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  1. Henk van der Worp1,
  2. Marienke van Middelkoop2,
  3. Fred Hartgens3,4,
  4. Bionka Huisstede5,
  5. Per Wilms1,
  6. Bas Kluitenberg1,
  7. Evert Verhagen6,7,8,
  8. Nadine Rasenberg2,
  9. Ron Diercks1
  1. 1Center for Sports Medicine, University of Groningen, University Medical Center, Groningen, The Netherlands
  2. 2Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
  3. 3Departments of Epidemiology and Surgery, Research School CAPHRI, Maastricht University, Medical Center+, Maastricht, The Netherlands
  4. 4Sports Medicine Center Maastricht, Maastricht, The Netherlands
  5. 5Department of Rehabilitation, Nursing Science and Sports, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
  6. 6Amsterdam Collaboration on Health & Safety in Sports, Department of Public & Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  7. 7Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation, University Australia, SMB Campus, Ballarat, Australia
  8. 8UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa


    Background In sedentary subjects use of medication is expected to be high which may cause problems when taking up exercise as several types of medication have been linked to musculoskeletal disorders.

    Objective To study the relation between medication use and the incidence of running-related injuries in novice runners.

    Design Prospective cohort study with propensity score matching analysis.

    Setting A nationwide start to run program for novice runners (N=7,660).

    Patients (or Participants) Novice runners (N=1,696) aged between 18–65 years taking part in a start to run program.

    Interventions (or Assessment of Risk Factors) Self-reported medication use was assessed with a questionnaire at baseline. Medication was categorized according to (1) condition and (2) chemical properties. Subjects who used medication were matched to controls using propensity score matching.

    Main Outcome Measurements Incidence rate differences were calculated between subjects that used medication and matched controls for each medication category.

    Results Women who took contraceptives had lower incidence densities of running-related injuries compared to matched controls both when medication was categorized according to condition (all contraceptives: incidence rate difference=−21.2 injuries/1000 h, 95% CI −41.9−−0.5) and according to chemical properties (hormonal contraceptives: incidence rate difference=−35.7 injuries/1000 h, 95% CI −61.3−−10.1). For other medication types no relation with injuries was established.

    Conclusions The study gives an overview of the influence of medication use on injuries in novice runners. Only for contraceptive use a relation with injuries was found. The use of contraceptives seems to have a preventive effect on the occurrence of injuries. An explanation for this finding may be the direct hormonal effect of contraceptives, for example on neuromuscular control and joint laxity, or an indirect effect through personal characteristics related to contraceptive use, such as health behaviour or risk-taking behaviour.

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