@article{1c2d5e6ddc5d4ef69ae5516ab1d5e830,
title = "How (not) to interpret a non-causal association in sports injury science",
abstract = "Objective: To discuss the interpretability of non-causal associations to sports injury development exemplified via the relationship between navicular drop (ND) and running-related injury (RRI) in novice runners using neutral shoes. Design: 1-year prospective cohort study. Setting: Denmark. Participants: 926 novice runners, representing 1852 feet, were included. Main outcome measure: The outcome was “a musculoskeletal complaint of the lower extremity or back caused by running, which restricted the amount of running for at least a week”. Results: Fewer feet with small ND than those feet with a reference ND sustained injuries at 50 (risk difference (RD) = −4.1% [95%CI = −7.9%;-0.4%]) and 100 km (RD = −5.3% [95%CI = −9.9%;-0.7%]). Similarly, fewer feet with a large ND sustained injuries than the feet with a reference drop at 250 (RD = −7.6% [95%CI = −14.9%;-0.3%]) and 500 km (RD = −9.8% [95%CI = −19.1%;-0.4%]). Conclusion: Non-causal associations can help to identify sub-groups of athletes at an increased or decreased risk of sports injury. Based on the current results, those with a small or large navicular drop sustain fewer injuries than those with a reference drop. Importantly, navicular drop does not cause RRIs, but influences the relationship between training load and RRI.",
keywords = "Causality, Injury, Navicular drop, Running",
author = "Mette Hjerrild and Solvej Videbaek and Daniel Theisen and Laurent Malisoux and {Oestergaard Nielsen}, Rasmus",
note = "Funding Information: This study received direct funding from Orthopedic Surgery Research Unit, Science and Innovation Center, Aalborg Hospital, Aarhus University and the Danish Rheumatism Association . Furthermore, Garmin and Adidas made it possible to buy GPS watches and running shoes at a reduced price. The authors were personally salaried by their institutions during the period of writing (although no specific salary was set aside or given for the writing of this paper). No funders had any role in the study design, data collection, analysis, decision to publish or preparation of the manuscript. All authors are independent researchers without any financial interest in the results presented. Funding Information: This study received direct funding from Orthopedic Surgery Research Unit, Science and Innovation Center, Aalborg Hospital, Aarhus University and the Danish Rheumatism Association. Furthermore, Garmin and Adidas made it possible to buy GPS watches and running shoes at a reduced price. The authors were personally salaried by their institutions during the period of writing (although no specific salary was set aside or given for the writing of this paper). No funders had any role in the study design, data collection, analysis, decision to publish or preparation of the manuscript. All authors are independent researchers without any financial interest in the results presented. Publisher Copyright: {\textcopyright} 2018 Elsevier Ltd",
year = "2018",
month = jul,
doi = "10.1016/j.ptsp.2018.05.009",
language = "English",
volume = "32",
pages = "121--125",
journal = "Physical Therapy in Sport",
issn = "1466-853X",
publisher = "Elsevier BV",
}