![]() These issues are not only important in sports medicine, but also for the rheumatologist. In this respect, tendons around the knees and ankles seem to be more prone to pathologies than the Achilles tendon. However, there are data suggesting a short and long term influence on involved tendons and entheses. A follow-up trial after ten years of long-distance running also did not show deterioration of knee joint structures on MRI. On the other hand, four magnetic resonance imaging (MRI) trials comparing the status of joints before and after a marathon competition could not demonstrate any relevant changes in the amount of synovial fluid in the hip, knee and metatarsophalangeal (MTP) joints, while another study found a small increase in knee joint effusions, but no other changes in MRI imaging after a marathon race. One trial in healthy volunteers showed an increase of joint effusions in five out of ten examined knees after physical exercise and another trial showed a higher rate of ankle joint effusions after extreme physical stress in comparison to moderate sportive activity. Some of them found increased amounts of synovial fluid in joints of individuals who perform regular physical exercise. However, only few studies with small numbers of subjects have dealt with this issue with conflicting results. ![]() ![]() It could be expected that physical stress acts as a stimulus on the production of synovial fluid and may provoke tendon irritation or enthesitis. The impact of physical exercise on the morphology of joints and surrounding structures like entheses and tendons is still a matter of debate. No significant changes of synovial effusion were detected in knee and talocrural joints. ConclusionsĪcute physical stress is significantly associated with hypervascularity of the patellar tendon. This observation was more frequent in male than in female participants ( p < 0.05). Hypervascularity of the patellar tendon was detected in 21 cases (10.0 %) at follow-up in contrast to one at baseline ( p < 0.001). Effusion size did not correlate with the timepoint of ultrasound assessment and was independent of covariates such as gender, age or running distance. The differences were not significant ( p > 0.05 each). 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. One 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. In addition to the ultrasound evaluation, information on training habits and past or present arthralgia or joint swelling was gathered. Findings consistent with joint effusion, tendon and/or entheseal pathologies were documented. Ultrasound assessment included grey scale and power Doppler examination of the knee and talocrural joints with surrounding tendons. Participants of the Munich marathon were examined by arthrosonography before and after long distance running. 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. The impact of physical exercise on joints and tendons is still a matter of debate.
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