After competing in New York City Marathon, ice can be a runner’s best friend when treating sore muscles

Dear Running Doc:

I just ran the NYC Marathon Sunday and set a personal record finishing in 3 hours 58 minutes. My whole body hurts! Is this normal? Should I use ice or heat?

- Joseph G., Port Washington, NY.

Thanks Joseph. Congrats on your PR. Thinking about that must ease the pain.

Yes, hurting after a marathon is normal. In fact, my friend Frank Shorter, one of America’s most famous marathoners, once said that everyone, including him, hurts after marathoning. “And if you don’t hurt, you aren’t getting your money’s worth,” he said.

If he can hurt, so can all of us. Muscles and soft tissues are strained and healing. Be sure you are eating protein to give you basic amino acids to build back the damaged tissues and take cool showers to reduce inflamed tissue.

Your question about heat vs. cold is a good one; I am asked that daily. There really isn’t much controversy about heat vs. ice. Most who treat athletes on a regular basis agree that from the first day through the first 24 hours, ice is the treatment of choice. Heat tends to further injure friable blood vessel walls thereby promoting leaking of fluid and increasing swelling. Ice, on the other hand, also vasodilates and does not injure the vessel wall, and, in fact, helps its integrity. Ice is truly a great vasodilator. Although initially vasoconstricting in the first few minutes, it then promotes vasodilation, as evidenced by the red area on the skin after icing.

After 24 hours we want to continue vasodilation to bring in blood flow with nutrients and cells to promote healing. The vessel wall has regained its integrity and both ice and heat work – after a 20-minute treatment, both result in an area that looks red due to increased blood flow. Which should you use? I prefer ice because it temporarily deactivates receptors in the vessel walls, thereby keeping the vessels open for an additional 45 minutes following a 20-minute treatment. When heat is applied, as soon as the heat comes off, the vessel area begins to cool the receptors and the vessel walls are reactivated to normal blood flow. Therefore, ice gives you a longer treatment for a 20-minute application. Contrary to grandma’s old advice of applying ice then heat, ice works better, three times a day for 30 minutes each time. You can ice up to six 20-minute treatments a day for the most effect.

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