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

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