To rest or to compete? A 4-week cohort study of analgesic use and willingness to compete hurt in Danish youth elite athletes

Objectives: To assess the association between analgesic use and willingness to compete hurt (WCH) in Danish youth elite athletes, and to explore factors associated with such willingness.Design: 4-week prospective cohort study.Methods: 592 Danish youth elite athletes (15-20 years) completed a baseline questionnaire assessing demo-graphic information, sport history, and WCH, and provided weekly reports on analgesic use for 4 weeks via text messages. Analgesic use was categorized as no use (0 weeks) or use across 1, 2, 3, or 4 weeks, and as the total number of days with analgesic use. Multinomial logistic regression and zero-inflated negative binomial re-gression analyses estimated the association between analgesic use and WCH. Linear backward stepwise regres-sion analysis was used to identify factors associated with WCH.Results: Overall, risk of analgesic use increased significantly with increasing WCH scores (relative risk ratios rang -ing from 1.06 (95% CI 1.0 to 1.12%) to 1.34% (95% CI 1.15 to 1.57)). The incidence rate of analgesic use increased significantly with increasing WCH scores (incidence rate ratio 1.09 (95% CI 1.04 to 1.14)). Associations between the investigated possible antecedent factors and WCH were weak and not considered practically important (R2 = 0.05 or lower). Conclusions: Higher WCH scores were associated with increasing risk of analgesic use, irrespective of the under-lying reason for the use, in Danish youth elite athletes, suggesting that analgesics may be an ingrained part of a sport-specific culture of risk acceptance. Future studies should include measures of culture, norms, and social in-teraction to better explain the variance in WCH.(c) 2023 The Authors. Published by Elsevier Ltd on behalf of Sports Medicine Australia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

This study assessed the association between analgesic use and willingness to compete hurt in Danish youth elite athletes, finding that higher WCH scores were associated with increased risk of analgesic use. The investigated factors related to WCH were weak and considered not practically important.