High-field magnetic resonance imaging assessment of articular cartilage before and after marathon running: does long-distance running lead to cartilage damage?

Am J Sports Med. 2010 Nov;38(11):2273-80. doi: 10.1177/0363546510372799. Epub 2010 Jul 14.


Background: There is continuing controversy whether long-distance running results in irreversible articular cartilage damage. New quantitative magnetic resonance imaging (MRI) techniques used at 3.0 T have been developed including T1rho (T1ρ) and T2 relaxation time measurements that detect early cartilage proteoglycan and collagen breakdown.

Hypothesis: Marathon runners will demonstrate T1ρ and T2 changes in articular cartilage on MRI after a marathon, which are not seen in nonrunners. These changes are reversible.

Study design: Cohort study; Level of evidence, 2.

Methods: Ten asymptomatic marathon runners had 3-T knee MRI scans 2 weeks before, within 48 hours after, and 10 to 12 weeks after running a marathon. The T1ρ and T2 MRI sequences in runners were compared with those of 10 age- and gender-matched controls who had MRI performed at baseline and 10 to 12 weeks.

Results: Runners did not demonstrate any gross morphologic MRI changes after running a marathon. Postmarathon studies, however, revealed significantly higher T2 and T1ρ values in all articular cartilage areas of the knee (P < .01) except the lateral compartment. The T2 values recovered to baseline except in the medial femoral condyle after 3 months. Average T1ρ values increased after the marathon from 37.0 to 38.9 (P < .001) and remained increased at 3 months.

Conclusion: Runners showed elevated T1ρ and T2 values after a marathon, suggesting biochemical changes in articular cartilage, T1ρ values remain elevated after 3 months of reduced activity. The patellofemoral joint and medial compartment of the knee show the highest signal changes, suggesting they are at higher risk for degeneration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological
  • Adolescent
  • Adult
  • Athletic Injuries / etiology*
  • Cartilage, Articular / injuries*
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Health Status Indicators
  • Humans
  • Magnetic Resonance Imaging / instrumentation*
  • Magnetic Resonance Imaging / methods
  • Male
  • Risk Factors
  • Running / injuries*
  • Running / physiology
  • Stress, Physiological*
  • Time Factors
  • Young Adult