The influence of long distance running on sonographic joint and tendon pathology: results from a prospective study with marathon runners

Abstract

BackgroundThe impact of physical exercise on joints and tendons is still a matter of debate. The aim of this study was to investigate with ultrasound the acute effects of extreme physical exercise on knee and ankle joints and their surrounding structures in trained athletes.MethodsParticipants of the Munich marathon were examined by arthrosonography before and after long distance running. Ultrasound assessment included grey scale and power Doppler examination of the knee and talocrural joints with surrounding tendons. Findings consistent with joint effusion, tendon and/or entheseal pathologies were documented. In addition to the ultrasound evaluation, information on training habits and past or present arthralgia or joint swelling was gathered.ResultsOne Hundred Five runners completed both the pre- and post-excercise ultrasound assessments (baseline and follow-up), resulting in the sonographic evaluation of 420 knee and talocrural joints. At baseline, 105 knee (50) and 38 talocrural joints (18.1) showed effusions, compared to 100 knee (47.6) and 33 talocrural joints (15.7 %) at follow-up. The differences were not significant (p > 0.05 each). Effusion size did not correlate with the timepoint of ultrasound assessment and was independent of covariates such as gender, age or running distance. Hypervascularity of the patellar tendon was detected in 21 cases (10.0 %) at follow-up in contrast to one at baseline (p < 0.001). This observation was more frequent in male than in female participants (p < 0.05).ConclusionsAcute physical stress is significantly associated with hypervascularity of the patellar tendon. No significant changes of synovial effusion were detected in knee and talocrural joints.

Modification of a sonographic enthesitis score to differentiate between psoriatic arthritis and young healthy volunteers

“…Furthermore, the patellar tendon is susceptible to showing hypervascularity after acute physical stress. A study performing PD examination on runners showed hypervascularity in the patellar tendon directly after a marathon (11).…”

Femoropatellar Joint Reaction Detected During a 4486 KM Ultramarathon with Mobile MRI

“…As a consequence of our MSUM study [52] and the studies on marathon and UM running [29,81], we would not advise asymptomatic athletes against endurance running, even in the case where higher graded retropatellar OA or chondral lesion might be present. On the contrary, due to the potentially protective character of endurance running [93], they are even more likely to be encouraged, regardless of age. We found, for the PFJ-reaction in a MSUM, the same conclusion as van Poppel et al [94] in their model based prospective study on more than 3,600 recreational runners: risk factors for relevant joint injuries are not related to running distance.…”

Erratum to: The influence of long distance running on sonographic joint and tendon pathology: results from a prospective study with marathon runners

“…After publication of the original article [ 1 ], we realised that we had failed to include the name of one of our co-authors, Markus A. Schramm, who had contributed substantially to the acquisition of the study data and was also involved in drafting the manuscript. His name was omitted in error and all of the original co-authors agree with the proposed change.…”