Serum creatine phosphokinase (CK) and CK-MB activity were determined in 21 trained runners participating in a marathon race (42.2 km). Enzyme activities immediately after the race increased two to three times compared with activities before the race. The greatest increases were found in the slowest runners, suggesting greater skeletal muscular trauma in the least trained or fit. As these are likely to include the older athletes who are also more likely to suffer acute myocardial injury during strenuous exercise, our findings assume special import in the interpretation of increased CK and CK-MB serum activities of older athletes.