Meb Keflezighi became the first American man to win the New York City Marathon since 1982 on Sunday.

Derartu Tulu of Ethiopia captured the women's race, with two-time defending champ Paula Radcliffe falling back to fourth then grabbing her left leg in pain after finishing.

Keflezighi, the 2004 Olympic silver medalist, learned after a disappointing performance in the U.S. Olympic trials in New York two years ago he had a stress fracture in his hip. He capped the long and painful comeback with a landmark victory against a deep field for his first major marathon title.

That day in 2007 he also lost close friend Ryan Shay, who collapsed and died during the race. Keflezighi said the tears he shed after winning were for Shay.

Born in Eritrea, the 34-year-old runner became a U.S. citizen in 1998. He was second in New York in 2004 and third in 2005. Wearing "USA" on the front of his jersey, Keflezighi won in 2 hours, 9 minutes, 15 seconds.

"The USA gave me all the opportunities there is in education, sports and lifestyle," he said. "To be able to represent the USA is a big thing for me."

With nearly 44,000 runners starting the 40th edition of the race, Keflezighi pulled away from Robert Cheruiyot of Kenya in the 23rd mile to beat the four-time Boston Marathon champ by 41 seconds. Alberto Salazar had been the last American men's champion, taking three straight titles from 1980-82.

Morocco's Jaouad Gharib finished third and Ryan Hall was fourth on an impressive day for U.S. distance running, with six Americans in the top 10 for the first time since 1979. The race doubled at the national men's marathon championship.

"I was just praying it could be my day and a lot can change by winning this race," Keflezighi said.

Many of the runners, stars and regular folks alike, pounded the pavement for a good cause.

"We're raising money to build the first public children's hospital in Kenya," actor Anthony Edwards said. "It'll be the largest children's hospital in Africa."

"I'm running with the number 1275 to represent the 1.275 million people living with a spinal cord injury in this country," said Matt Reeve, son of 'Superman' actor Christopher Reeve, who suffered a spinal cord injury that left him paralyzed.

All of the runners, however, had a singular goal.

"Finishing is the expectation I put on myself," Edwards said.

Ludmila Petrova, a 41-year-old Russian, was the runner-up for the second straight year in the women's race, while Christelle Daunay of France was third.

Radcliffe said she had tendinitis behind her knee. The world record-holder from Britain failed to win a marathon for just the third time in 11 starts.

The 37-year-old Tulu won Olympic gold medals on the track in the 10,000 meters in 1992 and 2000. Her only marathon title came in London in 2001.

She had struggled with her weight and endurance after the birth of her second daughter three years ago. But when she ran well at a half-marathon in Philadelphia on Sept. 20, she decided to enter New York.

"I did not come here necessarily expecting to win," she said, "but I did expect to be a strong competitor."

The first New York City Marathon was held in 1970 and had 127 runners.