Marathon Runner

We asked Erin Angelini, DPT, our expert at UPMC Centers for Rehab Services, to discuss life, recovery, and training before and after a marathon.

Erin has been a lifelong runner. She ran cross country and track in high school and college. Erin received a bachelor’s degree in health science and Spanish and a doctor of physical therapy degree from Lebanon Valley College. She is a certified USA Track and Field coach and an independent running coach. She recently completed her physical therapy sports residency at UPMC, which allowed her to fine tune her process for managing running-related injuries.

Here are some of her marathon recovery tips.

What Types of Injuries Are Most Common for Runners?

Runners are especially susceptible to overuse injuries when they increase distance, pace, or effort faster than tissues can adapt. The most common injuries we see clinically are patellofemoral pain syndrome, Achilles tendinopathies, hamstring tendinopathies, and shin splints (medial tibial stress syndrome).

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How Can Runners Avoid Injuries?

The best way to prevent running-related injuries is by maintaining a healthy balance between running, stretching, and strengthening routines. It is important that the runner pays attention to weekly efforts — which include both mileage and overall muscular fatigue as a result of the running and strength training — to ensure they are not advancing and making progress with their training too quickly. Many running-related injuries can be linked to quick advancement of weekly mileage and lack of recovery. Other things to consider aside from physical rest and recovery include adequate nutrition, hydration status, and sleep hygiene.

What Does Recovery Look Like After a Marathon?

Recovering after a marathon is different for each runner, but nutrition and hydration are the most immediate forms of recovery that should be emphasized after the race. Fueling with carbohydrate-rich whole foods and electrolyte drinks is important to restore the energy balance of the body. When looking at the next 24 to 48 hours, stretching and foam rolling of the lower body — including the quadriceps, hamstrings, glutes, and calves — can help with muscle soreness and discomfort. Walking, cycling, and swimming also are beneficial ways to encourage active muscle recovery.

When Can Runners Start Training Again After a Marathon?

When returning to running after a marathon, the considerations are twofold: both mental and physical. Training for a marathon can be exhausting and cause a runner to “burn out”. If that is the case, I would encourage the runner to take a break from the sport and practice active recovery. If the runner is ready to continue training, the next thing to consider is the current health of the musculoskeletal system.

If you have a nagging injury, be sure to take a period of rest longer than 7 days and then re-evaluate how the injury is healing. An athlete who is only feeling aches and pains from the race would benefit from 5 to 7 days of rest before returning to training. For runners who are well accustomed to the marathon distance, I would not recommend returning to running earlier than 3 days since the time of the last race to allow the muscles, joints, and bones to heal. When returning to running, the first 1 to 2 weeks should be a light, enjoyable effort to train while allowing the body to continue healing.

How Can Physical Therapy Help?

Physical therapy can be beneficial for runners who are struggling with chronic and recurrent running-related injuries. At select UPMC Centers for Rehab Services clinics — including the UPMC Rooney Sports Complex and UPMC Lemieux Sports Complex — we can do a running analysis and evaluation. It provides patient-specific feedback and an exercise prescription based on potential biomechanical deviations that could be related to the patient’s injury. Physical therapists teach ways to incorporate stretching and strengthening into the daily routine, increase mileage safely, and become a well-rounded runner.

Runners are tough. Marathon running is tough. With these tips, a healthy and balanced routine, and the support of UPMC Centers for Rehab Services and UPMC Sports Medicine, runners can keep doing what they love.

To learn more or schedule an appointment, please call 1-888-723-4CRS (4277) or visit

About UPMC Centers for Rehab Services

Whatever your therapy need – physical, occupational, or speech – UPMC Center for Rehab Services can create a personalized treatment plan for you. We have more than 70 outpatient facilities throughout western Pennsylvania, with convenient hours for your schedule. Our therapies follow the most up-to-date research for rehabilitation, and we treat numerous conditions, from arthritis and tendinitis, to injuries and symptoms related to other medical conditions.