It May Not Be the Smartest Thing to Do, but Sometimes It’s the Only Option: A Longitudinal Mixed-Methods Study of Analgesic Use in Youth Elite Athletes

OBJECTIVES: To (1) compare analgesic use over 36 weeks between endurance athletes, technical athletes, and team athletes, and (2) explore experiences and sociocultural factors impacting analgesic use. DESIGN: Longitudinal mixed-methods study METHODS: Six hundred eighty-nine youth elite athletes (44% girls/women, 15-20 years) provided weekly reports on number of days with analgesic use, reasons for use, and types of analgesics used for 36 weeks. Prevalence and frequency of analgesic use was compared between athletes from team sports, endurance sports, and technical sports using mixed-effects logistic and Poisson regression models. Reasons and types of analgesics used were compared between groups using Chi-square tests. Nine focus group interviews with 32 participants were conducted and analyzed using thematic analysis. RESULTS: There were no differences in odds of analgesic use between endurance athletes (reference group), technical athletes (odds ratio [OR], 0.94; 95% confidence interval [CI]: 0.65, 1.37), and team athletes (OR, 0.88; 95% CI: 0.62, 1.25). Similarly, there were no differences in rate of analgesic use between endurance athletes (reference group), technical athletes (incidence rate ratio [IRR], 0.97; 95% CI: 0.87, 1.07), or team athletes (IRR, 1.03; 95% CI: 0.94, 1.14). Reasons for use varied between groups, while the types of analgesics used were similar. Sociocultural factors impacting analgesic use included considering the potential consequences of using analgesics for pain and injury, and feeling responsible for team performance. CONCLUSION: Analgesics were commonly used among youth elite athletes in Denmark. Analgesic use generally did not vary between team athletes, endurance athletes, and technical athletes. Several norms, values, and structures in sports environments impacted analgesic use. J Orthop Sports Phys Ther 2025;55(5):1-11. Epub 3 April 2025. doi:10.2519/jospt.2025.13015.