The London Marathon: Post event muscle soreness and recovery

The months of hard training, the running equipment, the optimal running strategy, the training taper, and the pre-race diet are some of the concerns on runners’ minds before completing a marathon. However, despite the detailed preparation there is one more concern that marathon runners need to be aware of….………RECOVERY.

Running a marathon is one of the most strenuous events in sport, and whilst the pain upon crossing the finishing line is discomforting, it is a distant second to the debilitating ‘DOMS’ experienced in the days post-event. DOMS (or delayed onset muscle soreness to give its full title) is caused by microscopic damage to the muscle fibre as a result of prolonged exercise and / or repeated eccentric contractions (when the muscle lengthens under tension). The damage triggers a complex sequence of repair responses, which include inflammation and the release of noxious substances that sensitise nerve endings causing the muscles to feel painful. As marathon running is prolonged in nature and incorporates a large eccentric component, it is little wonder runners complain of DOMS in the days after a marathon.

Typically, DOMS will peak around 1 – 2 days after running a marathon and will last for up to 5 – 7 days. However, it is important to acknowledge that while DOMS subsides within a week this does not mean that the muscle is fully recovered. It is not uncommon for DOMS to have disappeared while the muscle is still damaged. Indeed, research has shown that evidence of muscle fibre damage and decrements in muscle strength are still evident 1 – 2 weeks after marathon running, despite DOMS dissipating after 5 days. This creates potential problems for runners because if they no longer feel DOMS after the marathon they could return to training before the muscle has fully recovered. Thus, even though the pain post-marathon might have gone after a week, it is recommended that marathon runners rest for 2 – 3 weeks before resuming normal training.

There are many suggested recovery strategies that runners can use to assist with alleviating the post-marathon DOMS. However, whilst some recovery strategies do appear to reduce DOMS, there is currently no magic lotion or potion available on the market that prevents muscle damage from occurring after running a marathon. Some of the most commonly used recovery strategies to reduce muscle damage post-marathon include:

Tart Cherry Juice: full of antioxidants; drinking 230 ml of tart cherry juice twice daily before, on the day of, and after running a marathon has been shown to reduce inflammation and aid the recovery of muscle strength. However, tart cherry juice was found to have little impact on reducing DOMS post-marathon.

Protein: amino acids (the basic building blocks of protein) are crucial for muscle growth and recovery after exercise. Research has shown that consuming 10 g of ‘branched chain amino acids’ twice daily for 7 days before and immediately after exercise alleviates DOMS and accelerates the recovery of muscle strength. Ingesting 500 ml of milk immediately and 2 hours after exercise has also been found to improve muscle strength recovery, although it has little effect on reducing DOMS.

Compression Garments: it is suggested that compression garments work by reducing the space available for inflammation to occur after muscle-damaging exercise. Whilst, there is evidence that wearing compression garments after exercise can reduce DOMS and inflammation, there is contradictory research that found wearing compression stockings for 72 h after a marathon have no effect on improving muscle strength or reducing inflammation.

Cold Water Immersion: short term exposure to cold water (5 – 15 minutes at 10 – 15 o C) decreases muscle temperature and blood flow, which are speculated to reduce post-exercise inflammation. Whilst, cold water immersion has been shown to alleviate DOMS in the days after exercise, it has no effect on improving the recovery of muscle strength post-exercise.

Massage: considered to increase blood flow to facilitate the clearance of metabolic by-products and cellular debris, massage is a widely used post-exercise recovery strategy. The general consensus points towards massage being effective in reducing DOMS, however, its effect on reducing muscle strength and performance decrements after exercise are inconclusive.

Foam Rolling: a relatively new recovery technique, foam rolling is a type of self-massage, which involves pressing your body mass against a foam roller and rolling it over a muscle. Foam rolling for 20 minutes a day post-exercise has been shown to reduce DOMS, although it has no effect on improving the losses of muscle strength in the days after muscle-damaging exercise.

Stretching: research into the effectiveness of stretching on post-exercise recovery suggest only a minimal effect on alleviating DOMS and no effect on improving the losses in muscle strength.

Exercise: it is suggested that increasing blood flow through light exercise removes noxious substances and increases the release of endorphins, causing a reduction in DOMS. However, this analgesic effect is only temporary and DOMS tends to resume after any light exercise has finished.

Given the subjective nature of DOMS, it is not possible to rule out that the effectiveness of recovery strategies are biased by the ‘placebo effect’. It is possible that the expectation of a recovery strategy to work influences the perceived level of muscle soreness experienced after exercise. It appears that rest in conjunction with tart cherry juice and protein supplements are effective strategies to assist post-marathon recovery.

 

Dr Dean Burt (BSc, MSc, PhD)

Technical Skills Specialist – Exercise Physiology

Read more about Sport and Exercise Psychology here.

Read more about Sport and Exercise at Staffordshire University here.

The London Marathon: The greatest race of earth

I’ve always run ever since I was a kid chalking start and finish lines on the pavement outside my parents’ home and having sprint races with my friends and brothers, sports day sprints at primary school, County Track Championship in the middle of blistering summers, wading through a foot of mud at Parliament Hill in the Southern Counties Cross County Championships and England Schools Championships, runs all around the world, in deep freezing snow, 38 degree deserts, up mountains, during torrential downpours. But nothing I have ever competed in is like the one and only time I completed London Marathon.  By comparison every other race is pedestrian.

PJ track

The London Marathon is unique for lots different reasons.  Firstly, the course is incredible situated as it is in the greatest city on earth and, as Samuel Johnson said “…when a man is tired of London, he is tired of life; for there is in London all that life can afford.” During those 26 miles and 385 yards you run past architecture from the most beautiful historical buildings which are landmarks to Britain’s history to the latest incredible gravity defying plate glass and chromium sky piercing structures.  You also run past a landscape that has been and continues to be at the centre of world for over thousand years.  But it’s more than that.

Watching the first London Marathon in 1981 and knew then at some point I would run the race.   I had applied for entry three times before finally getting in.  This time also coincided with the passing of one of my brothers from leukaemia, so there was an extra motivation to train, fund raise and complete.

For me the race came at the end of nine months of training.  Cold winter evenings trying to fit in fast runs after the children were in bed, 5 am starts to get my mileage in around work and life, 2-3 hour runs on a Sunday where afterwards I was so tired and hungry I would sit in a bath and eat!  Sarah my wife would find me an hour later asleep in the tepid water.  During that time my body metamorphosed.  I lost two stone and had to buy a whole new wardrobe, and I felt and looked great even if I was constantly tired and could stand up or sit down without making “old man noises.”

The week leading up to the race, as Trevor Barter recommends in this blog series I tapered training carbohydrate loaded.  For the first time in months I stopped running and didn’t feel constantly hungry.  The tapering and carb loading pre-race phase surprisingly made me feel terrible. My body was used to being rested and having so much glycogen in my muscles.  I suddenly had loads of time on my hands as I wasn’t running for hours but felt fatigued, a little miserable and restless.  It’s quite a strange feeling and my colleague and Sport Psychologist Dr Jamie Barker could probably explain how this not very helpful leading up to the biggest physical challenge of your life.  However, on the day once you start running you feel incredible because you are so ready.

I followed a friend’s advice and had my name printed on the front of my vest.  This probably one of the most import things I did as every step of the way someone is calling your name.  It’s like having your own personal motivator with your for every stride.  I admit I wasn’t so prepared for the sights and sounds, noises and smells and atmosphere of the race.  I have never been in a race where you are constantly running accompanied by constant noise, crowds, musicians, singers, people calling your name, cheering you on, the smell of bbq’s and street parties, people still drinking getting home form the Saturday night before.   I remember in particular the wall of noise that hits you when you cross Tower Bridge. This was like nothing I have experienced before.

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This combination of glycogen and crowd noise make you want to go faster and you have to make sure you don’t go off too fast.  I got to half way and felt incredible, indestructible.  I checked my watch and my heart rate monitor and calculated that if I upped my pace in the second half I could come close to a three hour finish time.  I remember at fourteen miles seeing my wife and children in the crowd and high fiving them as I ran past.  My plan was going well.  And then it all started to become harder…..

At seventeen miles my hamstrings became tighter, my gait shorter and I started to slow, each step became harder and each mile took longer.  I tried to concentrate, talk to myself and move my arms to move my legs.  Everyone started to overtake me.  At twenty one miles I passed my wife again but didn’t see her, the crowd sound had become white noise, my vision tunnelled.  I remember stopping at 22 miles and laying in the middle in the road to stretch my aching hamstrings.

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I just focused on the person in front of my and tried to stay with them.  I counted off the miles and tried to work out my pace and speed, but even simple calculations took me half a mile to complete.  I don’t really remember the last four miles until we got to the finishing straight where the noise got louder again and I tried to sprint!

I crossed the line with a mix of relief, accomplishment, pain, exhaustion; I thought of my brother and shed a tear.  I stood hands on hips and looked at the sight around me and was struck by the number of happy smiling people who were also crying.     Everyone should do it at least once in their life and every April as I sit on the sofa and watch it, I want to be part of it again and feel jealous of those who are running what is undoubtedly the greatest race on earth.

Maybe next year…

 

Dr Peter Jones

Head of School of Psychology, Sport and Exercise

Read more about the School of Psychology, Sport and Exercise here.

Eating in the long run: Nutritional aspects of running the London marathon.

Completing the London Marathon is a major achievement for many, whether this be in a fast time or simply completing the distance. To succeed requires a considerable amount of training and motivation. There are certain nutritional aspects that need to be taken into account: hydration and energy.

Although there are cases of runners overheating the typical climatic conditions for the London marathon should not pose major hydration problems, so providing the athlete starts the run fully hydrated and takes the opportunity to consume further fluids at feeding stations dehydration should not be a problem.

Providing sufficient energy to complete the run is another matter. The human body primarily provided energy for long duration exercise from carbohydrates and fats stored in the body. Even for thin people their fat supplies are considerable, it is the carbohydrate that causes the problem. There is a phrase that “fat burns in a carbohydrate flame”. This means that to be able to metabolise fat and to produce energy the body needs to be metabolising carbohydrate. Many people who have run a marathon will be familiar with the phrase “hitting the wall”, typically around the 20 mile mark. This coincides with the point when carbohydrate levels fall so low that the ability to produce energy becomes compromised and the runner slows down dramatically.

A good analogy here is the fuel in the tank of a car. A car with a full tank, driven at an economical speed will go further than a car being driven fast. This is because the higher speed uses the fuel more rapidly. This works the same for the marathon runner. The well-paced runner reaches the finish line with an empty tank and the fastest possible time.

Elite runners, through years of training have developed a very efficient energy production system and a huge fuel tank. Their muscles adapt to the miles of training by being able to store more glycogen (the storage form of carbohydrate) and also they have an ability to produce more energy from fat and also from protein. This enables them to “spare” their glycogen.  Thereby achieving phenomenal times such as Dennis Kimetto’s 2 hr 2min 57 sec in the Berlin marathon in September 2014.

Elite runners will also have a diet that is high in carbohydrate. The typical western diet has about 50% of its calories coming from carbohydrate. Elite endurance athletes are recommended to have at least 60% and perhaps up to 75% of their energy coming from carbohydrate. Typically the western diet contains about 200-250 grams of carbohydrate per day but the endurance athlete would be eating double that quantity or more. 7-12 grams of carbohydrate per kilogram of their body weight per day is the amount recommended by leading authorities. So for a 70 kg person this would be 490-840g of carbohydrate. Bearing in mind a portion of rice (62g uncooked) provides 47g of carbohydrate, this can represent quite a bit of food.

Recreational marathon runners (if that is not a contradiction in terms) do not have the benefit of long term adaptations created in response to years of training but there are things that can be done to the diet that can help.

When marathon running became a popular activity and a challenge that people sought to achieve research into nutritional aspects of running began to be published. A key realisation was that running time was significantly related to initial muscle glycogen levels and glycogen levels could be affected by dietary intake. This led to the creation of the carbohydrate loading diet in the 1970s. The classic carbohydrate loading diet involved a run to exhaustion seven days before the event. Followed by three days on a diet high in fats and protein but low in carbohydrate. This effectively starved the body of carbohydrate and made it crave carbohydrate when it became available. The runner would then eat a diet very high in carbohydrate and the body would store much greater quantities of glycogen. A rebound effect occurred. This led to the famous “pasta parties” the night before a marathon and runners tried to top off their stores of valuable carbohydrate.

The problem with this approach was that exhausting run and the low carbohydrate days. Runners were very lethargic, exhausted and not well prepared mentally for the up and coming run. It was realised that a less drastic approach was also quite effective. In the days leading up to the marathon the runner should taper their training and increase their carbohydrate consumption. This also leads to increased muscle glycogen levels.

In simple terms, to help with either completing the run or running faster, people should increase their carbohydrate consumption by eating greater than normal quantities of rice, pasta, potatoes and other carbohydrate rich foods and taper their training.

A key feature for success is always pace judgement. The faster you go the faster you will deplete your glycogen stores.

The following sources of information might be useful:-

http://www.runnersworld.com/nutrition-for-runners/how-to-carb-load-for-marathon-week

http://www.bbcgoodfood.com/howto/guide/what-eat-when-running-marathon

http://running.competitor.com/2014/04/photos/the-10-best-carbohydrate-sources-for-runners_12953

 

Trevor Barter

Senior Lecturer, Sport & Exercise

Read more about Sport & Exercise Science here.

Read more about Sport and Exercise at Staffordshire University here.

Common overuse injuries in marathon runners

Athletes in training for a marathon frequently experience injuries classified as “overuse” injuries.  These are not caused any external force or accident, but typically develop from the result of continuous miles and hours of running and training.

These injuries are often minor and and brought on through biomechanical faults within our running style and when combined with running, place additional stresses on joints, muscles and other tissues.

 

Listening to and recognising the early warning signs of these conditions are key to ensure that a minor problem, does not lead a more serious condition that could enforce withdrawal from training or competition.  Some of the main overuse injuries which affect runners.

 

  1. Runner’s knee

This is a descriptive term for pain just below the kneecap.  The pain first starts during running, and gradually gets worse when even more sedate activities including walking up or down stairs, squatting and even prolonged sitting with the knees bent can cause pain. These symptoms are the result of bruising and inflammation near the bottom of the kneecap.

 

The problem is often be caused by incorrect tracking of the kneecap as you run or over-pronation in the feet, which is often combined with inappropriate running shoes or the sudden increase in training load brought on by your upstart in training.

 

Once correctly diagnosed, runner’s knee can be corrected by fixing the causes of the biomechanical problems that caused it.  Studies have shown that up to 80% of runners with this condition can have symptoms relieved by the use of orthotics in combination with sports injury treatment.

 

  1. Iliotibial band (ITB) friction syndrome

It is not uncommon for runners to experience severe pain on the outside of the knee joint that worsens with the increases in training load and intensity. The iliotibial band is a band of tissue that runs from the hip, down the outside of the thigh, past the knee, and connects to the lower leg helping to keep the knee joint stable.

 

ITB friction syndrome occurs when this band becomes irritated as it rubs over a bony prominence near the knee (technically called the lateral epicondyle of the femur) which it passes over as you bend your leg at the knee.

 

Causes of ITB syndrome include excessive ankle pronation, but there are other possible causes, including tightness of the Tensor Fasciae Latae (TFL) muscle, or leg length discrepancies that result in tilting of the pelvis.  This condition can be exacerbated by sudden increases training, downhill running or on heavily cambered roads.

 

ITB syndrome may be managed or alleviated via stretching techniques for the ITB, icing after runs or deep friction massage / myofascial release.  Treatment may require a reduction or management of the training mileage and intensity, or complete rest while the underlying causes are addressed.

 

  1. Achilles tendonitis

achilles tendonitisThe Achilles tendon runs down the back of your heel, connecting the calf muscles to the heel.  Achilles tendonitis begins as an inflammation of this tendon; but if left untreated it can develop into a rupture of the tendon especially in athletes 35 and over.  Its early indicators are stiffness behind the ankle when you first rise from bed in the morning that diminish while you are running.

 

Factors associated with the onset of Achilles tendonitis are excessively tight calf muscles, over-pronation, wearing of high heels, worn out shoes and overtraining.   The condition can be managed and relieved with post run ice treatments, ensuring suitable footwear is worn; however reduction in training or complete rest may be needed required if severe enough.  It is recommended that incline running and speed work be avoided whilst symptoms are painful.

 

  1. Shin splints

shin splintsFrequently pains described in the lower leg is passed off as “shin splints”.  A term that is used to describe an injury referred to as medial tibial stress syndrome – or irritation of the muscles and tendons as they attach to the tibia.

 

Pain develops along the inner border of the shin, about 5-10 cm above the ankle. Initially, the pain may be felt at the beginning of a run; that  recedes as the session continues, but recurs on finishing the session.  When more severe the pain becomes, sharper, and more persistent, until eventually it becomes difficult to walk normally.

 

This common in new runners (often within their first three months of running) who have increased their training load too rapidly, or who are using inappropriate running shoes.

 

Treatment at first includes regular ice, together with reduced mileage or rest.  Addressing the causes is likely to include ensuring that shoes have adequate cushioning and stability, and building up training mileage slowly.

 

Brendon Skinner

Award Leader Sport Strength and Conditioning
Read more about Sport Strength and Conditioning here.

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