMC, said refueling in the hours after the race is key.
“Refueling would include hydration (with both water and electrolyte supplementation) in addition to adequate caloric food intake,” he said. “In the days after the race, the runner should work on physical and mental recovery from the race.”
Physical recovery includes stretching and strengthening, according to Comeau.
“Subsequently, the runner would look to return to [running] once recovered in the days to weeks after the marathon,” he said.
Right after you walk/jog/run across the finish line, Elizabeth Matzkin, chief of Women’s Sports Medicine at Brigham and Women’s, says you should walk for “a little bit.”
“This is your active recovery,” she said. “Enjoy the moment, make sure you are hydrated, and eat some carbs to restore immediate depletion. Change out of your wet/sweaty clothes and put on something dry. Make sure you stay warm.”
Runners should also consider changing into compression socks to help prevent blood pooling in the lower extremities, and Matzkin advised stretching in the two-plus hours after the race.
“Once you sit or lay down, consider putting your legs up for a similar effect,” she said.
In the following days, the Brigham doctor said to get “plenty” of rest since delayed onset muscle soreness can last between four or five days.
“You can go for a walk or a short bike ride to keep your muscles moving — but rest is extremely important,” Matzkin said. “Consider cross-training (swimming, yoga, biking) rather than feeling the need to run.”
Short and easy running can be taken up after the first week, and by three weeks after the race, runs can be longer or faster.
“The old mantra is to rest for one day for every 1-mile run — so after a marathon, you should take it easy for 26 days,” she said.
Ashwin Babu, a sports medicine physiatrist with the Massachusetts General Hospital Sports Medicine Service, said rest, hydration, nutrition, and sleep are most important immediately after a long endurance event like a marathon.
“Many athletes find that some gentle cross-training exercise in the days to weeks after a marathon will help with recovery,” he said.
Overall, he said runners should pay the same attention to their recovery as they did their training.
“If the runner is concerned that something doesn’t feel quite right, they should seek treatment from a qualified medical professional,” the MGH doctor said. “The recovery phase can be different from runner to runner, even from race to race, so listening to your body is key.”
Runners should walk at least 10 to 15 minutes after crossing the finish line in order to allow the heart rate to come down and return to its resting state, says Jaclyn Riedel, senior physical therapist at Newton-Wellesley Hospital.
“The finish line will have heat sheet blankets, snacks, and fluids — take them!” she said. “The blankets are a great way to cool down slowly and avoid getting cold too quickly. Eat a small snack within 30-60 minutes after the race. This is the time when the body is eager to replenish blood sugar levels, depleted energy stores, and start repairing muscle tissue. Pick something that is easy to digest — it’s helpful to refer back to foods that have worked throughout training after longer runs.”
If you’re not hungry immediately after the race, you can wait till your appetite returns. Later in the day, eating a larger meal high in carbohydrates with protein will be helpful as you continue to replenish and rehydrate.
Matthew Salzler, an orthopedic surgeon at Tufts, says rehydrating with fluids and electrolytes and continuing to move are paramount when you’ve completed the 26.2-mile course.
“It’s also important to replenish your calories, so make sure you eat well in the following hours and days,” he said. “Compression stockings can help with recovery in the first few hours and days. It’s helpful to get in some very light aerobic work in the next day or two to help flush out lactic acid. Finally, whether it’s during, right after, or a couple days after the marathon, if you have a concerning pain, get it evaluated ASAP.”
“One thing to not do immediately after a marathon: stop moving. Do not stop moving!” Hezel said.
“Runners should absolutely not stop immediately after crossing the finish line, as there is potential for exercise-associated collapse and a trip to our medical tent,” Comeau said.
“Do not sit down immediately after crossing the finish line,” Matzkin said. “Do an active recovery by walking. Avoid alcohol. If you are going to celebrate with an alcoholic beverage or two — make sure you are first rehydrated from the long run! Avoid deep tissue massage for the first 24+ hours. Your muscles are damaged from the run and need some time to recover.”
“Return to running too soon,” Babu said. “Too often we see athletes give inadequate time and effort to the recovery process. This can lead to injury, frustration, and unnecessary time away from the sport they love.”
“The day after the marathon is a rest day — no running, no cross-training,” Riedel said. “Later in the week, you can begin to start short and low-effort, low-impact activities. This would include swimming, aqua jogging, biking, and elliptical to name a few. It’s helpful to increase circulation and get muscles moving, but keep the intensity low.”
“Stop moving,” said Salzler. “After finishing a 26.2-mile run, the last thing you want to do is continue walking, but that’s very important. It’s not just for logistical purposes, but you need to keep your leg muscles moving to keep your blood pumping back to your heart.”
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