Recovery after running: post-race tips

Whether seeing nearly 60,000 people run the London Marathon has inspired you to try running longer distances, or you’re starting to train for your first couch to 5k, it’s important to take post-race recovery seriously. While you may have trained for months in order to get your personal best in a race, the risks do not end at the finish line, with even experienced marathon athletes being caught out.

Dr Lara Kingwill, an Urgent Care Doctor from our walk-in clinic in St John’s Wood, warns that not taking your recovery post-race seriously can cause potentially dangerous risks, with the most common being taking anti-inflammatories and overhydrating.

“Completing the London Marathon is a huge achievement, but the body is still under significant strain once the race is over,” says Kingwill. “There are a number of common pitfalls we see every year, particularly around medication and hydration, which are easily avoidable with the right advice.”

A major concern is the use of anti-inflammatories such as ibuprofen post-race.

“Anti-inflammatories can place added strain on the kidneys after prolonged exertion, which is why we advise avoiding them where possible,” she says. “This is one of the most common mistakes runners make. If pain relief is needed, paracetamol is generally preferred, but it’s always best to check with a pharmacist or GP.”

Hydration is another area where runners can often make mistakes; a lesser-known but serious risk is overhydration.

“Many runners focus on avoiding dehydration, but drinking excessive amounts of water without electrolytes or food can dilute sodium levels in the body,” says Dr Kingwill. “This can be dangerous. The safest approach is to drink based on thirst or when needed, rather than following a fixed schedule.”

In this article, Dr Kingwill offers 10 recovery tips to help you understand what to expect after running long distances and when you should seek medical attention after racing:

Is chest pain normal after finishing a marathon, and when should runners seek medical help?

Chest pain is not normal after a marathon. Although mild chest tightness can persist temporarily after intense exertion – any severe, persistent, or spreading chest pain should be treated as a medical emergency.

Why might urine appear very dark or cola-coloured after a race?

Dark urine – often referred to as tea or coke coloured urine, can be a warning sign of dehydration or muscle breakdown causing kidney injury, hydrate well quickly, and if it doesn’t return to normal with fluids, urgent medical advice is needed.

What does it mean if someone feels dizzy, confused, or disoriented after stopping?

Feeling slightly lightheaded can occur after stopping suddenly, but any dizziness, confusion or headache may signal dehydration, heat-related illness or kidney injury. This should be checked promptly by medical professionals.

Should runners be concerned if they have not urinated for a prolonged period post-race?

Runners should pass urine within 2-4 hours of completing a marathon or it could indicate dehydration or kidney strain and warrants medical assessment.

Why can heart rate remain elevated hours after finishing?

It’s normal for a heart rate to stay raised during recovery, however after 4 hours it should have returned to <100bpm at rest. If it remains unusually high or is paired with other symptoms, it’s best to seek medical advice.

How can runners tell the difference between normal soreness (DOMS) and a more serious injury?

Post-race muscle soreness tends to feel general and improves with time. Any ongoing, sharp, localised or worsening pain may point to injury and should be assessed, especially if associated with swelling or weakness in the limb.

What are the key warning signs that pain is more than a minor “niggle”?

Pain that causes limping, visible swelling, any numbness or weakness in the limb or doesn’t improve with rest is a clear sign to stop and get it checked.

Why do some runners experience nausea, chills, or “marathon flu” symptoms after the race?

The runner’s body immune stress response can trigger these symptoms, particularly if their temperature drops quickly after the race. They are also more at risk for picking up other colds/infections for the days after the rest ends. If symptoms are severe or persist beyond 48 hours, medical advice should be sought.

How long should runners rest before returning to exercise?

Most runners need several days to recover, and a minimum of 5-7 days without running is recommended with some specialists recommending up to 2 weeks. Pushing through fatigue or pain too soon increases the risk of injury and should be avoided.

Is it safe to take ibuprofen or anti-inflammatories after a marathon?

Anti-inflammatories such as ibuprofen/Neurofen can place added strain on the kidneys after prolonged exertion, they should be avoided if possible and plain paracetamol is preferred. It’s best to speak to a pharmacist or GP before taking them.

Runners are also advised to prioritise rest, with at least 5 to 7 days off running recommended, and up to two weeks for some individuals.

As participation continues to grow, the message is clear: getting to the start line is only part of the journey, and avoiding common recovery mistakes, particularly around anti-inflammatories and hydration, is essential for a safe recovery.

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