One article on PainSci cites Luke 2010: The Complete Guide to Patellofemoral Pain Syndrome
PainSci summary of Luke 2010: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.
Studies (like Williams) have shown that runners probably do not get more knee osteoarthritis than anyone else, which is a bit surprising: surely regular pounding wears out joints? Researchers took a bunch of fancy pictures of the insides of knees before and after a marathon, using a new MRI technique that can detect early cartilage degeneration: “Runners showed elevated T1rho and T2 values after a marathon, suggesting biochemical changes in articular cartilage” and “the patellofemoral joint and medial compartment of the knee show the highest signal changes, suggesting they are at higher risk for degeneration.” Sounds bad, doesn’t it? Also, perhaps some biomarkers of trouble “remain elevated after 3 months of reduced activity” — but it’s arguable that those results were not actually statistically significant.
It’s also an open question whether any of this is clinically significant: it’s not clear that signs of stress actually mean anything in and of themselves. On the contrary, this study seems to support the idea that the risk, while real, is also reassuringly reversible and counter-intuitively minor.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
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 (T1rho) and T2 relaxation time measurements that detect early cartilage proteoglycan and collagen breakdown.
HYPOTHESIS: Marathon runners will demonstrate T1rho 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 T1rho 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 T1rho 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 T1rho values increased after the marathon from 37.0 to 38.9 (P < .001) and remained increased at 3 months.
CONCLUSION: Runners showed elevated T1rho and T2 values after a marathon, suggesting biochemical changes in articular cartilage, T1rho 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.
- “Effects of running and walking on osteoarthritis and hip replacement risk,” Paul T Williams, Medicine & Science in Sports & Exercise, 2013.
- “The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis,” Eduard Alentorn-Geli, Kristian Samuelsson, Volker Musahl, Cynthia L Green, Mohit Bhandari, and Jón Karlsson, Journal of Orthopaedic & Sports Physical Therapy, 2017.
- “Low Prevalence of Hip and Knee Arthritis in Active Marathon Runners,” Danielle Y Ponzio, Usman Ali M Syed, Kelly Purcell, Alexus M Cooper, Mitchell Maltenfort, Julie Shaner, and Antonia F Chen, Journal of Bone & Joint Surgery, 2018.
- “Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative,” Grace H Lo, Sarra M Musa, Jeffrey B Driban, Andrea M Kriska, Timothy E McAlindon, Richard B Souza, Nancy J Petersen, Kristi L Storti, Charles B Eaton, Marc C Hochberg, Rebecca D Jackson, C Kent Kwoh, Michael C Nevitt, and Maria E Suarez-Almazor, Clin Rheumatol, 2018.
Specifically regarding Luke 2010:
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.
- Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Nakale 2018 Foot Ankle Int.
- No Added Benefit of Combining Dry Needling With Guideline-Based Physical Therapy When Managing Chronic Neck Pain: A Randomized Controlled Trial. Stieven 2020 J Orthop Sports Phys Ther.
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.