Athletes Play Through Pain-What Does That Mean for Rehabilitation Specialists?

Abstract

Context: Pain in sport has been normalized to the point where athletes are expected to ignore pain and remain in the game despite the possible detrimental consequences associated with playing through pain. While rehabilitation specialists may not have an influence on an athlete's competitive nature or the culture of risk they operate in, understanding the consequences of those factors on an athlete's physical well-being is definitely in their area of responsibility.

Objective: To explore the factors associated with the experiences of subelite athletes who play through pain in gymnastics, rowing, and speed skating.

Design: The authors conducted semistructured interviews with subelite athletes, coaches, and rehabilitation specialists. They recruited coach participants through their provincial sport organization. Athletes of the recruited coaches who were recovering from a musculoskeletal injury and training for a major competition were then recruited. They also recruited rehabilitation specialists who were known to treat subelite athletes independently by e-mail.

Setting: An observation session was conducted at the athlete's training facility. Interviews were then conducted either in a room at the university or at a preferred sound-attenuated location suggested by the participant.

Participants: The authors studied 5 coaches, 4 subelite athletes, and 3 rehabilitation specialists.

Interventions: The authors photographed athletes during a practice shortly before an important competition, and we interviewed all the participants after that competition. Our photographs were used during the interview to stimulate discussion.

Results: The participant interviews revealed 3 main themes related to playing through pain. They are: Listening to your body, Decision making, and Who decides.

Conclusion: When subelite athletes, striving to be the best in their sport continue to train with the pain of an injury, performance is affected in the short-term and long-term consequences are also possible. Our study provides some insight into the contrasting forces that athletes balance as they decide to continue or to stop.

Keywords: culture of risk; decision making; harm reduction; injury management; listening to your body; return to play.