Can I PLEASE have a massage when I finish?


“I have noticed that more and more races are not having massage therapists at the finish. Why is this? I always like that massage after a race!” – Billy W., East Hampton, NY

Great question, Billy. I get this question at each marathon expo and I think it is time that everyone knows the answer.

Yes, marathon medical directors and race organizers who understand running physiology have limited massage in finish areas. Of course it feels good to be touched, but medical science has taught us that it is not the best thing for runners at this time.

Here is why:

When you run a race, your body uses its energy stores and makes lactic acid as a by-product. If you have a massage within the first two hours of finishing a race, you move that acid around, causing more cellular damage and more soreness and inflammation the next day. After two hours, the body naturally buffers this acid (returning it to a neutral pH); then it is advisable to get a massage to move by-products out of your muscles. Obviously, race organizers don’t want participants hanging out for two hours waiting for a massage. You would be better served to make an appointment with a local massage therapist after returning home or to your hotel.

So what can you do to lessen post-event muscle soreness? Try these tips for less soreness the next day:

•Ice and ice bath when you return home.

•Cool showers for a day or two. Warm water or heat will cause more inflammation.

•Stay away from ICY HOT and BIOFREEZE and the like. They work by a chemical that again makes inflammation “hotter.”

•Try to get a massage anywhere from two to six hours after finishing. That is the best time to get the buffered by-products out.

•After you are eating and urinating normally, taking a NSAID (non-steroidal anti-inflammatory) may be of assistance.

If you do all this, you will feel way better the next day than if you got a massage right after you finish.

Enjoy the ride.

Lewis G. Maharam, MD, FACSM

Got a question about running health, injuries, or similar topics? Email your question to Doc at!

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Which injuries can I run through?

“I am planning to run my sixth marathon this winter. I’ve heard of many different injuries and conditions, which some doctors tell their patients they can run through while others tell them not to run. Can you tell me, once and for all, what injuries or conditions I should not run with?” – E.L., Miami Beach, FL

I hear this question year after year, sitting at the Medical Desk at marathon expos: “I hurt blah blah and my doctor told me I shouldn’t run. Can I run?” I usually ask the runner, halfway kidding, “If I told you not to run, would you?” Invariably, the answer is, “Yes!”

Assuming that you are healthy, have been cleared by your doctor, and have trained adequately, there are really only four reasons to keep a runner from running a marathon:

  1. You have a fever of 101 degrees F or higher. Fevers are the body’s way of killing an infection. When you run a marathon, your body heat rises naturally due to your increased metabolism. If you start high, your body’s way of cooling you down starts off “out-of-whack” and can lead to a heat illness, coma, or death. Your body’s proteins, which make up the structures of your vital organs, break down at high temperatures. If you need Tylenol (acetaminophen) to keep your fever below 101, you really should lay off running until you are naturally cooler.
  2. You have so much pain that it affects your running form. Runners are the smartest athletes. They don’t need a coach to tell them when their natural running form changes. They do need a sports doc to tell them, however, to stop running if they have so much pain that their form is changing due to that pain. Compensating for that pain will cause an injury somewhere else. Again, it is just not worth the time you may spend recovering. If it is before the marathon, just don’t run this one. If it happens during the race, first try backing down on stride length and speed; if you can go with good/normal form slower, finish the race. Chances are you won’t do more damage that way. If you can’t maintain form even at a slower pace, stop and ask a doc at a medical station to check you out. It’s FREE ADVICE on race day: take advantage! In either case, visit your sports doc at your earliest convenience to rid yourself of this problem for good.
  3. You are experiencing new medical symptoms (like chest pain) since your last physical. Running may be like a stress test daily for you. If you are ignoring chest pain or a new medical symptom like increased thirst, dry mouth, shortness of breath, or increased urination, please get a real check-up by your internist. You may have developed a medical condition that requires attention. Cared for properly, it may not keep you from running; left unchecked, it could do you harm while running a long distance.
  4. You have a fracture or stress fracture in a weight-bearing bone. Runners will do anything to continue running. I’ve seen runners stop at med stations with a broken tibia (shinbone) sticking out of their skin asking for some tape so they can finish the race! Running on a stress fracture can lead to its fracturing all the way through and a devastating open fracture (sticking through your skin) on race day. This will result in surgery, a long healing period, a possible non-union (non-healing), and further complications as well as the psychological trauma of being off running for months. It is just not worth the risk. If you have a stress fracture, listen to your sports physician, take the time off weight-bearing exercise (you can run in the pool) and be ready for the next race. And if you are in a walking cast, I know you want to compete, but have your doctor make it waterproof and get your exercise via water running and don’t mess up the healing process by walking the race on it.

So, if you don’t have one of the above four, chances are you are safe to run. Have a great, safe race.

Enjoy the ride.
Lewis Maharam, M.D.

Got a question about running health, injuries, or similar topics? Email your question to Doc at!

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