Transcription:
Race Recovery: Important Tips

Melanie Cole (Host): Knowing how to recover from an endurance event is just as important as knowing how to compete. My guest today is Dr. David Hryvniak. He’s a physician in the department of physical medicine and rehabilitation at UVA Health Systems and at the UVA Runners Clinic. He’s also team physician for UVA athletics. Welcome to the show, Dr. Hryvniak. Let’s talk about first race day. Before we talk about recovery, I’d like to talk about event day. To plan for a good event, what would like them to do the day of, when they wake up in the morning before a long race or any event?

Dr. David Hryvniak (Guest): I really think it begins during your training. Really, preparing for a race is you have to practice everything. You’re not only practicing the running in that aspect, but you want to practice your eating. You want to practice the things you will be eating during the race as well as pre-race, so that way you don’t get any GI disturbances during a race. You also want to practice hydrating as well. And you want to have a routine down prior to the race. I always tell people, “You don’t want to try anything new on race day, whether that be shoes, what you’re eating or what you’re drinking.”

Melanie: Are there some things you like people to eat and/or drink on race day that will help them get to the end of the event and recover faster?

Dr. Hryvniak: It certainly depends on the event that you’re going to be doing. The typical carbo-loading that many people did before racing doesn’t have a whole lot of literature to back it up, but a lot of people find that the pasta and carbohydrates are easier on the stomach, so most people can tolerate that. I always say, “Find something that works well for you the night before as well as the morning of.” And, if it’s going to be a hot race you really need to make sure you’re hydrating before the race. We want you using both sports drink as well as water and making sure that you’re topped off before you begin the race.

Melanie: You said sports drinks as well as water. Is there a time when one is preferable over the other?

Dr. Hryvniak: I find that if it’s going to be really hot, I prefer sports drinks, because you’re getting some electrolytes in that mixture. There is a risk of people overhydrating, especially if they’re just drinking water, and there’s such a thing that we worry about in the marathon medical finish tent at some of the marathons we cover, it’s called “hypernatremia.” That’s where people basically dilute out their salt because they drink too much water during the race and before the race. So, I always find a mix of both sports drink and water, and mixing those up, is the best to prevent that.

Melanie: Is there anything people can do to limit the soreness during an event that’s going to occur after recovery. Is that only based on their training?

Dr. Hryvniak: Some of it has to do with training. Some of it has to do with making sure that you’re properly fueled beforehand. And then, as we’ll talk about a little bit later, with recovery, there are certain things that we can do to help limit delayed onset muscle soreness immediately after the race as well as that evening and in the following days and weeks as you recover from the race.

Melanie: What are some of those? Let’s get to the recovery part of it and what can you do? Let’s just start with soreness and musculoskeletal issues that might happen if you’re feeling knee pain, if you’re feeling a little swollen, maybe you’ve built up a little water retention, or you know you’re going to feel sore. What do you want people to do? Do you want them to stretch? Do you want them to sit right down? What do you want them to do?

Dr. Hryvniak: I usually break it down into immediately post-race and then that evening and the following day. So, immediately post-race is as soon as you cross the line, the thought is everyone wants to stop. You’ve finished your marathon, you want to stop, but the best thing to do is continue to walk around for 10-15 minutes because that’s going to help get rid of some of the waste products including lactic acid that’s in your legs and allow your body to use those muscles that you have to pump that out of your muscles. If it’s a shorter race, some people like to do a cool down jog, so a 10-15 minute real slow jog. Along the same lines, we’re trying to get all the waste products out of their legs. I find immediately post-race, that’s the best thing to do for the first 15-20 minutes after you finish.

Melanie: If you’re feeling knees and ankles and such, do you like them to ice once they’ve done their walking around for a while?

Dr. Hryvniak: Either using ice directly to the joint or an ice bath is very helpful for people. So, usually we recommend that after an event or after you’re done cooling down, doing it for about 10-15 minutes at a time, you don’t want to do it much longer than that. You can either create an ice bath at home and put some ice in your bathtub and sit in there for 10-15 minutes and really ice down all your legs, or you can specifically put an icepack on that joint. But, ice is very helpful. I do caution people to not use anti-inflammatories like Advil or Aleve immediately post-race because that can sometimes have its effects on your kidneys. So, I ask people to avoid using that immediately after the race, even if they’re having some joint aches or pains.

Melanie: Dr. Hryvniak, you are an avid distance runner. Have you ever taken an ice bath? How uncomfortable are those?

Dr. Hryvniak: We used to do them after every workout. I ran at the College of William and Mary, and three times a week we would take ice baths. Some of my teammates would do it more often. It is an uncomfortable feeling until you get used to it. But, if you’re not an avid person who likes to sit in the cold, it’s definitely difficult in terms of handling that cold. But, I would usually read a magazine or a book or watch TV and that seems to help take your mind off of it.

Melanie: Tell us about your long distance runs.

Dr. Hryvniak: I ran in high school and college and then through med school, I continued to race at the marathon and the half marathon distance. I run four our local post-collegian Olympic training team, it’s called the Ragged Mountain Racing Team here in Charlottesville. We have had several people qualify for the Olympic trials this year. I’m still trying to continue to run well at the marathon and on the road.

Melanie: That’s fantastic. What about food and beverages after a race? Now we’re hearing more and more about chocolate milk and you mentioned energy drinks. So, what do you want people to do just after as far as nutrition?

Dr. Hryvniak: There’s really an ideal window. I usually tell people 20-40 minutes after you finish activity is the ideal window when your body is going to absorb the most nutrients and allow you to recover the best. So, I always tell people, “Let’s get some kind of carb, protein and fat in during that period of time.” I usually say do a 3:1 ratio in terms of carb to protein, so something like chocolate milk that has some carbs in it, sugars, as well as it has some protein and fat, is really an ideal post-race drink. Several companies make other kinds of recovery drinks that have similar types of ratios in terms of the carbs, protein and fat. But, even just some sports drinks will get you at least the carbs in if you can’t tolerate the chocolate milk. It’s really important to rehydrate after a race. Especially hot races, we need to replenish our weight loss. It’s not uncommon to lose a couple to a few pounds after a hot race. So, we really want to replenish that weight loss because that is all water loss in terms of that weight, and replenish our electrolytes. So, using some water as well as an electrolyte type drink, like a Gatorade or PowerAde is useful for that.

Melanie: What about the protein drinks, Muscle Milk and such? People think if you drink these really high protein drinks, 30 grams, 40-50 grams, that it goes right to your muscles and helps them replenish.

Dr. Hryvniak: You want some protein, but what I find is that can upset people’s stomach, especially post-race, and it’s very difficult to absorb that much protein in a short span of time. So, really, you only end up absorbing some of that and the rest of it is wasted. So, I think finding that perfect ratio, and the literature shows us that 3:1 ratio. You really want to be replenishing your carbs because that’s what your body is predominantly burning, that and glycogen when you’re racing. The protein will help with muscle building and recovery in terms of that. Then, we actually use some fat when we do endurance racing as well, so we want to replenish some of that as well.

Melanie: In the last few minutes, tell us about the emotional impact of finishing a major race, Dr. Hryvniak. People want to feel that high. They want to feel that satisfaction in knowing that they did something. What does it feel like?

Dr. Hryvniak: It’s exciting when you finish your first marathon or your first race and you cross the finish line. And then, there’s a little bit of a letdown, because you’ve trained for this event for months and months and now it’s done, and a lot of people are like, “What do I do next?” I’ve found in the past, at least finishing, I think I’ve finished at least 15 marathons, that the first hour or so after the marathon, you hate the event, and then about an hour later you’re looking for the next one. So, there’s definitely a certain amount of motivation to look for your next race after you’re finished but you have to be careful and give yourself a break. I always recommend people make sure they get good sleep that night, take advantage of those free post-race massages that they have at a lot of races. If they don’t have that, do some foam rolling after. And then, for the next several days, especially after a marathon, really make sure you’re resting, retouch with your family, do some things that you weren’t able to do during your training cycle to refresh your mind. And then, you can begin training for your next event.

Melanie: Just tell us about the UVA Runners Clinic at UVA Health Systems.

Dr. Hryvniak: We are the only clinic in the area that is for runners and we are staffed by runners. So, all our physicians are experienced runners and we’re all board certified in sports medicine. Our goal here is we don’t like to tell people that they have to stop running, so we like to get people back out on the roads and will use different tools to help diagnose injuries and get people back on their feet. So, we use gait analysis and customized rehab programs. We’ll make a return to run programs for people coming off an injury or a long break off running. Our enjoyment comes from getting people back out there and able to compete. We also cover a lot of the local races, high school, college and a lot of the local road races, including the men’s 4-miler or women’s 4-miler, the Charlottesville 10-miler and the marathon, which are all major events here locally.

Melanie: Thank you so much. What great information, Dr. Hryvniak. Thank you so much for being with us today. You’re listening to UVA Health Systems Radio. For more information you can go to www.uvahealth.com. That’s www.uvahealth.com. This is Melanie Cole. Thanks for listening.