Posted 7 May

Essential foot recovery: A podiatrist's guide to post-marathon care

After months of dedicated training and the exhilaration of crossing that finish line, your marathon journey doesn't end when you collect your medal. Whether you've conquered the iconic London Marathon, challenged yourself with an ultra-distance event in the Lake District, or completed a multi-day hiking expedition in Europe, your feet have carried you through an extraordinary feat of endurance. Now it's time to give them the attention and care they deserve.

At Flawless Feet, we have a team of dedicated podiatrists, that have years of experience taking care of feet, preparing feet for challenges and helping with the recovery. This comprehensive guide will walk you through essential recovery practices to get you back on your feet after pushing them to their limits.

The immediate aftermath: first 24 hours

The post-event assessment

The moment you finish your event, take a few minutes to assess the condition of your feet. Remove your shoes and socks in a clean area and check for:

• Blisters, note their location, size, and whether they're intact or broken
• Hot spots, areas of redness that haven't yet blistered but feel tender
• Chafing, particularly between toes or where laces may have rubbed
• Discolouration of toenails, potential signs of subungual haematomas (blood under the nail)
• Swelling, compare one foot to the other for asymmetrical puffiness

This quick assessment will guide your immediate care needs and help you identify any areas requiring special attention.

The essential cool-down

Your feet, like all muscles after intense activity, benefit tremendously from careful cooling. As soon as feasible after your event:

• Cold water immersion, fill a basin with cold water (not ice cold) and immerse your feet for 10-15 minutes. This helps reduce inflammation and provides immediate relief.
• Elevate, when resting, position your feet above the level of your heart to help reduce swelling.
• Gentle compression, consider wearing compression socks designed for recovery—not your running compression gear, but specifically designed recovery socks with graduated pressure.

Blister management

Blisters require careful attention to prevent infection and further discomfort:

• Intact blisters, leave them intact if possible, covering with a sterile dressing or specialised blister plaster.
• Broken blisters, clean gently with mild soap and water, apply an antiseptic solution, and cover with a sterile, non-adherent dressing.
• Never tear away skin from broken blisters, as this removes the natural protective barrier.

Days 1-3: The critical recovery period

Maintaining exceptional foot hygiene during this period is paramount:

• Daily washing, clean your feet thoroughly with mild soap and lukewarm water.
• Thorough drying, pay special attention to the spaces between toes, patting gently rather than rubbing.
• Fresh air allow your feet breathing time out of socks and shoes when at home.
• Antiseptic application, for any open wounds, apply a suitable antiseptic cream or solution.

Massage and mobilisation

Once the immediate inflammation has subsided (typically 24-48 hours post-event):

• Self-massage, using a small amount of moisturising cream, gently massage the soles of your feet, arches, and heels in circular motions.
• Ball rolling, roll a tennis or golf ball under your foot for 2-3 minutes per foot.
• Toe spreading, gently separate your toes and hold for 10 seconds, repeating 5-10 times.
• Ankle circles, perform gentle ankle rotations in both directions to maintain mobility.

Rest and active recovery

The balance between rest and active recovery is crucial:

• Avoid long periods of standing, limit time on your feet for 48-72 hours.
• Short, gentle walks, brief 5-10 minute walks help promote circulation without overloading.
• Swimming, a non-weight-bearing activity that promotes circulation and overall recovery.
• Avoid immediate return to impact activities, no running for at least 3-7 days, depending on your experience level and the event's intensity.

Week 1-2: Rebuilding and strengthening

Rebuilding Foot Strength

After the initial recovery period, begin targeted exercises to rebuild foot strength:

• Towel scrunches, place a small towel flat on the floor and use your toes to scrunch it towards you.
• Marble pickup, practice picking up marbles with your toes and placing them in a bowl.
• Calf raises, start with double-leg raises, progressing to single-leg as strength returns.
• Foot doming, without curling your toes, try to shorten your foot by raising the arch.

We have a YouTube video sharing the 5 foot exercises you should be doing daily to strengthen your feet.

Footwear transition

Your post-event footwear choices are crucial for proper recovery:

• Recovery sandals, consider structured recovery footwear with arch support and cushioning.
• Avoid completely flat shoes, opt for footwear with some arch support to prevent strain.
• Gradual transition, don't immediately return to minimal footwear, even if that's your normal preference.
• Replace worn running shoes, if your marathon shoes have significant wear, now is the time to replace them before returning to training.

Nutrition for foot health

Supporting tissue repair through nutrition:

• Hydration, continue optimal hydration to support cellular repair processes.
• Protein intake, ensure adequate protein consumption to support tissue repair.
• Vitamin C, essential for collagen production and soft tissue repair.
• Zinc and copper, minerals that play key roles in wound healing and tissue regeneration.

Long-term care and prevention

Toenail care

Marathon running frequently leads to toenail trauma that may not be immediately apparent:

• Keep nails trimmed straight across, never cut down at the corners.
• Monitor for changes, watch for discolouration or thickening in the weeks following your event.
• Professional assessment, if a nail becomes painful or significantly discoloured, book and appointment with us.
• Be patient, remember that damaged nails may take 6-12 months to fully grow out.

Preventative practices

Use your recovery period to reflect on preventative measures for future events:

• Footwear assessment, consider whether your current running shoes provided adequate support and protection.
• Gait analysis, book a professional us to identify any biomechanical issues.
• Custom orthotics, determine if you might benefit from custom-made orthotic insoles for future training, we can talk through if orthotics are required at your gait analysis appointment.
• Lacing techniques, experiment with different lacing patterns that might prevent specific pressure points.

When to seek professional help

While most post-marathon foot issues resolve with proper self-care, certain symptoms warrant professional attention:

• Persistent pain, particularly if it's getting worse rather than better after 3-5 days.
• Signs of infection, increased warmth, redness, swelling, or discharge from blisters.
• Numbness or tingling, may indicate nerve compression issues.
• Discolouration that doesn't improve, particularly in toenails or specific areas of the foot.
• Difficulty walking, if your gait remains significantly altered after the initial recovery period.

Your feet have just accomplished something extraordinary. By implementing these recovery strategies, you're not only ensuring a faster return to your regular activities but also protecting your long-term foot health. Remember that recovery isn't merely the absence of training—it's an active process that deserves as much attention as your pre-race preparation.

The journey of a thousand miles begins with a single step, but the journey to your next thousand miles begins with proper recovery. Treat your feet with the respect they've earned, and they'll continue to carry you towards your next finish line, whatever and wherever that may be.

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