The NLstart2run study: Economic burden of running-related injuries in novice runners participating in a novice running program

Luiz C., Jr. Hespanhol, Bionka M. A. Huisstede, Dirk-Wouter Smits, Bas Kluitenberg, Henk van der Worp, Marienke van Middelkoop, Fred Hartgens, Evert Verhagen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: To investigate the economic burden of running-related injuries (RRI) occurred during the 6-week 'Start-to-Run' program of the Dutch Athletics Federation in 2013. Design: Prospective cohort study. Methods: This was a monetary cost analysis using the data prospectively gathered alongside the RRI registration in the NLstart2run study. RRI data were collected weekly. Cost diaries were applied two and six weeks after the RRI registration to collect data regarding healthcare utilisation (direct costs) and absenteeism from paid and unpaid work (indirect costs). RRI was defined as running-related pain that hampered running ability for three consecutive training sessions. Results: From the 1696 participants included in the analysis, 185 reported a total of 272 RRIs. A total of 26.1% of the cost data (71 RRIs reported by 50 participants) were missing. Therefore, a multiple imputation procedure was performed. The economic burden (direct plus indirect costs) of RRIs was estimated at (sic)83.22 (95% CI(sic)50.42-(sic)116.02) per RRI, and (sic)13.35 (95% CI(sic)7.07-(sic)19.63) per participant. The direct cost per RRI was (sic)56.93 (95% CI (sic)42.05-(sic)71.81) and the indirect cost per RRI was (sic)26.29(95% CI (sic)0.00-(sic)54.79). The indirect cost was higher for sudden onset RRIs than for gradual onset RRIs, with a mean difference of (sic)33.92 (95% CI (sic)17.96-(sic)49.87). Conclusions: Direct costs of RRIs were 2-fold higher than the indirect costs, and sudden onset RRIs presented higher costs than gradual onset RRIs. The results of this study are important to provide information to public health agencies and policymakers about the economic burden of RRIs in novice runners.
Original languageEnglish
Pages (from-to)800-804
JournalJournal of Science and Medicine in Sport
Issue number10
Publication statusPublished - Oct 2016


  • Sports injury
  • Epidemiology
  • Cohort studies
  • Epidemiological monitoring
  • Costs and cost analysis


Dive into the research topics of 'The NLstart2run study: Economic burden of running-related injuries in novice runners participating in a novice running program'. Together they form a unique fingerprint.

Cite this