Preparing for Your Next Marathon with Physical Therapy

Marathon running can be one of the most challenging and demanding athletic feats, requiring significant physical and mental strength. It is essential to physically prepare for a marathon for optimal function on race day and create a post-race recovery plan. Physical therapists can accompany marathon runners throughout the training process, from strengthening your musculoskeletal system and addressing injuries to helping you actively recover post-race.

Marathon Preparation

Training for a marathon is critical as it gradually prepares your body for long-distance runs at specific paces while allowing for the appropriate rest and recovery time your body needs. Marathon training can begin 16 to 20 weeks before the race and include three to five runs per week. These long distance runs over the course of several months place a great deal of stress and wear and tear on the musculoskeletal system; muscle strains and injuries are common during the training period.

A physical therapist works with a marathon runner to develop good training habits, performs a motion screen to evaluate the runner’s biomechanics, and crafts an exercise program to increase the runner’s muscle strength, flexibility, and endurance over the entire period of training and post-race recovery. This helps reduce the risk of developing overuse injuries during training and targets important muscle groups with specific strengthening exercises. Should an injury occur during training, a physical therapist can treat and address the injury to help the runner return to running safely.

An important aspect of marathon preparation is tapering as you approach race day. Training for the race should peak two-to-three weeks before race day. Tapering means reducing the volume and duration of training to allow the body to recover. This is done by cutting weekly mileage by 50% and then 75% in the two weeks prior to the race. Tapering can help the runner maximize their performance by protecting the body from fatigue on race day and reducing risk of injury.

Common Running Injuries

Common injuries during marathon training include strained muscles, tendinitis, sprains of various joints, compressive reactions in bones due to cumulative stress from running, plantar fasciitis, Achilles tendinitis, and IT Band syndrome. Achilles tendinitis involves pain and stiffness along the Achilles tendon whereas IT Band syndrome involves pain on the outside of the knee and snapping and popping in the knee.

When an injury occurs, the physical therapist completes an injury assessment and creates a treatment plan tailored to the injury. Treatment may include manual therapy, an exercise rehabilitation program, and biomechanics instruction for proper form to avoid re-injury. 

Post-Marathon Recovery

It is crucial to rehabilitate your body after a marathon and allow your body to recover in the first few weeks post-marathon. Engaging in an active recovery period with the support of a physical therapist helps prevent long-lasting injuries and ensures a safe return to training.

Studies have shown that marathon runners who take a break from cardio activity during the week following a race recovery more quickly. If you return too quickly to intensive exercise during the first week, your muscular strength and work capacity can be impaired. It usually takes between four to eight weeks for a runner to fully recover from a marathon.

Immediately following the race, it’s important to continue gently moving and completing post-run stretches. Focus on refueling with nutritious foods and re-hydrating with water and sports drinks to replenish electrolytes. The first seven-to-ten days after the race are a critical period for body recovery post-marathon. Begin with low-intensity exercise and do cross training. Rest your joints and muscles during this time.

The initial four weeks of post-marathon recovery are the optimal time to engage in active recovery with your physical therapist. Your physical therapist will help you rebuild a solid foundation and correct bio-mechanical issues and running form to prevent injury in the future. The therapist may perform manual therapy to restore tissue health and movement and designs a post-marathon exercise program to help you rebuild strength, mobility, flexibility, and balance. When you return to running, use a reverse taper to gradually return to high intensity running. Begin by running 50% of your usual weekly mileage when you start training again and 75% the following week at a moderate intensity.

Running a marathon is an impressive athletic feat that requires discipline, intense preparation, and active recovery. As you prepare for your next marathon, work with a physical therapist for your best run yet and a safe recovery.