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

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $74.00

1 year subscription

USD  $99.00

Student 2 year subscription

USD  $141.00

2 year subscription

USD  $185.00

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.

Barrette is with the School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada. Harman is with Dalhousie University, Halifax, Nova Scotia, Canada.

Barrette (amyfbarrette@gmail.com) is corresponding author.
  • 1.

    Wiese-Bjornstal D. Psychology and socioculture affect injury risk, response, and recovery in high-intensity athletes: a consensus statement. Scand J Med Sci Sports. 2010;20:103–111. PubMed ID: 20840568 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Curry T. A little pain never hurt anyone: athletic career socialization and the normalization of sports injury. Symb Interact. 1993;16(3):273–290. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Safai P. Healing the body in the “culture of risk”: examining the negotiation of treatment between sport medicine clinicians and injured athletes in Canadian intercollegiate sport. Sociol Sport J. 2003;20(2):127–146. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Hammond L, Lilley J, Pope G, Ribbans W, Walker N. ‘We’ve just learnt to put up with it’: an exploration of attitudes and decision-making surrounding playing with injury in English professional football. Qual Res Sport Exerc Health. 2013;6(2):161–181. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Hibberd E, Myers J. Practice habits and attitudes and behaviors concerning shoulder pain in high school competitive club swimmers. Clin J Sport Med. 2013;23(6):450–455. PubMed ID: 24042443 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Deroche T, Woodman T, Stephan Y, Brewer B, Le Scanff C. Athletes’ inclination to play through pain: a coping perspective. Anxiety Stress Coping. 2011;24(5):579–587. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Simon J, Docherty C. Current health-related quality of life is lower in former Division I collegiate athletes than in non-collegiate athletes. Am J Sports Med. 2013;42(2):423–429. PubMed ID: 24318608 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    International Association for the Study of Pain. IASP Taxonomy. 2018. http://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698&&navItemNumber=576. Accessed January 17, 2018.

    • PubMed
    • Export Citation
  • 9.

    Craig K. The social communication model of pain. Can Psychol. 2009;50(1):22–32. doi:

  • 10.

    Fordyce W. Behavioral Methods for Chronic Pain and Illness. Saint Louis, MO: C.V. Mosby Co; 1976.

  • 11.

    Sullivan M, Thibault P, Savard A, Catchlove R, Kozey J, Stanish W. The influence of communication goals and physical demands on different dimensions of pain behavior. Pain. 2006;125(3):270–277. PubMed ID: 16860479 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Cook K, Roddey T, Bamer A, Amtmann D, Keefe F. Validity of an observation method for assessing pain behavior in individuals with multiple sclerosis. J Pain Symptom Manage. 2013;46(3):413–421. PubMed ID: 23159684 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    van der Putten A, Vlaskamp C. Pain assessment in people with profound intellectual and multiple disabilities; a pilot study into the use of the Pain Behaviour Checklist in everyday practice. Res Dev Disabil. 2011;32(5):1677–1684. PubMed ID: 21440413 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Vervoort T, Craig K, Goubert L, et al. Expressive dimensions of pain catastrophizing: a comparative analysis of school children and children with clinical pain. Pain. 2008;134(1):59–68. doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Nixon H. The relationship of friendship networks, sports experiences, and gender to expressed pain thresholds. Sociol Sport J. 1996;13(1):78–86. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Hammond L, Lilley J, Pope G, Ribbans W. The impact of playing in matches while injured on injury surveillance findings in professional football. Scand J Med Sci Sports. 2013;24(3):e195–e200. PubMed ID: 24118123 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Beers M, Fletcher A, Jones T, Porter R. The Merck Manual of Medical Information. Whitehouse Station, NJ: Merck Research Laboratories; 2003.

    • Search Google Scholar
    • Export Citation
  • 18.

    Young K, White P, McTeer W. Body talk: male athletes reflect on sport, injury, and pain. Sociol Sport J. 1994;11(2):175–194. doi:

  • 19.

    Cruz E, Higginbottom G. The use of focused ethnography in nursing research. Nurs Res. 2013;20(4):36–43. doi:

  • 20.

    Roper J, Shapira J. Ethnography in Nursing Research. Thousand Oaks, CA: Sage Publications; 2000.

  • 21.

    Morse J.M. Qualitative nursing research: A contemporary dialogue. Sage Publications; 1990.

  • 22.

    Gagnon AJ, Carnevale F, Mehta P, Rousseau H, Stewart DE. Developing population interventions with migrant women for maternal-child health: a focused ethnography. BMC Public Health. 2013;13(1):1–14.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Graham LJ, Connelly DM. 'Any movement at all is exercise': A focused ethnography of rural community-dwelling older adults' perceptions and experiences of exercise as self-care. Physiotherapy Canada. 2013;65(4):333–341.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Kilian C, Salmoni A, Ward-Griffin C, Kloseck M. Perceiving falls within a family context: a focused ethnographic approach. Canadian Journal on Aging. 2008;27(04):331–345.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications; 2013.

  • 26.

    Malcom N. “Shaking it off” and “toughing it out”. J Contemp Ethnogr. 2006;35(5):495–525. doi:

  • 27.

    Broome A. Psychological treatments for chronic pain. In: Karas E, ed. Current Issues in Clinical Psychology Boston, MA: Springer; 1985:59–76. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Twycross A. children’s cognitive level and their perception of pain. Paediatr Nurs. 1998;10(3):24–27. PubMed ID: 9687773 doi:

  • 29.

    LaFleur C, Raway B. School-age child and adolescent perception of the pain intensity associated with three word descriptors. Paediatr Nurs. 1999;25(1):45–55.

    • Search Google Scholar
    • Export Citation
  • 30.

    Gaston-Johansson F, Albert M, Fagan E, Zimmerman L. Similarities in pain descriptions of four different ethnic-culture groups. J Pain Symptom Manage. 1990;5(2):94–100. PubMed ID: 2348093 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Brewer B, Van Raalte J, Linder D. Athletic identity: Hercules’ muscles or Achilles heel? Int J Sport Psychol. 1993;24(2):237–254.

  • 32.

    Pike E, Maguire J. Injury in women’s sport: classifying key elements of “risk encounters”. Sociol Sport J. 2003;20(3):232–251. doi:

  • 33.

    Roderick M. Adding insult to injury: workplace injury in English professional football. Sociol Health Illn. 2006;28(1):76–97. doi:

  • 34.

    Nixon H. Social pressure, social support, and help seeking for pain and injuries in college sports networks. J Sport Soc Issues. 1994;18(4):340–355. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Nixon H. A social network analysys of influences on athletes to play with pain and injuries. J Sport Soc Issues. 1992;16(2):127–135. doi:

  • 36.

    Young K, White P. Threats to sport careers: elite athletes talk about injury and pain. In: Coakley J, Donnelly P, eds. Inside Sports. London, UK: Routledge; 2001:203–213.

    • Search Google Scholar
    • Export Citation
  • 37.

    Turner A, Barlow J, Ilbery B. Play hurt, live hurt: living with and managing osteoarthritis from the perspective of ex-professional footballers. J Health Psychol. 2002;7(3):285–301. PubMed ID: 22114251 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Madrigal L, Robbins J, Gill D, Wurst K. A pilot study investigating the reasons for playing through pain and injury: emerging themes in men’s and women’s collegiate rugby. Sport Psychol. 2015;29(4):310–318. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Theberge N. “Just a normal bad part of what I do”: elite athletes’ accounts of the relationship between health and sport. Sociol Sport J. 2008;25(2):206–222. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Liston K, Reacher D, Smith A, Waddington I. Managing pain and injury in non-elite rugby union and rugby league: a case study of players at a British University. Sport in Society: Cultures, Commerce, Media, Politics. 2006;9(3):388–402. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Robbins JE, Rosenfeld LB. Athletes’ perceptions of social support provided by their head coach, assistant coach, and athletic trainer, pre-injury and during rehabilitation. J Sport Behav. 2001;24(3):277–297. http://search.proquest.com/openview/0fbb2e29f359482934bf247afffca4d9/1?pq-origsite=gscholar&cbl=3015

    • Search Google Scholar
    • Export Citation
  • 42.

    Young K, White P. Sport, physical danger, and injury: the experiences of elite women athletes. J Sport Soc Issues. 1995;19(1):45–61. doi:

All Time Past Year Past 30 Days
Abstract Views 68 68 23
Full Text Views 9 9 5
PDF Downloads 7 7 3