Dr. Matthew Sedgley of MedStar Health Sports Medicine, is the co-primary care sport medicine director of the Baltimore Running Festival.
Dr. Matthew Sedgley of MedStar Health Sports Medicine, is the co-primary care sport medicine director of the Baltimore Running Festival. (Photo courtesy of MedStar Health)

Anyone planning to run a marathon or half marathon this weekend as part of the Baltimore Running Festival has no doubt been training for weeks and has already felt at least a twinge of soreness. That's to be expected. But runners are likely to feel better rather quickly, especially if they have trained well, hydrated and even gone for quick "recovery runs" after the longest training days on the schedule, according to Dr. Matthew Sedgley, a MedStar Health Sports Medicine physician who helps direct medical care during the big running event.

What is a normal length of time for muscle soreness after a run?


Muscle soreness is usually broken down into either acute muscle soreness, which happens within a few minutes of intense exercise such as what happens when sprinting or lifting, or delayed onset muscles soreness (commonly called DOMS). DOMS presents 24 hours to 72 hours after an intense workout that maybe one is not generally accustomed to. For a long run, most athletes will have acute muscle soreness at the end of the race without experiencing DOMS for a few days. DOMS is more common when muscles are asked to fire in a position when they are elongating, sometimes called an eccentric exercise that causes some micro tearing of the muscles.

What should you do immediately after and then later on to aid recovery?

Among runners, the expression to "drink to thirst" is often heard. In other words, don't just drink to satisfy being thirsty. Drink to replenish lost fluids to sweat. Drinking to thirst can help flush out the muscles, but the level of lactic acid seems less a determinant on soreness than we once thought.

Certainly some advocate ice, which probably numbs the muscles. But ice baths have not been shown in studies to do much, despite their popularity, to decrease the amount of breakdown products in the blood.

Possibly the most important thing to do is to train well. Doing a training run down hill throughout training protects against soreness and aids in recovery. This is called the "repeat bout effect" by some. Some long distance runners also advocate a gentle shorter run the next day or two as a "recovery run." Thus, exercise can actually be the best medicine to help muscle soreness.

While many stretch dynamically — using the body's full range of motion — prior to a run and statically after a run, the medical literature is not as dogmatic on stretching per se.

Some reports of using turmeric (the spice in curry) as a natural anti inflammatory have been made, but multiple runs with this spice seem to help a lot less.

Another report said using diphenhydramin (Benadryl) diminished muscle soreness. However, the damage to the muscles from the drug was more severe, so definitely avoid that one.

How much Tylenol or Advil is too much?

Interestingly, while ibuprofen (Advil) can make pain go away during and immediately after a run, it can also be harsh on the kidneys. Dosing is tough so I advise not to use it in running. Acetaminophen (Tylenol) can be easier on the stomach but can also be harmful to the liver if taken in too high a dose.

When is it an injury to muscles, tendons or bones and not just soreness and when should you see a doctor?

Those doing long runs need to listen to their bodies. Pain that is not going away in two weeks needs to be seen by a physician and pain that stops you from running completely needs more immediate attention.

After a big race, how much rest do you need before going on a short or long run again?

It varies, as professional runners who train year round might be able to do a marathon or ultra marathon a month. Novice runners would need to consider their race schedule more closely. A short one-to-two-mile run a day or two after a marathon that is done gently can help one feel better. Running long races or runs back to back is a recipe for possible stress fracture or tendon injury.