Is the immediate effect of marathon running on novice runners' knee joints sustained within 6 months after the run? A follow-up 3.0 T MRI study

Skeletal Radiol. 2020 Aug;49(8):1221-1229. doi: 10.1007/s00256-020-03391-2. Epub 2020 Feb 17.


Objective: To evaluate changes in the knee joints of asymptomatic first-time marathon runners, using 3.0 T MRI, 6 months after finishing marathon training and run.

Materials and methods: Six months after their participation in a baseline study regarding their knee joints, 44 asymptomatic novice marathoners (17 males, 27 females, mean age 46 years old) agreed to participate in a repeat MRI investigation: 37 completed both a standardized 4-month-long training programme and the marathon (marathon runners); and 7 dropped out during training (pre-race dropouts). The participants already underwent bilateral 3.0 T MRIs: 6 months before and 2 weeks after their first marathon, the London Marathon 2017. This study was a follow-up assessment of their knee joints. Each knee structure was assessed using validated scoring/grading systems at all time points.

Results: Two weeks after the marathon, 3 pre-marathon bone marrow lesions and 2 cartilage lesions showed decrease in radiological score on MRI, and the improvement was sustained at the 6-month follow-up. New improvements were observed on MRI at follow-up: 5 pre-existing bone marrow lesions and 3 cartilage lesions that remained unchanged immediately after the marathon reduced in their extent 6 months later. No further lesions appeared at follow-up, and the 2-week post-marathon lesions showed signs of reversibility: 10 of 18 bone marrow oedema-like signals and 3 of 21 cartilage lesions decreased on MRI.

Conclusion: The knees of novice runners achieved sustained improvement, for at least 6 months post-marathon, in the condition of their bone marrow and articular cartilage.

Keywords: Bone; Cartilage; Knee; MRI; Marathon running.

MeSH terms

  • Athletic Injuries / diagnostic imaging*
  • Bone Marrow / diagnostic imaging
  • Cartilage, Articular / diagnostic imaging
  • Edema / diagnostic imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Injuries / diagnostic imaging*
  • Knee Joint / diagnostic imaging*
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods*
  • Male
  • Marathon Running* / injuries
  • Middle Aged
  • Prospective Studies