All politics and no play makes Johnny a dull boy: Why Boston Marathon Runners Can Expect Quadriceps and Calf Muscle Pain - Running downhill makes it worse, and other tips for coping: Pickle juice or cherry juice?

From The Wall Street Journal:

One experience unites all long-distance runners: At some point a marathon becomes an experiment in discomfort and pain management.

Don't fret if you are the sort of marathoner who plans to drag yourself across the finish line at the Boston Marathon next Monday in five-plus hours, your thighs feeling as if knives are jabbing with every step. There are very likely races when last year's winners, Lelisa Desisa and Rita Jeptoo, experience their share of misery, too. Last month, Mo Farah, the Olympic champion in the 5,000- and 10,000-meter races, collapsed after crossing a finish line—of the New York City Half Marathon.

"I doubt anyone has ever run a marathon without feeling some degree of aches, pains or tightness in leg muscles and joints," said Amby Burfoot, winner of the 1968 Boston Marathon.

Few long-distance runners, even those with years of experience, understand how to react or exactly what is happening in their quadriceps and calf muscles when pain begins to crest, usually somewhere between the 16th and 23rd miles.

"Unfortunately, that 'dead' feeling is probably not going to go away, even by slowing down," said Jack Daniels, the renowned long-distance coach and exercise scientist who leads the Run SMART Project, a top coaching service for runners.

 

Here's the good news: That type of pain is perfectly normal, even somewhat inevitable, most experts say. There is actually some micro-tearing going on inside the muscles, which can't work the way they want to under that level of stress.

 

"A muscle gets sore and goes into spasm when it gets pissed off, and the causes of that are nutritional and functional," says Jordan Metzl, a sports medicine physician at the Hospital for Special Surgery in New York, who has completed more than 30 marathons and is a 10-time Ironman finisher.

 

The trickier question is what to do about the pain and soreness. The best midrace treatments ("remedies" would be the ultimate misnomer) include counterintuitive alternatives ranging from don't slow down to drinks that don't sound particularly thirst-quenching.

 

Slowing down too much just extends the period of pain, whose causes involve real damage to microfibers within the affected muscles.

 

Running the downhill segments of a really long-distance race—Boston's rolling course has plenty of these—is one of the best ways to injure a muscle, according to Kerry Kuehl, a physician and expert in exercise science at the Oregon Health and Science University in Portland.

 

The act of striding, landing on the foot and then bounding into the next stride is what sports-medicine physicians refer to as "eccentric contraction."

 

"You're lengthening the muscle and then loading on it," Dr. Kuehl said. That causes a disruption or tearing of the "myofibrils," which are the thousands of tiny strands within the muscles, as well as damage to the muscle-cell membranes. The membranes and myofibrils become inflamed, and that hurts, Dr. Kuehl said.

 

The pain can't be totally prevented, but Dr. Metzl said it can be delayed until later in the race through strength training, so the muscles don't break down so quickly.

 

A big problem with long-distance runners, according to Dr. Metzl, is that many of them do plenty of running but not much else. (I'm running Boston, and I plead guilty as charged.) That puts a limit on how far they can run pain-free.

 

Dr. Metzl recommends a strength workout that involves quick explosive repetitions, including squats, planks, sit-ups, push-ups and leg lifts but comparatively little weight work.

 

Of course, it's probably too late for anyone running Boston to gain much strength before Monday. For them, the focus has to be on dealing with muscles that are careening toward spasm.

 

This is where the pickle and bitter cherry juice come in.

 

Muscles, in addition to hurting because of micro-tears, also stop functioning well and start hurting when they no longer have the proper fuel, experts say.

 

Running a marathon burns a lot of fuel, especially fluids and salts, which the body loses when it perspires. A dehydrated muscle doesn't contract well, which is what it needs to do with every step, and it starts to hurt.

 

Muscles also don't function well when they don't have the necessary amount of electrolytes, which conduct electrical impulses that enable muscle cells to contract. Electrolytes are formed from sodium, calcium, chloride, magnesium and potassium.

 

Gatorade and other sports drinks have electrolytes, but pickle juice has about as much concentrated sodium as any liquid on the planet that athletes have been able to stomach during intense exercise.

 

Pickle juice isn't widely available at most marathon water stations, though drinking it isn't a new strategy. The Philadelphia Eagles drank it during a 2000 game against the Dallas Cowboys when temperatures climbed to 109 degrees Fahrenheit. The Eagles won.

 

Still in pain and want to reach for the ibuprofen? Consider the juice from Montmorency cherries instead.

 

About five years ago, Dr. Kuehl, the Oregon physician, studied the effects of the tart, bitter juice on inflammation.

 

He and a team of researchers conducted a double-blind test of 54 runners participating in the Hood to Coast relay race that covers 200 miles up and down steep terrain from Mount Hood to the Pacific Ocean.

 

"It's a really good race to test muscle soreness," Dr. Kuehl said.

 

Runners who drank the juice equivalent of 45 to 50 cherries before, during and after the race reported significantly less pain than those who drank a placebo. Medical examinations corroborated those reports.

 

Cherry juice is rich in antioxidants, which combat some of the muscle inflammation from the micro-tears that cause pain. And cherry juice isn't a drug that could cause ulcers or kidney damage, Dr. Kuehl said.

 

Still hurting? Probably—which might mean the only option left is to try thinking about something else. "Concentrate on another part that is not feeling bad," said Dr. Daniels, the Run SMART coach.

 

"Be optimistic and don't be thinking, 'Wow, I still have 5 or 6 miles to go.' Better to concentrate on the task at hand, what you are doing, how much of your body is relaxed and quit thinking how far you still have to go."