A course that covers 4,500 kilometers in 64 days, on foot, without a single day’s rest: an impossible distance for the average jogger. The experienced runners who participated in the Transeurope Footrace 2009, which ran from Bari, Italy, to Nordkapp, Norway, did make it – at least some of them. But how did their musculoskeletal systems and hearts change under such extreme conditions, and which processes in their brains support their efforts?

These are the questions that Dr. Uwe Schütz of the University Clinic Ulm in Germany wants to answer. To do so, he started a unique research project in which he followed along on the entire course of the run, from April 15 to June 21, with a big trailer that houses a MAGNETOM Avanto™ magnetic resonance imaging (MRI) system. Each day, up to eleven participants were examined in the trailer. “This run was a unique study setting,” says Schütz, who specializes in sports medicine and radiology. “Because we were able to do progressive checks via MRI for the first time, and not just before and after examinations, we hope that we will get a chance to understand and trace the processes that take place in the body.”

Schütz and his team examined a group of 42 test subjects from among the event’s total of 67 participants. The test subjects were split at random into three examination groups. In the first group, injuries to the lower part of the musculoskeletal system were monitored. The doctors have already been able to arrive at initial findings regarding the “shin splint” syndrome, in which patients experience pain in the shin area after particularly heavy strain. In the field of sports medicine, there is no agreement as to whether this syndrome represents an actual disease in its own right or is a symptom of various causes. It is also unclear which tissues, specifically, are affected – with the result that both inflammations of the bone marrow and excessive muscle strain are discussed as causes. The findings generated by Schütz and his colleagues to date, however, seem instead to indicate injuries to the extensor tendons or tenosynovitis.

The MRI trailer also made it possible for the radiologists to carry out, for the first time, a qualitative analysis of cartilage under long-term strain in order to determine what kinds of running strain bring about which biochemical changes in cartilage. To achieve this, the team used the Siemens application syngo^® MapIt, which enables cartilage analysis using specifically weighted cartilage mapping.