Last issue had an article about how to taper off and peak for a marathon. This issue's bookend coaching advice is about recovering from your marathon. This area of race preparation has as much dogma and myths attached to it as tapering does.

Here is some advice that will have you back in good health, resuming your usual training schedules, and ready to race again in the shortest possible time. Local marathoners Cheryl Young, Melissa Hehn, and Bob Ferry from the Pacers Miles Ahead group were interviewed for their post marathon rituals. With small exceptions they all generally follow the standard recommendations.

But first you might be interested to read a description of what happens to your body during a marathon by David Costill, Ph.D., and former head of the exercise physiology department at Ball State University, Indiana. "A lot of things happen to the body as a result of running the marathon. You become overheated, dehydrated, and muscle-depleted. Your hormonal milieu gets thrown out of whack, and you traumatize your muscles." He adds, "you have to bide your time to get your body back in balance."

Other research on the effects of running a marathon from muscle biopsies consistently show ruptured fibers, inflammation within the muscle, and spillage of intracellular contents outside the muscle. The list goes on: displacement of red and white blood cells, derangement and discontinuity of contractile filaments, and some hard wear and tear on the connective tissues attaching to and surrounding the muscle. It can take your muscles and skeletal system from seven to ten days, or longer, to recover. Some biopsy research shows lingering muscle fiber damage 30 days after a marathon.

Also, your stress hormones cortisol, glucagon, and epinephrine become dramatically elevated after long distance events. All of this is enough to make you think twice about running the 26.2- mile event. Here then, is some advice on how to recover properly.

Immediate Post Marathon Recovery
Keep moving, gradually slowing down to a walk, to allow your stressed system to attain a steady state and normalize. Stopping suddenly can cause lightheadedness, dizziness, and even fainting, if your blood pressure drops too rapidly. Your cool-down should ease you back down to resting state gently to begin the repair process of removal of metabolic wastes.

Get Your Feet Up
Much of the soreness after a marathon is due to swelling from fluids that have accumulated between the muscles, causing pressure on nerve endings near the skin. Costill recommends elevating your legs to help ease the pain.

To Massage or Not?
A gentle massage might help. Not the usual deep friction and pressure point work you normally have to keep your legs healthy, but a light stroking of the surface in the direction of the heart. However, even a light massage may be too painful immediately post-race. A better time is 24 to 72 hours post race. Cheryl Young will visit the massage tent set up by the race afterwards, which she claims greatly helps with recovery, while all three of our runners have regular massage sessions after the marathon.

Icing?
Icing can be done every few hours after the marathon to good effect--it reduces pain because the cold deadens the nerve endings. An added benefit is that for a while (about 10 minutes) it slows down the blood flow to the traumatized muscles. Continuing to ice longer than this dilates the arteries, increasing blood flow to the legs. This pumps out the waste products and brings in nutrients and proteins to begin the repair work. A cool shower may be helpful, and running cold tap water over your legs can be very refreshing.

And no matter how relaxing it seems, avoid hot tub parties after the marathon unless you want the post race soreness to get worse. Heating adds to the micro trauma, contributing to swelling and inflammation. The time for hot pads and hot tubs will be about four to five days after the race when your muscle tissue has stabilized. Even then, hot--cold--hot--cold contrast therapy may be more beneficial for a while.

Get Some Rest
Get home and have a nap, or at least lie down for an hour or two.

Nutrition and Rehydration
Dozens of research papers have investigated glycogen replenishment after marathons. All find the same thing-- your muscle cells have experienced severe glycogen depletion. The studies conclude that complete repletion of glycogen stores requires a high-carbohydrate diet for at least 46 hours, and is most rapid during the first 10 hours of recovery.

Edward Coyle, Ph.D., exercise physiologist at the University of Texas, Austin, says that getting glycogen into your system within the first two hours of stopping is the most crucial. "The muscles absorb glycogen like a sponge," he says, but "four to six hours after the race the absorption rate starts to decline." You need to carbohydrate load again after the race.

Having participated in several marathons, and witnessed the shark-like feeding frenzy of marathon finishers, it is clear that runners are ready almost immediately for solid foods. These should include fruit such as bananas to replace your potassium losses. Choose fruits that contain iron, zinc, calcium, chromium, sodium, and magnesium.

Nancy Clark, R.D., one of the foremost sports nutritionists in the country, recommends fruit or yogurt as ideal foods, superior to candy bars or cookies. Costill says it is okay to eat cookies and candies because the body does not really care where it gets the carbohydrates from at this stage.

How much should you be eating? About two calories of carbohydrate per pound of body weight--say 300 calories for a 150-pound runner. And keep eating for the first two hours.

Four hours after the race you should be recovered enough to eat a full mixed meal, including some protein along with the usual carbohydrates. It is commonly reported that marathoners have a craving for high protein foods after the event. For several days after the race your overall carbohydrate intake should be sixty-five percent or more of your total caloric intake. That is, if you can stand the sight of another plate of spaghetti or slice of bread!

Cheryl Young says, "I pay most attention to making sure I am getting enough protein." Bob Ferry follows the "same basic diet as pre-race (complex carbs, lean protein, lots of fruits/veggies) but also want as many antioxidant-rich foods and supplements as possible in the days immediately following a marathon." Melissa Hehn pays special attention to breakfast before long runs.

Drink plenty of fruit juice, electrolyte and mineral replacement drinks, which are better than soft drinks because you will get vitamins and minerals, vs. sugar and caffeine from soft drinks. And do not forget water. Start drinking fluids immediately and have more than you think you can handle, as your thirst mechanism is not particularly accurate for quenching your thirst.

Hehn agrees. "I paid special attention to how often I was drinking and what I was drinking. I used Nunn and incorporated it into my training so I would be accustomed to it on race day." Bob Ferry has "tons of water and recovery drinks (Gu20 is my favorite). A couple of beers never hurt." Young follows a similar practice, "lots of water and Gatorade."

You will know you are rehydrating adequately when you start urinating again, which can be several hours after the event. Urine should be clear and pale. Despite the refreshing taste, beer (or any alcohol) is counterproductive because it is a diuretic and prevents you from rehydrating properly at a critical time.

Aspirin, Painkillers, Anti-inflammatory Medications?
Your quadriceps will be very sore, especially when going down stairs or a slope. Sports medicine physicians recommend avoiding painkillers and anti-inflammatory drugs despite their palliative effects--muscle tissue repair actually takes longer if you ingest these medications. Although Melissa Hehn does not take any anti-inflammatories, Young and Ferry will take Advil if needed.

Infection
You are highly susceptible to infections after a marathon so take extra care of any blisters or bloody toenails--recovering your health is of prime importance.

Stretching?
There is no conclusive research showing stretching reduces post exercise soreness and pain after marathons. Sharp stretching is counterproductive, flaring up inflammation of the muscle tissues; slow, gentle stretching within your range may help temporarily reduce stiffness.

Our trio from Pacers all stretch as part of their recovery. "Light stretching in the days immediately following the race" is part of Ferry's standard recovery procedure, as is Young's. "MUST, before and specifically after" her marathon, while Hehn's flexibility from yoga classes pays off here.

Post Race Running/Training
Your recovery will be proportional to your mileage before the marathon. In other words, the more training you put in leading up to the marathon, the better and faster the recovery.

Studies have yet to show post race running benefits the recovery of the marathoner. Drs. Costill and Hagerman cooperated in a marathon study conducted on 10 male marathon runners competing in the Athens (Ohio) Marathon. Many interesting results came from this pioneering study. One group of marathoners did short, easy, 20 to 45 minute treadmill running for five days post marathon (exercise-recovery group), while a second group rested completely for five days (rest- recovery group).

Both groups had identical glycogen restoration, suggesting that light exercise does not facilitate glycogen repletion. Indeed, the rest-recovery group had a greater recovery of leg extension strength and work capacity than the exercise-recovery group. Muscle strength still remained depressed below normal for both groups even after seven days. These findings and many other studies since raise doubts about the value of exercise during the days following an exhaustive event such as a marathon. Thus Costill recommends not running for a full week, although some marathoners start running as soon as four days after the marathon.

Bob Ferry starts easy running the second day after the marathon, while Hehn and Young take a full week off before returning to running.

However if you must run, workouts should be kept short and easy on a flat, soft grass surface. Your goal is to regain your usual "spring" and normal training distances without undue soreness. This usually kicks in somewhere around 12 to 21 days after the marathon.

A more interesting alternative is to do no impact activities such as swimming, pool running, or cycling on a stationary exercise bike, giving your legs a chance to recover. Weight training exercises for the legs should be avoided for two or three weeks, as further breakdown of muscle tissue will occur.

There is a range of activities that our Pacers trio does. Young does pool running two days a week, Ferry does some cycling/spinning and otherwise no impact cardio work, and Hehn returns to her twice-weekly yoga classes.

When Can You Race Again?
The higher your pre-marathon mileage, the sooner you can race. Cheryl Young prefers to wait four to six weeks before racing again--she learned the hard way by racing three weeks after a marathon once. "I'm definitely taking it easier afterwards and learning to give the marathon the respect it deserves," she adds. Bob Ferry waits for three to four weeks before a shorter race up to 10 miles, but "I wouldn't race another marathon for at least three months."

Common sense tells us to avoid speed training and intervals during this recovery phase. Elite runners show amazing recovery after repeated marathons within a short time frame of each other.

Whenever you feel like you have regained your normal training "feel" be warned: there may be a false recovery for a week or so, when you feel fine. Listen to Cheryl Young's story here. "I ran 10 miles two days after my first marathon and then went right back to 40 miles per week. BIG mistake, which I paid dearly for six months down the road, and it was a good two years to feeling better! Big crash and burn."

Racing during this phase may put you back in the limping mode. It is best to be sure and wait a week or two longer until you are completely recovered.

So, here are more than a dozen tips for regaining your health and your game after a marathon. Always be aware of the severe damage that you have done to your body and, when in doubt, it is wiser to take it easy than to push yourself.

References and Bibliography
Marathon: The Ultimate Training and Racing Guide, Hal Higdon, Rodale Press.

Serious Training for Serious Athletes, Rob Sleamaker, Leisure Press.

Sports Physiology, Richard Bowers, Edward Fox, Wm. Brown Publishers.

Inside Running -- Basics of Sports Physiology, David Costill, Benchmark Press.

Roy Stevenson is an exercise physiologist and teaches physical education and exercise science at Highline Community College. He set a New Zealand under-20 record when he ran a 2:42:28 marathon at age 19 and competed in New Zealand championships on the track, road, and cross-country. He has coached several hundred runners from around the Puget Sound.

Acknowledgements: Many thanks to Cheryl Young, Melissa Hehn, and Bob Ferry for their assistance with this article.