Dear Running Doc:

I finished my first marathon in 5:40:59 this past summer! What a great time! I followed all your advice, but the night after the event starting at about 3 a.m. both my feet started killing me. I could not walk! It hurt to have my comforter rest on them! Is this normal? What is it? How can I prevent it? I will be running NYC soon.

Jill G., Westbury, N.Y.

Congrats, Jill. How cool to have finished and achieved that goal! And what you write about is not at all uncommon and is actually the greatest complaint call I receive in the middle of the night post first-time marathon finish. As with most injuries and conditions, it is most easily prevented if understood.

What you are describing, if there is no boney tenderness or swelling, is what I have termed: marathon feet. In basic terms it is inflamed soft tissues of the feet from the street pounding of the 26.2 (although also seen at the 13.1 distance as well) roads. We most commonly see this in people who have trained on softer surfaces (like the reservoir track in New York City) or who wear thinner racing flats when they did not train in them.

These inflamed soft tissues get more and more painful until it truly is hard to walk or even put a comforter over them.

To prevent and/or treat marathon feet:

Now, if you have pain the Monday after the event, 15-minute ice baths three times a day and a non-steroidal anti-inflammatory may be necessary for two days to calm the inflammation down. If you feel boney tenderness, see a doctor sooner than later because you may not have marathon feet but have a stress or full fracture of a bone in your foot.

I hope this helps. If anyone out there in reader-land has any other ideas how to prevent marathon feet please join the discussion and send it to me. And Jill, congrats again. Great job.

Enjoy the ride.

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Lewis G. Maharam, MD, FACSM is one of the worlds most extensively credentialed and well-known sports health experts. Better known as Running Doc, Maharam is author of Running Docs Guide to Healthy Running and past medical director of the NYC Marathon and Rock n Roll Marathon series. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.

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