Muscle pathomorphology in m. quadriceps of marathon runners. Early signs of strain disease or functional adaptation?

Muscle biopsies were obtained from m. vastus lateralis of five male marathon runners and five sprinters. The athletes performed their last competition at least 2 weeks prior to the investigation. No clinical signs of discomfort or injury were observed in the runners. The biopsy specimens from the sprinters showed an ordinary overall morphology, although fibre sizes varied considerably within and between the individuals. In contrast, in the marathon runners, structural deviations of pathologic value appeared in four out of five subjects. The fibre shapes were irregular, irrespective of fibre type, and internal architectural changes were common. An increased amount of connective tissue was found. A majority of fibres showed one or more central nuclei. A few fibres were flat and there were also evidence of fibre type grouping. The divergent picture might be an expression of repeated fibre injury with subsequent processes. If so, a peripheral, relative, arterial insufficiency is suggested as a possible aetiology. However, it cannot be ruled out that the deviations express a functional adaptation to the extreme endurance demands.