How does running your first marathon affect your spine?

Published September 2021 in Skeletal Radiology

Our first study of the spine was based on the 2019 Richmond Marathon. We wanted to better understand the impact of long-distance running on runners’ lumbar spines, by assessing changes before and after their first marathon running experience, including the marathon event and the training leading up to it.

Long-distance running is extremely popular, with over a million runners participating in marathon runs (42 km) each year. Despite the well-known cardiorespiratory benefits of running, there have been concerns related to the impact of marathon running on lumbar spine health, especially on intervertebral disc (IVD) conditions. During running, significant compression and rotational forces are exerted on the lower lumbar discs. However, it is yet unclear whether repetitive running as in a marathon is harmful to the lumbar spine.

The objective of our study was to evaluate MRI lumbar spine findings of first-time marathon runners before and after a 4-month training programme ending in a marathon race and thus to better understand whether this running dose is harmful to lumbar spine health. All participants were in their 30s, with no known spine problems.

We found that 500 miles of running had no adverse effects on the lumbar spines of runners, even when early degenerative changes are present. Furthermore, we found evidence that pre-existing sacroiliac joint abnormalities actually regressed after the marathon.

 

In short

The study

  • Our objective was to assess spine health before and after training for and completing a marathon.

  • The study was a collaboration with organisers of Richmond Runfest, which helped us source participants in 2019.

  • We recruited 28 participants who met the requirements: to be aged 18+, have no known spine problems, and to have never run a marathon. 14 were male, 14 were female.

  • They underwent MRI scans of the lower spine 16 weeks before the date of the marathon and two weeks after the event.

  • 21 runners completed the standardised, 4 month–long training programme and the marathon; 7 runners did not complete the training or the marathon.

What we found

  • Degeneration of the spinal discs was common among participants, with no back pain reported. Mild degeneration was the most prevalt, while 4 participants showed moderate degeneration and one had severe degeneration.

  • The presence and level of disc degeneration did not affect marathon finishing times.

  • None of the seven participants who dropped out of the training wihdrew due to any spinal concerns.

  • The severity of disc degeneration did not change between the two MRI scans.

What it means

  • Our research showed that running 500 miles over 4 months, followed by a marathon, had no adverse effect on the lower lumbar spine.

  • We also found evidence that some abnormalitis of the sacroiliac joints regressed following the training programme.

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