@article{ref1,
title="How (not) to interpret a non-causal association in sports injury science",
journal="Physical therapy in sport",
year="2018",
author="Hjerrild, Mette and Videbaek, Solvej and Theisen, Daniel and Malisoux, Laurent and Oestergaard Nielsen, Rasmus",
volume="32",
number="",
pages="121-125",
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. <br><br>DESIGN: 1-year prospective cohort study. SETTING: Denmark. PARTICIPANTS: 926 novice runners, representing 1852 feet, were included. MAIN OUTCOME MEASURE: The outcome was &quot;a musculoskeletal complaint of the lower extremity or back caused by running, which restricted the amount of running for at least a week&quot;. <br><br>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%]). <br><br>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. This illustrates that non-causal associations are unsuitable to respond to the question: Why do sports injury develop?<br><br>Copyright © 2018 Elsevier Ltd. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1466-853X",
doi="10.1016/j.ptsp.2018.05.009",
url="http://dx.doi.org/10.1016/j.ptsp.2018.05.009"
}