Post marathon recovery

Well done to all those who ran the London Marathon on Sunday!

The months of hard work and training paid off.

Now that you have completed the race, what next? How to ensure a smooth recovery?

We asked Mr Akash Patel, Trauma and Orthopaedic Surgeon, and a keen runner himself, how runners can improve their recovery times post-race, and when to see a doctor if something does not feel right.

Post marathon recovery

After running a marathon, anti-inflammatory painkillers (such as ibuprofen) should be avoided at least for a couple of days, as they can damage your kidneys and have a negative effect on your cardiovascular and gastrointestinal systems (such as ulcers and bleeding).

Active recovery is better than lounging on the sofa, but you should avoid running for a few days, so try some gentle yoga routines, a walk or easy lengths in a pool instead.

A hot bath in the days following your run will also help speed up your recovery. This is because heat promotes blood flow to the muscles by dilating (expanding) your blood vessels. This helps increase circulation, which aids healing.

After about one week, you should be ready to run again! However, instead of going full pelt, this should be a short 20–30-minute test run where you scan your body and observe if and where you feel any pain. If you feel sore and tired, this is a sign that you need to set aside more time for rest and recuperation. 

How to reduce your risk of injury

Running offers numerous health benefits, including improved cardiovascular fitness, weight management, and stress reduction. However, it is important to take proper precautions, and listen to your body to minimise the risk of injury.

As a keen runner myself, understanding the benefits and risks has really helped my training and prevented hip or knee problems from developing. When I previously ran the London Marathon, I kept these six things front of mind in the run-up to race day:

1. Proper footwear: Everyone’s feet are different, which can make buying shoes tricky. However, it is important to invest in good-quality running shoes that fit your feet and running style. Rather than buying shoes online, you can have your gait analysed and try on a few trainers at a running store, which should help you find a suitable pair. You should also buy good socks, including compression socks to wear in the days after your marathon, as these can help speed up your recovery.
2. Warm-up: Always warm up before a run to prepare your muscles and reduce the risk of injury. Stretching hamstrings, quadriceps, gluteal and calf muscles is key. Aim for a dynamic (rather than static) stretching routine, which includes leg swings, walking and sideways lunges, and high knees.
3. Hydration: Stay hydrated before, during, and after your run to maintain energy levels and prevent dehydration.
4. Gradual progression: Don’t push too hard too fast. Gradually increase your mileage and intensity to avoid overtraining.
5. Strength training: Incorporate strength exercises to build a solid foundation and prevent imbalances.
6. Variety: Mix up your routine with different types of runs, like speed work, hills, long runs, and cross-training, to keep it interesting and improve overall fitness.

Remember – everyone is different, so adapt these tips to your specific goals and abilities. It is also a good idea to consult with a coach or healthcare professional for personalised advice.

What are the most common symptoms of knee problems?

Common symptoms include:

• Pain
• Stiffness
• Swelling
• Catching, clicking and locking
• Giving way
• Difficulty bearing weight

Can knee problems be prevented?

Injuries cannot be completely avoided, especially if you are following a strict training regime. However, the risk of injury can be reduced by keeping these key principles in mind:

1. Maintain a healthy weight: Excess weight puts added stress on the knees, increasing the risk of issues, such as cartilage injury.
2. Stay active: Regular exercise helps strengthen the muscles around the knees, providing better support and reducing the risk of injury. Low-impact activities like swimming and cycling can help strengthen your muscles and improve overall fitness without stressing the joints.
3. Avoid overuse: Don’t overexert your knees with repetitive high-impact activities. Give your knees time to rest and recover.
4. Maintain flexibility: Stretch regularly to maintain good joint flexibility and prevent stiffness.
5. Listen to your body: If you experience pain or discomfort in your knees, don’t ignore it. Seek medical advice and address any issues promptly to prevent them from worsening.

What are the main causes of knee pain?

Knee pain can be caused by a range of factors and underlying conditions. Some of the main causes include:

Injuries: This includes ligament injuries (such as ACL , MCL , or PCL tears), meniscus tears, and fractures, which can result from accidents, sports injuries, or falls.

Osteoarthritis: This degenerative joint disease results in the breakdown of cartilage in the knee joint and is a significant cause of knee pain.

Tendonitis: Inflammation of the tendons around the knee, often due to overuse or repetitive motions.

Bursitis: Inflammation of the bursae (small fluid-filled sacs) around the knee joint, which can be caused by repetitive movements or trauma.

Patellofemoral Pain Syndrome (Runner’s Knee): Characterized by pain in the front of the knee, often associated with activities like running and jumping.

Iliotibial Band Syndrome: An overuse injury that affects the iliotibial band, a tendon running along the outside of the thigh and knee.

Rheumatoid Arthritis: An autoimmune disease that can affect the knees and other joints, causing pain and inflammation.

Gout: A type of arthritis that can lead to sudden and severe knee pain due to the buildup of uric acid crystals in the joint.

How are knee problems diagnosed?

I would take a full history, examine the knee and then organise investigations such as X-rays, MRI scans, CT scans, and ultrasound scans.

How are knee problems treated?

The treatment depends on the cause. Options include non-surgical and surgical treatments.

Non-operative measures include painkillers, physiotherapy, activity modification, lifestyle changes, heat/ice packs, knee braces, weight loss and injections.

The most common surgical options include arthroscopy (keyhole surgery), specific ligament/cartilage/knee cap procedures and knee replacements.

Mr Akash Patel is a double fellowship trained Consultant Trauma and Orthopaedic Surgeon, with specialist expertise in hip and knee disorders.

Find out more and book an appointment: https://hje.org.uk/consultants/mr-akash-patel/