CINXE.COM

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class="tk-markdown">Pain in Athletes: Current Knowledge and Challenges</div></tk-markdown></h1><div class="authors"><span article-author="" class="single-author ng-star-inserted" _nghost-hep-c19=""><span _ngcontent-hep-c19="" class="white ng-star-inserted"><a _ngcontent-hep-c19="" href="#" class="author-name">Rafael Krasic Alaiti</a><span _ngcontent-hep-c19="" class="comma">, </span></span></span><span article-author="" class="single-author ng-star-inserted" _nghost-hep-c19=""><span _ngcontent-hep-c19="" class="white ng-star-inserted"><a _ngcontent-hep-c19="" href="#" class="author-name">Felipe J.J. Reis</a><span _ngcontent-hep-c19="" class="comma last">, </span></span></span><tk-side-panel keydown="test"><div class="cd-panel from-right" id="panel-4918"><header class="cd-panel-header from-right"><button aria-label="close side panel" class="cd-panel-close"></button></header><div class="cd-panel-container from-right"><div class="cd-panel-content"><div class="panel-content"><div><div class="author-name-large"> </div></div></div></div></div></div></tk-side-panel></div><div class="keyword-container flex-parent ng-star-inserted"><span article-keyword="" class="keywords ng-star-inserted"><a class="keyword white" href="/articles?tag=pain%20management">pain management</a></span><span article-keyword="" class="keywords ng-star-inserted"><a class="keyword white" href="/articles?tag=athletic%20injury">athletic injury</a></span></div><div class="copyright-wrapper"><copyright-license _nghost-hep-c7=""><span _ngcontent-hep-c7="" class="copyright-license"><span _ngcontent-hep-c7="" class="oa-logo ng-star-inserted"><svg _ngcontent-hep-c7="" version="1.1" id="svg-oa-logo" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewBox="0 0 2500 1000" xml:space="preserve" style="enable-background: new 0 0 2500 1000;"><title _ngcontent-hep-c7="">Copyright Logo</title><g _ngcontent-hep-c7=""><path _ngcontent-hep-c7="" d="M1056.8,302.4v30.7h90.1v-30.7c0-74.3,60.5-134.8,134.8-134.8c74.3,0,134.8,60.5,134.8,134.8v222.2h90.1V302.4 c0-124-100.9-224.9-224.9-224.9C1157.7,77.6,1056.8,178.4,1056.8,302.4 M1356.3,654.3c0,41-33.3,74.3-74.3,74.3 c-41,0-74.3-33.3-74.3-74.3c0-41.1,33.3-74.3,74.3-74.3C1323.1,580,1356.3,613.2,1356.3,654.3" class="svg-fill"></path><path _ngcontent-hep-c7="" d="M1106,653.5c0-96.6,78.6-175.1,175.1-175.1c96.6,0,175.1,78.6,175.1,175.1c0,96.6-78.6,175.1-175.1,175.1 C1184.6,828.6,1106,750,1106,653.5 M1016,653.5c0,146.2,119,265.2,265.2,265.2c146.2,0,265.2-119,265.2-265.2 c0-146.2-119-265.2-265.2-265.2C1135,388.3,1016,507.3,1016,653.5" class="svg-fill"></path></g></svg></span><span _ngcontent-hep-c7="" class="copyright-text ng-star-inserted"><span _ngcontent-hep-c7="" tk-tooltip="" trigger="click" tabindex="0"><span _ngcontent-hep-c7="" class="uppercase">ccby-nc-4.0</span></span></span></span></copyright-license><span id="copyright-and-doi-separator" class="ng-star-inserted"> • </span><a target="_blank" class="doi-link ng-star-inserted" href="https://doi.org/10.26603/001c.37675">https://doi.org/10.26603/001c.37675</a></div></div><div class="cover_attribution ng-star-inserted"><span><tk-unsplash-blurb _nghost-hep-c4="">Photo by <a _ngcontent-hep-c4="" target="blank" href="https://unsplash.com/@julientromeur?utm_source=scholastica&utm_medium=referral">julien Tromeur</a> on <a _ngcontent-hep-c4="" href="https://unsplash.com/?utm_source=scholastica&utm_medium=referral">Unsplash</a></tk-unsplash-blurb></span></div></div></div></div></article-header><article-info-bar class="ng-tns-c22-2"><div><div class="info-bar-content medium-12 columns" style="background-color: rgb(255, 255, 255);"><div class="row"><div class="medium-9 columns"><div class="journal serif"><a routerlink="/" href="/" style="color: rgb(51, 51, 51);">IJSPT</a></div><div id="article-citation" style="color: rgb(51, 51, 51);"><tk-citation _nghost-hep-c2=""><div _ngcontent-hep-c2="" class="ng-star-inserted"><div _ngcontent-hep-c2="" class="rendered-citation ng-star-inserted"><div _ngcontent-hep-c2=""><div class="csl-entry"> <div class="csl-left-margin">1.</div><div class="csl-right-inline">Alaiti RK, Reis FJJ. Pain in Athletes: Current Knowledge and Challenges. <i>IJSPT</i>. 2022;17(6):981-983. <a class="cite-link" href="https://doi.org/10.26603/001c.37675">doi:10.26603/001c.37675</a></div> </div></div></div></div></tk-citation></div></div><div class="medium-2 columns end"></div></div></div></div></article-info-bar><div class="row ng-tns-c22-2"><div class="medium-6 medium-offset-3 columns ng-tns-c22-2"><article-actions class="ng-tns-c22-2" _nghost-hep-c15=""><div _ngcontent-hep-c15="" id="article-actions"><div _ngcontent-hep-c15="" class="row"><div _ngcontent-hep-c15="" class="medium-4 medium-centered columns"><tk-dropdown _ngcontent-hep-c15="" class="tk-theme"><div class="dropdown-wrapper"><span tabindex="0" class="dropdown-trigger" aria-controls="dropdown-4894" id="trigger-dropdown-4894" aria-expanded="false"><a _ngcontent-hep-c15="" class="dropdown-trigger"> Save article as...<span _ngcontent-hep-c15="" class="drop-symbol">▾</span></a></span><span class="dropdown" id="dropdown-4894" hidden=""><div _ngcontent-hep-c15="" class="dropdown-content"><ul _ngcontent-hep-c15=""><li _ngcontent-hep-c15=""><button _ngcontent-hep-c15=""><i _ngcontent-hep-c15="" class="fi-page-pdf"></i>PDF </button></li><li _ngcontent-hep-c15=""><button _ngcontent-hep-c15=""><i _ngcontent-hep-c15="" class="fi-page-pdf"></i>XML </button></li><li _ngcontent-hep-c15=""><button _ngcontent-hep-c15=""><i _ngcontent-hep-c15="" class="fi-list"></i>Citation (BibTeX) </button></li></ul></div></span></div></tk-dropdown></div></div></div></article-actions></div><div class="medium-3 columns ng-tns-c22-2"><article-metrics class="ng-tns-c22-2" _nghost-hep-c21=""></article-metrics><p class="view-more-stats ng-tns-c22-2"><a class="ng-tns-c22-2 ng-star-inserted" href="/article/37675-pain-in-athletes-current-knowledge-and-challenges/stats">View more stats</a></p></div></div><div class="row ng-tns-c22-2"><div class="medium-6 columns medium-centered ng-tns-c22-2"></div><tk-side-panel keydown="test" class="ng-tns-c22-2"><div class="cd-panel from-right" id="panel-7320"><header class="cd-panel-header from-right"><button aria-label="close side panel" class="cd-panel-close"></button></header><div class="cd-panel-container from-right"><div class="cd-panel-content"><div class="panel-content"><div class="ng-tns-c22-2"></div></div></div></div></div></tk-side-panel><tk-side-panel keydown="test" class="ng-tns-c22-2"><div class="cd-panel from-right" id="panel-6203"><header class="cd-panel-header from-right"><button aria-label="close side panel" class="cd-panel-close"></button></header><div class="cd-panel-container from-right"><div class="cd-panel-content"><div class="panel-content"></div></div></div></div></tk-side-panel></div><div class="article-body ng-tns-c22-2 american-medical-association"> <p class="drop-letter-pg">Pain in athletes has been traditionally equated with tissue damage (i.e., an acute traumatic or overuse injury).<a class="cite" id="cite-1--139329" data-citation-ids="139329"><sup>1</sup></a> However, chronic pain presents a challenge to team sports since it is not fully explained by ongoing biomechanical stress or overuse injury. Although biomechanical factors can indeed be a relevant nociceptive input for some individuals, it cannot be the main factor to explain pain in athletes.</p> <p>Knowledge about pain has evolved during the last three decades from a cartesian (pain = tissue damage) into a multidimensional perspective in which several factors such as tissue overload, nociceptive gain, cognitive, emotional, behavioral, lifestyle and several other factors interact in complex ways, leaving the individual more or less prone to experience pain.<a class="cite" id="cite-2--139330" data-citation-ids="139330"><sup>2</sup></a> It is well-known that chronic pain cannot be explained solely by patho-anatomical changes. Thus, a narrow focus on biophysical factors (e.g., structural, biomechanical) can contribute to misconceptions about pain, higher threat value of pain, protective behavior and foster disability.<a class="cite" id="cite-3--139329" data-citation-ids="139329"><sup>1</sup></a> In addition, it can lead to overtesting (unnecessary exams), overdetection (detection of clinically unimportant findings), overtreatment (unnecessary treatment for a condition that is not life-threatening or would never cause any symptoms) and high costs.<a class="cite" id="cite-4--139329-139331" data-citation-ids="139329,139331"><sup>1<span>,</span>3</sup></a></p> <p>Although the International Olympic Committee (IOC) published a consensus on pain management in elite athletes enhancing the biopsychosocial approach,<a class="cite" id="cite-5--139332" data-citation-ids="139332"><sup>4</sup></a> the clinical implications of applying current pain knowledge to clinical practice has been barely discussed. According to the IOC consensus, a rational approach to pain management in athletes begins with classifying the type of pain.<a class="cite" id="cite-6--139332" data-citation-ids="139332"><sup>4</sup></a> In this aspect, pain can be classified by its time frame (i.e., acute or chronic), mechanism of onset (i.e., traumatic or non-traumatic) and according to its manifestation (i.e., gradual or sudden). Pain can be classified by its mechanisms as nociceptive, neuropathic or nociplastic. In chronic pain cases, pain can also be classified using the current version of the International Classification of Diseases (ICD-11) as chronic primary pain (e.g., chronic non-specific low back pain) or chronic secondary pain, (e.g., chronic cancer pain, chronic posttraumatic and postsurgical pain, chronic neuropathic pain, chronic headache and orofacial pain, chronic visceral pain, and chronic musculoskeletal pain).<a class="cite" id="cite-7--139333" data-citation-ids="139333"><sup>5</sup></a></p> <p>Adequate chronic pain management in athletes depends on identifying pain mechanisms and contributory factors considering a multidimensional perspective. For example, the most commonly reported risk factors for low back pain in sports were higher athlete training volumes, change to increased training load and history of low back pain.<a class="cite" id="cite-8--139334" data-citation-ids="139334"><sup>6</sup></a> Nevertheless, psychosocial factors including emotional distress, symptoms of anxiety, catastrophic thinking, and pain-related fear, were associated with prolonged recovery and lower return to sport rates.<a class="cite" id="cite-9--139335" data-citation-ids="139335"><sup>7</sup></a> Pain catastrophizing was reported as the most important factor associated with increased pain intensity in injured athletes.<a class="cite" id="cite-10--139335" data-citation-ids="139335"><sup>7</sup></a> An athlete’s psychological readiness to return to play was associated with the outcomes of rehabilitation.<a class="cite" id="cite-11--139336" data-citation-ids="139336"><sup>8</sup></a> The literature presents evidence that pain-related fear, maladaptive beliefs, catastrophizing, and avoidance behavior are key factors in the development of disability in chronic musculoskeletal and primary pain conditions.<a class="cite" id="cite-12--139337" data-citation-ids="139337"><sup>9</sup></a> The social domain is less commonly discussed in the literature and usually involves relationships, social support, engagement in care, environmental influences, and socioeconomic factors.<a class="cite" id="cite-13--139338" data-citation-ids="139338"><sup>10</sup></a></p> <p>Although there have been substantial advances in pain knowledge, there are still some challenges to overcome to properly apply these concepts in sports. First, pain experience should be considered based on complex systems approaches, meaning that pain experience results from the dynamic and non-linear interactions among many (known and unknown) factors. Team sports should also be aware to avoid the pendulum swinging too far from a biophysical to a narrow psychosocial perspective. Thus, it is important not to overlook the “bio” in the multidimensional perspective, since training parameters and biomechanical factors can be associated with some clinical conditions (e.g., lower limb tendinopathy). It is also important to recognize the limitations of the biopsychosocial model in which several factors (e.g., mental health, guilt, stigma, emotional support, feelings of shame, perceived injustice, interpersonal relationships, culture, class, macro socio-economic, political context, religiosity/spirituality, access to healthcare, sleep and nutrition quality) are rarely investigated and their influence on the athlete’s pain experience remains unknown.<a class="cite" id="cite-14--139338" data-citation-ids="139338"><sup>10</sup></a> Second, the implementation of the current ICD classification for chronic pain in sports can contribute to better epidemiological data since definitions and reporting styles across studies present a broad variation. Third, focus on the biophysical factors (e.g., exams, tests) can lay aside patient’s perspective on wellness and care experiences. In this aspect, team sports should implement patient-reported outcome measures in their clinical pain assessment to establish patient-oriented evidence to better inform patient care decisions. Several measurement instruments have been developed and tested in non-athletes. Thus, efforts to develop athlete-specific or sport-specific assessment instruments should be done. Lastly, pain curriculum and training in undergraduate health care programs are insufficient in different disciplines and countries. Further discussion on the need and implementation of a specific course in pain and in sports in professional degree education programs should be considered.</p> </div><div id="history-dates" class="ng-tns-c22-2 ng-star-inserted"><p class="submitted-at ng-tns-c22-2 ng-star-inserted"><strong class="ng-tns-c22-2">Submitted</strong>: <tk-timestamp format="LONG_DATE" class="ng-tns-c22-2"><span>August 01, 2022 CDT</span></tk-timestamp></p><p class="accepted-at ng-tns-c22-2 ng-star-inserted"><strong class="ng-tns-c22-2">Accepted</strong>: <tk-timestamp format="LONG_DATE" class="ng-tns-c22-2"><span>August 14, 2022 CDT</span></tk-timestamp></p></div><div id="copyright-statement" class="ng-tns-c22-2 ng-star-inserted"><p class="ng-tns-c22-2">© The Author(s)</p></div><div id="article-citations" class="ng-tns-c22-2 american-medical-association ng-star-inserted"><h2 class="ng-tns-c22-2 ng-star-inserted">References</h2><citation class="ng-tns-c22-2 ng-star-inserted"><div class="citation" id="citation-139329"><div class="ng-star-inserted"> <div class="csl-entry"> <div class="csl-left-margin">1.</div><div class="csl-right-inline">Caneiro JP, Alaiti RK, Fukusawa L, Hespanhol L, Brukner P, O’sullivan PP. 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The first issue was released February 1, 2006. Beginning V4N1, the Journal became an online publication and all archives were posted on the NAJSPT website. Members and subscribers have immediate access to the publication and articles are available for purchase by non-members. Subscriptions are also available for non-members.\n\nOn January 1, 2011, the journal became the _International Journal of Sports Physical Therapy_, and serves as a benefit of membership for countries around the world. It is an official publication of the International Federation of Sports Physical Therapy (IFSPT).\n\nBeginning January 2021, the IJSPT ownership was transfer to the North American Sportsmedicine Institute for operational control and publishing. The journal retained and expanded the Editorial Board in order to continue the mission and vision that began over fifteen years ago.\n\n*MISSION: To inform the profession of sports physical therapy and providers of sports healthcare via a relevant, timely, and sustainable peer-reviewed publication with global reach. To provide an outlet for scholarly dissemination of clinically relevant musculoskeletal, sport, and activity related research.**\n\n*VISION: To be the leading source of scientifically rigorous, clinically relevant evidence to advance the rehabilitation and care of athletes throughout the world.*\n\nTo be updated automatically when the latest issue goes live, please subscribe:\n[Sign Up Here!](https://nasmi.org/ijspt-sign-up/)\n\n\nThe journal is currently indexed by PubMed, CINAHL and Sport Discus.","short_description":"The International Journal of Sports Physical Therapy is a peer-reviewed journal relating to all aspects of sports physical therapy.","editorial_board":"[View the full Editorial Board here](https://ijspt.org/editorial-board/)","submission_guidelines":"## Please note there is a one time $100 submission fee per manuscript. 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IJSPT welcomes submissions that enhance the practice of sports physical therapy from all disciplines in all countries.\n\n**MANUSCRIPT SUBMISSION**\nPlease read these instructions carefully and follow them closely to ensure that the review and publication of your paper is as efficient and quick as possible. Please also refer to the Journal Policies and Copyright information.\n\nAny manuscript submitted to IJSPT for peer review is original work, has been written by the stated authors, and has not been submitted or published elsewhere. **Manuscripts must not be under simultaneous consideration by any other publications before or during the peer review process. Articles published in IJSPT may not be published elsewhere without written permission from the publisher.**\n\nOnly manuscripts that meet the aims and scope of IJSPT are reviewed. 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protocol","Application","Assessment","Hop","Performance","Return to sport","Video","arthrogenic muscle inhibition","early management","quadriceps activation","Artificial Intelligence","machine learning","FMS","functional movement","assessment","digital technology","feasibility","adolescents","athlete","exercise","physical therapy intervention","epidemiology","incidence","odds of injury","previous injury","likelihood","Athlete","Dominant limb","Intercollegiate","kicking","landing","lower extremity","athlete assessment","pre-participation examination","standardization","warm-up","Athlete exposure","Injury prevention","Low back pain","Shoulder pain","Swimming","balance","training adaptations","sport-specificity","athletic injuries","professional athletes","postural balance","sport injuries","athletic performance","college athletes","pelvic floor dysfunction","pelvic floor muscle activity","sports physical therapy","teamwork","auditory cueing","kinetics","feedback","step rate","avulsion","gymnast","ischial tuberosity","nonoperative treatment","backlash","call to action","bashing rhetoric","modalities","biophysical agents","electrophysical agents","back pain","kinetic chain","lower limbs pain","overhead sports","shoulder pain","preventative medicine","Balance adjustment system","Chronic ankle instability","Postural control","Randomized control trial","ball velocity","normalization","shoulder strength","baseball","isometric","upper extremity","coronavirus","major league baseball","COVID-19","elbow valgus","hip range of motion","throwing","arm pain","shoulder","torso","muscles","onbaseu","pitching","movement screen","outcome measure","youth athletics","trunk rotation","lumbar locked rotation","Baseball","Movement System","Valgus Extension Overload","Batting","Baseball pitching","fatigue","Motus sleeve","recovery","elbow valgus torque","between-limb","vertical jump","limb dominance","biceps femoris","electromyography","hamstring injury prevention","high-speed running","joint-dominance","semitendinosus","biceps tendinopathy","biceps tenodesis","biceps tendon","tendinopathy","Delphi study","intervention","abdominal bracing","spine","squat","theraband","upper limb","human health","prevention","performance","mobility","blood flow restriction","occlusion training","tibia","bone mineral density","hypoanalgesia","pain","subacromial pain","total knee arthroplasty","home exercise","Blood Flow Restriction","Shoulder Instability","Shoulder Strength","blood flow restriction training","BFRT","cross-sectional area","rotator cuff","cadaver","dry needling","multifidus","safety considerations","ultrasound","cadaver study","patellar displacement","measurement","validity","Cadence","Gait Retraining","Metronome","Step Rate","running related injuries","cartilage rehab","OCA","OATS","MACI","cesarean section","female athlete","post-partum","Psychological impact","Social impact","Patient expectations","Loss of identity","Musculoskeletal 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Works submitted to The International Journal of Sports Physical Therapy (IJSPT) must comply with these policies, which are based on the Committee on Publication Ethics (COPE) Code of Conduct and Best Practice Guidelines for Journal Editors and the International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. Falsification or fabrication of data, plagiarism, including duplicate publication of the author's own work without proper citation, and misappropriation of the work are all unacceptable practices. Any cases of ethical misconduct are treated very seriously and will be dealt with in accordance with the COPE guidelines. \n\nAll articles published open access will be immediately and permanently free for everyone to read, download, copy and distribute. IJSPT policies are compatible with all major funders open access and self-archiving mandates. As such, IJSPT does not require authors of original (primary) research papers to assign copyright of their published contributions. Ownership and usage will be governed by the Creative Commons license: CC-BY-NC.\n\nIJSPT will permit the author to deposit versions of their work on his/her personal website, university's institutional repository or employer's intranet. Authors may deposit all versions on their manuscript, either the submitted version, accepted version (author accepted manuscript) and/or the published version (version of record). The final peer-reviewed manuscript must appear alongside the following notice: \"This is a non-final version of an article published in final form in : (provide complete journal citation)\".\n\nORIGINALITY\nBy submitting your manuscript to IJSPT, it is understood that this it is an original manuscript and is unpublished work and is not under consideration elsewhere. Plagiarism, including duplicate publication of the author’s own work, in whole or in part without proper citation is not tolerated by the journal. Manuscripts submitted to the journal may be checked for originality using anti-plagiarism software.\n\nETHICS APPROVAL FOR PAPERS SUBMITTED TO IJSPT\nAll studies involving human beings, human tissue from living donors and confidential patient information must be accompanied by written approval from an institutional review board (IRB), ethics committee, or similar agency. If the investigation was performed in a country where approval is not required for retrospective studies based on patient data, a copy of the relevant regulations and a current URL (web address) where the regulations can be found should be provided. Studies involving human cadaveric tissue should be accompanied by IRB or similar agency approval, or a statement of waiver from the appropriate body if approval is not required at the institution where the study was performed. \n\nPATIENT CONFIDENTIALITY AND CONSENT TO PARTICIPATION:\nManuscripts reporting human studies must contain statements indicating that informed, written consent has been obtained (unless waived by the IRB/ethics committee) and that studies have been performed according to the Declaration of Helsinki. If individuals might be identified from a publication (eg, from images), the authors must obtain explicit written consent from the individual. All case reports must include a statement of release or other written form of approval from the patient or patients indicating that they approve publication of the details of their case.\n\nDISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST:\nThe IJSPT editors believe that transparency in research is essential. At the point of submission, each author should reveal any financial interests or connections, direct or indirect, or other situations that might raise the question of bias in the work reported or the conclusions, implications, or opinions stated – including pertinent commercial or other sources of funding for the individual author(s) or for the associated department(s) or organization(s), personal relationships, or direct academic competition. When considering whether you should declare a conflicting interest or connection please consider the conflict of interest test: Is there any arrangement that would embarrass you or any of your co-authors if it was to emerge after publication and you had not declared it? \nAll submissions must be accompanied by a completed Conflict of Interest Statement in their submitted manuscript. Authors may use the ICMJE disclosure form. The corresponding author is responsible for collecting and reporting disclosures from all authors. The completed disclosure form shall include complete disclosure from all authors and any other individuals acknowledged as contributing to the conduct or analysis of the research or writing of the manuscript. If the manuscript is published, Conflict of Interest information, including if none was declared, will be communicated in a statement in the published paper. All editors and reviewers must file a potential conflict of interest declaration annually in the IJSPT manuscript review system.\n\nRESEARCH MISCONDUCT \nIf the editors suspect research misconduct in a submitted manuscript, the article in question will be held until the matter is resolved. The editors will contact authors and any appropriate third party to ascertain whether the grounds for investigation are justified. If research misconduct is suspected after a paper is accepted and published, the matter will be investigated according to COPE guidelines. Potential cases of serious research misconduct will be referred to the IJSPT Ethics Committee for evaluation and recommendations for action. The final determination of action will be made by the Editor-in-Chief. Depending upon the seriousness of the misconduct, the paper may be retracted and the authors’ institution may be notified. In any case of serious research misconduct, all authors of such an article may be banned from future publication in IJSPT for a specified period of time or indefinitely. \n\nIJSPT utilizes the CrossCheck system to screen papers for evidence of plagiarism. This includes plagiarism of the works of others, redundant publication, and self-plagiarism. If a submitted paper shows similarities to other papers by the authors, the authors may be asked to modify it or the paper may be rejected. If a submission is plagiarized from the work of others, that submission will be rejected and further sanctions may be instituted as described above. Manipulation or enhancement of any images contained in a manuscript, whether electronic or otherwise, should be declared in the legend to the image. \n\nPEER REVIEW PROCESS\nAll submissions to the journal are initially reviewed by the Editor and Associate Editors. At this stage, manuscripts may be rejected without peer review if it is felt that they are not of high enough priority or not relevant to the journal. This fast rejection process means that authors are given a quick decision and do not need to wait for the review process. Manuscripts that are not instantly rejected are sent out for double blind peer review, usually to two independent reviewers. Based on the feedback from these reviewers and the Editors’ judgment a decision is given on the manuscript. Manuscripts may also be sent out for statistical review. The editors and reviewers of IJSPT treat all submitted manuscripts as confidential documents, which means they will not divulge information about a manuscript to anyone without the authors’ permission nor use knowledge of its contents for their own benefit. During the process of manuscript review, the following people may have access to manuscripts: Editors and editorial staff and the external peer reviewers. The average time from submission to first decision is 38 days.\n\nPUBLICATION OF CORRECTIONS\nIJSPT will publish corrections for errors discovered after publication, whether the error was by the authors or occurred during the publication process. However, it is the responsibility of the authors to minimize the possibility of errors by carefully reviewing all proofs prior to publication.\n\nALLEGATIONS OF MISCONDUCT – ETHICAL RESPONSIBILITIES OF AUTHORS\nThe International Journal of Sports Physical Therapy follows the ICMJE’s Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals. It is expected of authors, reviewers and editors that they follow the best-practice guidelines on ethical behavior contained therein.\nEthical Responsibilities of Authors\nThis journal is committed to upholding the integrity of the scientific record. As such, the International Journal of Sports Physical Therapy will follow the COPE guidelines on how to deal with potential acts of misconduct.\nAuthors should refrain from misrepresenting their research results which could damage the trust in the journal, the professionalism of scientific authorship, and ultimately the entire scientific process. Maintaining the integrity of the research and its presentation is helped by following the rules of good scientific practice, which include:\n•\tThe manuscript should not be submitted to more than one journal for simultaneous consideration.\n•\tThe submitted work should be original and should not have been published elsewhere in any form or language (partially or in full), unless the new work concerns an expansion of previous work. (Please provide transparency on the re-use of material to avoid the concerns about text-recycling (‘self-plagiarism’).\n•\tA single study should not be split up into several parts to increase the quantity of submissions and submitted to various journals or to one journal over time.\n•\tConcurrent or secondary publication is sometimes justifiable, provided certain conditions are met. Examples include: translations or a manuscript that is intended for a different group of readers.\n•\tResults should be presented clearly, honestly, and without fabrication, falsification or inappropriate data manipulation (including image based manipulation). Authors should adhere to discipline-specific rules for acquiring, selecting and processing data.\n•\tNo data, text, or theories by others are presented as if they were the author’s own (‘plagiarism’). Proper acknowledgements to other works must be given (this includes material that is closely copied (near verbatim), summarized and/or paraphrased), quotation marks (to indicate words taken from another source) are used for verbatim copying of material, and permissions secured for material that is copyrighted.\n•\tResearch articles and non-research articles (e.g. Opinion, Review, and Commentary articles) must cite appropriate and relevant literature in support of the claims made. Excessive and inappropriate self-citation or coordinated efforts among several authors to collectively self-cite is strongly discouraged.\n•\tAuthors should avoid untrue statements about an entity (who can be an individual person or a company) or descriptions of their behavior or actions that could potentially be seen as personal attacks or allegations about that person.\n•\tAuthors are strongly advised to ensure the author group, the Corresponding Author, and the order of authors are all correct at submission. Adding and/or deleting authors during the revision stages is generally not permitted, but in some cases may be warranted. Reasons for changes in authorship should be explained in detail. Please note that changes to authorship cannot be made after acceptance of a manuscript.\nUpon request authors should be prepared to send relevant documentation or data in order to verify the validity of the results presented. This could be in the form of raw data, samples, records, etc. Sensitive information in the form of confidential or proprietary data is excluded.\nHandling of unethical publishing behavior\nThe International Journal of Sports Physical Therapy and NASMI Publishing adhere to the Committee for Publication Ethics (COPE) Guidelines regarding misconduct and retractions. We take ethical allegations very seriously and believe it is our responsibility to maintain the integrity of the scientific record as far as possible.\nOur relationship with our authors is based on trust and we publish submitted material in good faith. In cases of alleged or proven scientific misconduct, fraudulent publication or plagiarism, the publisher, in close collaboration with the editors, will take all appropriate measures to clarify the situation and to amend the article in question. If a possible breach of ethics is brought to our attention, we will refer the case to our Board of Directors for investigation. The panel includes representation from our legal department, as well as senior management and editorial staff. Initially, the Journal and/or Publisher will carry out an investigation following COPE guidelines. If, after investigation, there are valid concerns, the author(s) concerned will be contacted under their given e-mail address and given an opportunity to address the issue. The BoD may seek advice from the journal’s Editorial Board, and may need to escalate an investigation to author’s institution(s) for further information. \n\nThe BoD will decide the most appropriate course of action to take according to industry guidelines. The publisher, together with the editors, shall take reasonable steps to identify and prevent the publication of papers where research misconduct has occurred, and under no circumstances encourage such misconduct or knowingly allow such misconduct to take place. \nDepending on the situation and results of the investigation, this may result in the Journal’s and/or Publisher’s implementation of the following measures, including, but not limited to:\n•\tIf the manuscript is still under consideration, it may be rejected and returned to the author.\n•\tIf the article has already been published online, depending on the nature and severity of the infraction:\no\tan erratum/correction may be placed with the article\no\tan expression of concern may be placed with the article\no\tor in severe cases retraction of the article may occur.\nThe reason will be given in the published erratum/correction, expression of concern or retraction note. Please note that retraction means that the article is maintained on the platform, watermarked “retracted” and the explanation for the retraction is provided in a note linked to the watermarked article.\n•\tThe author’s institution may be informed\n•\tA notice of suspected transgression of ethical standards in the peer review system may be included as part of the author’s and article’s bibliographic record.\nPlease note:\no\tMisconduct investigations are sensitive and can take time\no\tIJSPT and NASMI publishing has the right to contact an individual’s institution regarding allegations of misconduct, according to the COPE Guidelines\no\tIJSPT and NASMI publishing has the right to request proof of identity in cases where identity theft is alleged or suspected\no\tIJSPT and NASMI publishing reserves the right not to work with anyone who is abusive to our staff, authors, reviewers or editors\nTo report any concerns relating to potential misconduct, please contact the IJSPT editorial office. You can find contact information for IJSPT here: https://ijspt.org/contact-2/\nIJSPY will follow the COPE guidelines on responding to whistleblowers, which includes protecting your anonymity.\n\nAUTHORSHIP GUIDELINES (FROM ICMJE)\nWhy Authorship Matters\nAuthorship confers credit and has important academic, social, and financial implications. Authorship also implies responsibility and accountability for published work. The following recommendations are intended to ensure that contributors who have made substantive intellectual contributions to a paper are given credit as authors, but also that contributors credited as authors understand their role in taking responsibility and being accountable for what is published.\nBecause authorship does not communicate what contributions qualified an individual to be an author, some journals now request and publish information about the contributions of each person named as having participated in a submitted study, at least for original research. Editors are strongly encouraged to develop and implement a contributorship policy. Such policies remove much of the ambiguity surrounding contributions, but leave unresolved the question of the quantity and quality of contribution that qualify an individual for authorship. The ICMJE has thus developed criteria for authorship that can be used by all journals, including those that distinguish authors from other contributors.\n\n**Who Is an Author?**\nThe ICMJE recommends that authorship be based on the following 4 criteria:\n•\tSubstantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND\n•\tDrafting the work or revising it critically for important intellectual content; AND\n•\tFinal approval of the version to be published; AND\n•\tAgreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\nIn addition to being accountable for the parts of the work he or she has done, an author should be able to identify which co-authors are responsible for specific other parts of the work. In addition, authors should have confidence in the integrity of the contributions of their co-authors.\nAll those designated as authors should meet all four criteria for authorship, and all who meet the four criteria should be identified as authors. Those who do not meet all four criteria should be acknowledged. These authorship criteria are intended to reserve the status of authorship for those who deserve credit and can take responsibility for the work. The criteria are not intended for use as a means to disqualify colleagues from authorship who otherwise meet authorship criteria by denying them the opportunity to meet criterion #s 2 or 3. Therefore, all individuals who meet the first criterion should have the opportunity to participate in the review, drafting, and final approval of the manuscript.\nThe individuals who conduct the work are responsible for identifying who meets these criteria and ideally should do so when planning the work, making modifications as appropriate as the work progresses. We encourage collaboration and co-authorship with colleagues in the locations where the research is conducted. It is the collective responsibility of the authors, not the journal to which the work is submitted, to determine that all people named as authors meet all four criteria; it is not the role of journal editors to determine who qualifies or does not qualify for authorship or to arbitrate authorship conflicts. If agreement cannot be reached about who qualifies for authorship, the institution(s) where the work was performed, not the journal editor, should be asked to investigate. The criteria used to determine the order in which authors are listed on the byline may vary, and are to be decided collectively by the author group and not by editors. If authors request removal or addition of an author after manuscript submission or publication, journal editors should seek an explanation and signed statement of agreement for the requested change from all listed authors and from the author to be removed or added.\nThe corresponding author is the one individual who takes primary responsibility for communication with the journal during the manuscript submission, peer review, and publication process. The corresponding author typically ensures that all the journal’s administrative requirements, such as providing details of authorship, ethics committee approval, clinical trial registration documentation, and disclosures of relationships and activities are properly completed and reported, although these duties may be delegated to one or more coauthors. The corresponding author should be available throughout the submission and peer review process to respond to editorial queries in a timely way, and should be available after publication to respond to critiques of the work and cooperate with any requests from the journal for data or additional information should questions about the paper arise after publication. Although the corresponding author has primary responsibility for correspondence with the journal, the ICMJE recommends that editors send copies of all correspondence to all listed authors.\nWhen a large multi-author group has conducted the work, the group ideally should decide who will be an author before the work is started and confirm who is an author before submitting the manuscript for publication. All members of the group named as authors should meet all four criteria for authorship, including approval of the final manuscript, and they should be able to take public responsibility for the work and should have full confidence in the accuracy and integrity of the work of other group authors. They will also be expected as individuals to complete disclosure forms.\nSome large multi-author groups designate authorship by a group name, with or without the names of individuals. When submitting a manuscript authored by a group, the corresponding author should specify the group name if one exists, and clearly identify the group members who can take credit and responsibility for the work as authors. The byline of the article identifies who is directly responsible for the manuscript, and MEDLINE lists as authors whichever names appear on the byline. If the byline includes a group name, MEDLINE will list the names of individual group members who are authors or who are collaborators, sometimes called non-author contributors, if there is a note associated with the byline clearly stating that the individual names are elsewhere in the paper and whether those names are authors or collaborators.\n**Non-Author Contributors**\nContributors who meet fewer than all 4 of the above criteria for authorship should not be listed as authors, but they should be acknowledged. Examples of activities that alone (without other contributions) do not qualify a contributor for authorship are acquisition of funding; general supervision of a research group or general administrative support; and writing assistance, technical editing, language editing, and proofreading. Those whose contributions do not justify authorship may be acknowledged individually or together as a group under a single heading (e.g. \"Clinical Investigators\" or \"Participating Investigators\"), and their contributions should be specified (e.g., \"served as scientific advisors,\" \"critically reviewed the study proposal,\" \"collected data,\" \"provided and cared for study patients\", \"participated in writing or technical editing of the manuscript\").\nBecause acknowledgment may imply endorsement by acknowledged individuals of a study’s data and conclusions, editors are advised to require that the corresponding author obtain written permission to be acknowledged from all acknowledged individuals.\n\n\n\n","banner_style":"color","banner_color":"#495368","banner":{"id":149,"name":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","size":null,"content_type":null,"url":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","thumb":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","small":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","medium":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","large":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg"},"journal_id":2159,"image_metadatum":{"id":20692,"cover_metadata":null,"imageable_id":149,"imageable_type":"CustomPage","created_at":"2020-10-30T15:03:56.949Z","updated_at":"2020-10-30T15:03:56.949Z"}},{"id":159,"slug":"159-international-perspective","page_title":"IFSPT International Perspective","nav_item_title":"International Perspective","body":"**The IFSPT International Perspective**\n_Kristian Thorborg_$^1$, _Luciana D Mendonça_$^1$, _Colin Paterson_$^1$, _Barb Hoogenboom_$^2$\n$^1$_International Federation of Sports Physical Therapy (IFSPT)_\n$^2$_International Journal of Sports Physical Therapy (IJSPT)_\n\nThe International Journal of Sport Physical Therapy (IJSPT) and The International Federation of Sports Physical Therapy (IFSPT) introduce a new article form in the IJSPT called: “The IFSPT International Perspective”. These IFSPT International Perspectives should contain perspectives on sports physical therapy that are relevant to the International Sports Physical Therapy community. They are editorial and commentary–type articles authored by acknowledged and respected experts or organizational key-persons in the world of sports physical therapy. These articles have an 800-word limit, and should only include 10 references. IFSPT International Perspective articles are intended to present sports physical research and relevant topics, in order to increase visibility, discussion, and debate. We invite leaders in the field to offer important information, share new ideas, and promote the role of the sports physical therapist in physical activity and sport worldwide. We ask IFSPT International Perspective authors to approach their chosen topic in a respectful, scholarly tone. IFSPT perspectives articles are generally submitted by invitation from the Editor in Chief and the International Editors in the IJSPT. However, self-nominations for an invitation to submit an IFSPT International Perspective manuscript are welcome and should be addressed to the Editor in Chief, including a current curriculum vitae and a short summary of the intended content. All IFSPT perspective articles will be reviewed by the Editor in Chief, and the International Editors in the IJSPT. \n","banner_style":"image","banner_color":"#59A5D8","banner":{"id":159,"name":"photo-1525534240745-6b6f65e8a25f","size":1320979,"content_type":"image/jpeg","url":"https://s3.amazonaws.com/production.scholastica/custom_page/159/original/photo-1525534240745-6b6f65e8a25f?1609879635","thumb":"https://s3.amazonaws.com/production.scholastica/custom_page/159/thumb/photo-1525534240745-6b6f65e8a25f?1609879635","small":"https://s3.amazonaws.com/production.scholastica/custom_page/159/small/photo-1525534240745-6b6f65e8a25f?1609879635","medium":"https://s3.amazonaws.com/production.scholastica/custom_page/159/medium/photo-1525534240745-6b6f65e8a25f?1609879635","large":"https://s3.amazonaws.com/production.scholastica/custom_page/159/large/photo-1525534240745-6b6f65e8a25f?1609879635","source":"Unsplash","user_id":"Mn705zsygaQ","username":"kaung_myat_min","last_name":"Min","first_name":"Kaung Myat"},"journal_id":2159,"image_metadatum":{"id":21664,"cover_metadata":{"source":"Unsplash","user_id":"Mn705zsygaQ","username":"kaung_myat_min","last_name":"Min","first_name":"Kaung Myat"},"imageable_id":159,"imageable_type":"CustomPage","created_at":"2021-01-05T20:47:17.817Z","updated_at":"2021-01-05T20:47:17.817Z"}},{"id":165,"slug":"165-ijspt-sponsors","page_title":"IJSPT Sponsors","nav_item_title":"IJSPT Sponsors","body":"#Thank you!\nThe International Journal of Sports Physical Therapy is proud to support the profession through excellence in peer-reviewed, open-access research. The IJSPT strives to provide an outlet for researchers and clinicians alike to disseminate their hard work to many. The ability to do this would not be possible without the support of our sponsors and strategic partnerships. The ability to keep publishing at no cost to the author or the reader is something that we are very proud of. The IJSPT would like to thank the following companies for their commitment to advance our mission, vision, and goals.\n\n##UNDERWRITING SPONSOR\n[Genie Health](https://genie.health)\n\n##FOUNDING SPONSORS\n[Biodex](www.biodex.com)\n[Enovis](https://enovis.com) formerly DJO Global/Chattanooga\n[Exertools](www.exertools.com)\n[Hyperice](www.hyperice.com)\n[Trazer](www.trazer.com)\n[Woodway](www.woodway.com)\n\n##PLATINUM SPONSORS\n[ELvation](https://elvationusa.com)\n[ATI](https://www.atipt.com)\n\n###GOLD SPONSORS\n[Hawkgrips](www.hawkgrips.com)\n[Structure and Function](www.structureandfunction.net)\n[Winback](www.winback.us)\n[Kayezen](https://kayezen.com)\n\n\n\n","banner_style":"color","banner_color":"#676565","banner":{"id":165,"name":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","size":null,"content_type":null,"url":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","thumb":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","small":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","medium":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","large":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","color1":"rgba(0,0,0,.07)","color2":"rgba(0,0,0,1)"},"journal_id":2159,"image_metadatum":{"id":26969,"cover_metadata":{"color1":"rgba(0,0,0,.07)","color2":"rgba(0,0,0,1)"},"imageable_id":165,"imageable_type":"CustomPage","created_at":"2021-04-28T15:02:54.667Z","updated_at":"2021-04-28T15:02:54.667Z"}},{"id":350,"slug":"350-register","page_title":"Register for full access to IJSPT","nav_item_title":"Register","body":"For regular IJSPT updates, issue announcements, eduactional opportunites and more...please register with IJSPT here: [Sign Up](https://nasmi.org/ijspt-sign-up/)","banner_style":"color","banner_color":"#d90202","banner":{"id":350,"name":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","size":null,"content_type":null,"url":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","thumb":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","small":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","medium":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","large":"https://assets.scholasticahq.com/assets/websites/custom_page_banner-36911cbcf707a1ddb979fdfb91f3ba4811eace65a3ffe772124b0b1c2ab53c50.jpg","color1":"rgba(0,0,0,.07)","color2":"rgba(0,0,0,1)"},"journal_id":2159,"image_metadatum":{"id":40013,"cover_metadata":{"color1":"rgba(0,0,0,.07)","color2":"rgba(0,0,0,1)"},"imageable_id":350,"imageable_type":"CustomPage","created_at":"2022-03-29T18:51:31.926Z","updated_at":"2022-03-29T18:51:31.926Z"}}]} window.ARTICLE = {"id":37675,"journal_id":2159,"issue_id":4682,"title":"Pain in Athletes: Current Knowledge and Challenges","abstract":null,"position":0,"created_at":"2022-08-14T19:23:41.942Z","attachment_ids":[],"published":true,"published_at":"2022-10-01T19:29:00.000Z","doi_url":"https://doi.org/10.26603/001c.37675","author_info":"Rafael Krasic Alaiti, Felipe J.J. Reis","slug":"37675-pain-in-athletes-current-knowledge-and-challenges","short_description":"A look at the the clinical implications of applying current pain knowledge to clinical practice.","featured":false,"section_id":2111,"cover":{"id":37675,"name":"photo-1638604813811-6f3c53deff9c","size":302827,"content_type":"image/jpeg","url":"https://s3.amazonaws.com/production.scholastica/article/37675/original/photo-1638604813811-6f3c53deff9c?1660505565","thumb":"https://s3.amazonaws.com/production.scholastica/article/37675/thumb/photo-1638604813811-6f3c53deff9c?1660505565","small":"https://s3.amazonaws.com/production.scholastica/article/37675/small/photo-1638604813811-6f3c53deff9c?1660505565","medium":"https://s3.amazonaws.com/production.scholastica/article/37675/medium/photo-1638604813811-6f3c53deff9c?1660505565","large":"https://s3.amazonaws.com/production.scholastica/article/37675/large/photo-1638604813811-6f3c53deff9c?1660505565","color1":"rgba(54,59,80, .07)","color2":"rgba(4,6,58, 1)","source":"Unsplash","user_id":"4MvRfdT1iss","username":"julientromeur","last_name":"Tromeur","first_name":"julien"},"arxiv_html_url":null,"arxiv_uuid":null,"keyword_list":["pain management","athletic injury"],"zip_download_path":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.zip","markdown":"Pain in athletes has been traditionally equated with tissue damage (i.e., an acute traumatic or overuse injury).[@139329] However, chronic pain presents a challenge to team sports since it is not fully explained by ongoing biomechanical stress or overuse injury. Although biomechanical factors can indeed be a relevant nociceptive input for some individuals, it cannot be the main factor to explain pain in athletes.\n\nKnowledge about pain has evolved during the last three decades from a cartesian (pain = tissue damage) into a multidimensional perspective in which several factors such as tissue overload, nociceptive gain, cognitive, emotional, behavioral, lifestyle and several other factors interact in complex ways, leaving the individual more or less prone to experience pain.[@139330] It is well-known that chronic pain cannot be explained solely by patho-anatomical changes. Thus, a narrow focus on biophysical factors (e.g., structural, biomechanical) can contribute to misconceptions about pain, higher threat value of pain, protective behavior and foster disability.[@139329] In addition, it can lead to overtesting (unnecessary exams), overdetection (detection of clinically unimportant findings), overtreatment (unnecessary treatment for a condition that is not life-threatening or would never cause any symptoms) and high costs.[@139329; @139331]\n\nAlthough the International Olympic Committee (IOC) published a consensus on pain management in elite athletes enhancing the biopsychosocial approach,[@139332] the clinical implications of applying current pain knowledge to clinical practice has been barely discussed. According to the IOC consensus, a rational approach to pain management in athletes begins with classifying the type of pain.[@139332] In this aspect, pain can be classified by its time frame (i.e., acute or chronic), mechanism of onset (i.e., traumatic or non-traumatic) and according to its manifestation (i.e., gradual or sudden). Pain can be classified by its mechanisms as nociceptive, neuropathic or nociplastic. In chronic pain cases, pain can also be classified using the current version of the International Classification of Diseases (ICD-11) as chronic primary pain (e.g., chronic non-specific low back pain) or chronic secondary pain, (e.g., chronic cancer pain, chronic posttraumatic and postsurgical pain, chronic neuropathic pain, chronic headache and orofacial pain, chronic visceral pain, and chronic musculoskeletal pain).[@139333]\n\nAdequate chronic pain management in athletes depends on identifying pain mechanisms and contributory factors considering a multidimensional perspective. For example, the most commonly reported risk factors for low back pain in sports were higher athlete training volumes, change to increased training load and history of low back pain.[@139334] Nevertheless, psychosocial factors including emotional distress, symptoms of anxiety, catastrophic thinking, and pain-related fear, were associated with prolonged recovery and lower return to sport rates.[@139335] Pain catastrophizing was reported as the most important factor associated with increased pain intensity in injured athletes.[@139335] An athlete's psychological readiness to return to play was associated with the outcomes of rehabilitation.[@139336] The literature presents evidence that pain-related fear, maladaptive beliefs, catastrophizing, and avoidance behavior are key factors in the development of disability in chronic musculoskeletal and primary pain conditions.[@139337] The social domain is less commonly discussed in the literature and usually involves relationships, social support, engagement in care, environmental influences, and socioeconomic factors.[@139338]\n\nAlthough there have been substantial advances in pain knowledge, there are still some challenges to overcome to properly apply these concepts in sports. First, pain experience should be considered based on complex systems approaches, meaning that pain experience results from the dynamic and non-linear interactions among many (known and unknown) factors. Team sports should also be aware to avoid the pendulum swinging too far from a biophysical to a narrow psychosocial perspective. Thus, it is important not to overlook the \"bio\" in the multidimensional perspective, since training parameters and biomechanical factors can be associated with some clinical conditions (e.g., lower limb tendinopathy). It is also important to recognize the limitations of the biopsychosocial model in which several factors (e.g., mental health, guilt, stigma, emotional support, feelings of shame, perceived injustice, interpersonal relationships, culture, class, macro socio-economic, political context, religiosity/spirituality, access to healthcare, sleep and nutrition quality) are rarely investigated and their influence on the athlete's pain experience remains unknown.[@139338] Second, the implementation of the current ICD classification for chronic pain in sports can contribute to better epidemiological data since definitions and reporting styles across studies present a broad variation. Third, focus on the biophysical factors (e.g., exams, tests) can lay aside patient's perspective on wellness and care experiences. In this aspect, team sports should implement patient-reported outcome measures in their clinical pain assessment to establish patient-oriented evidence to better inform patient care decisions. Several measurement instruments have been developed and tested in non-athletes. Thus, efforts to develop athlete-specific or sport-specific assessment instruments should be done. Lastly, pain curriculum and training in undergraduate health care programs are insufficient in different disciplines and countries. Further discussion on the need and implementation of a specific course in pain and in sports in professional degree education programs should be considered.","pdf_download_path":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.pdf","xml_download_path":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.xml","preview_url":"https://ijspt.scholasticahq.com/article/37675-pain-in-athletes-current-knowledge-and-challenges","workflow_state":"published","first_page":"981","last_page":"983","typesetting_completed_at":"2022-08-29T12:51:37.773Z","citation_download_paths":{"bibtex":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.bibtex","ris":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.ris","csl_json":"/api/v1/articles/37675-pain-in-athletes-current-knowledge-and-challenges.csl_json"},"manuscript_id":null,"publication_method":"typeset","doi_status":"success","copyright_license_data":{"identifier":"ccby-nc-4.0","value":"CC BY-NC (Attribution-NonCommercial)","license_deed_url":"https://creativecommons.org/licenses/by-nc/4.0","license_code_url":"https://creativecommons.org/licenses/by-nc/4.0/legalcode","description":"This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (4.0) which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited."},"url":"https://ijspt.scholasticahq.com/article/37675-pain-in-athletes-current-knowledge-and-challenges","can_publish":false,"can_unpublish":true,"to_csl":{"id":"37675","type":"article-journal","title":"Pain in Athletes: Current Knowledge and Challenges","container-title":"International Journal of Sports Physical Therapy","language":"en","container-title-short":"IJSPT","publisher":"NASMI","url":"https://doi.org/10.26603/001c.37675","DOI":"10.26603/001c.37675","page":"981-983","volume":"17","issue":"6","issued":{"date-parts":[[2022,10,1]]},"author":[{"given":"Rafael Krasic","family":"Alaiti"},{"given":"Felipe J.J.","family":"Reis"}]},"doi_attributes":{"id":17086,"number":"10.26603/001c.37675"},"article_type":"research-article","raw_title":"Pain in Athletes: Current Knowledge and Challenges","submitted_at":"2022-08-01T19:30:00.000Z","accepted_at":"2022-08-14T19:30:00.000Z","most_recently_published_article_id":126334,"subject_categories":[],"inline_attachment_ids":[],"supplementary_attachment_ids":[],"article_metadata_status":"metadata_not_started","article_authors_status":"authors_not_started","article_funding_sources_status":"funding_sources_not_enabled","article_files_status":"files_not_started","steps_completed":false,"amendment_type":null,"related_article_dois":[],"amendment_doi":null,"title_with_footnote_references":"Pain in Athletes: Current Knowledge and Challenges","csl":"american-medical-association","third_party_metrics":["altmetric"],"updated_at":"2023-11-08T03:39:09.946Z","product_name":null,"product_url":null,"book_review_title":null,"book_review_isbn":null,"copyright_statement":"© The Author(s)","jel_codes":[],"article_form_special_metadata_fields":[],"articles_jel_codes":[],"typesetting_request_id":4548,"plaintext_title":"Pain in Athletes: Current Knowledge and Challenges","citation_numbers_sheet_id":null,"amendee_article_url":null,"amender_article_url":null,"amender_article_amendment_type":null,"typesetting_fee":{"words":{"count":1177,"fee":1800},"attachments":{"count":0,"fee":0},"figures":{"count":0,"fee":0},"tables":{"count":0,"fee":0},"block_equations":{"count":0,"fee":0},"total":1800},"formatted_type":"Typeset","language":"en","generated_doi":"10.26603/001c.37675","attachments":[],"primary_pdf":null,"authors":[{"id":2252039,"name":"Rafael Krasic Alaiti","first_name":"Rafael Krasic","last_name":"Alaiti","suffix":null,"email":null,"manuscript_id":null,"submitter":false,"created_at":"2022-08-14T19:37:05.444Z","article_id":37675,"position":0,"link":null,"orcid_id":null,"orcid_verified":null,"orcid_name":null,"note":null,"degrees":null,"formatted_name_with_degrees":"Rafael Krasic Alaiti","author_type":"person","organization":null,"academic_position":null,"gender":null,"sexual_orientation":null,"economic_background":null,"race":null,"free_form_race":null,"corresponding":false,"person":true,"affiliations":[{"id":2193634,"institution_name":"Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, Universidade de São Paulo; Research, Technology, and Data Science Office, Grupo Superador","department":null,"position":0,"ror_id":null,"full_name":"Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, Universidade de São Paulo; Research, Technology, and Data Science Office, Grupo Superador"}],"credit_roles":[],"orcid_record":null},{"id":2252040,"name":"Felipe J.J. Reis","first_name":"Felipe J.J.","last_name":"Reis","suffix":null,"email":null,"manuscript_id":null,"submitter":false,"created_at":"2022-08-14T19:37:05.446Z","article_id":37675,"position":1,"link":null,"orcid_id":null,"orcid_verified":null,"orcid_name":null,"note":"**Corresponding author:**\nProf. Felipe Reis \nFederal Institute of Rio de Janeiro, Campus Realengo - Rua Carlos Wenceslau, 343, Realengo. CEP 21715-000, Rio de Janeiro – RJ – Brazil. \nPhysiotherapy Department - Federal Institute of Education, Science and Technology Rio de Janeiro- IFRJ, Rio de Janeiro, Brazil\nPhone +55 (21) 3463-4497  \nEmail: felipe.reis@ifrj.edu.br","degrees":null,"formatted_name_with_degrees":"Felipe J.J. Reis","author_type":"person","organization":null,"academic_position":null,"gender":null,"sexual_orientation":null,"economic_background":null,"race":null,"free_form_race":null,"corresponding":true,"person":true,"affiliations":[{"id":2194325,"institution_name":"Department of Physiotherapy, Instituto Federal do Rio de Janeiro; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education \u0026 Physiotherapy, Vrije Universiteit Brussel","department":null,"position":0,"ror_id":null,"full_name":"Department of Physiotherapy, Instituto Federal do Rio de Janeiro; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education \u0026 Physiotherapy, Vrije Universiteit Brussel"}],"credit_roles":[],"orcid_record":null}],"issue":{"id":4682,"title":null,"description":"Welcome to V17N6 of The International Journal of Sports Physical Therapy, published by The North American Sports Medicine Institute (NASMI). This issue of IJSPT brings twenty-one peer-reviewed, high-quality, and clinically important research articles from around the world to your inbox, to assist you in your quest for evidence-based practice in sports physical therapy. We also bring relevant and timely articles including an International Perspective, “Pain in Athletes: Current Knowledge and Challenges” to provoke thought and spark critical conversations related to practice. \n\nIn addition, we are pleased to present the abstracts from the Orthopedic Summit IJSPT Research Symposium, held September 23, 2022, at the Encore Boston.\n \nThe staff at IJSPT continue to be grateful for the ongoing support of all of our generous sponsors, most notably our founding sponsors. We could not do this work without you! Please engage with these companies when you consider equipment ordering, practice support, and clinical needs.\n\nWe encourage you to follow IJSPT on social media and to invite your colleagues and friends to as well!\nWe encourage you to follow IJSPT on Social Media:\n[Facebook](https://www.facebook.com/IJSPT/)\n[Twitter](https://twitter.com/IJSPT)\n[Instagram](https://www.instagram.com/intjsportspt/)\n[LinkedIn](https://www.linkedin.com/company/international-journal-of-sports-physical-therapy/?viewAsMember=true)\n\nWe continue to seek new manuscript reviewers to assist in the scientific process of peer review. The IJSPT is eager to support our established reviewers as well as new reviewers. You can give back to your profession in this all-important task, if interested in being a part of our international review team, please contact Ashley Campbell, Managing Editor (acampbell@ijspt.org).\n \nSign up for IJSPT (and queue your colleagues to do the same!) to receive the journal in your inbox first! Sign up [here](https://nasmi.org/ijspt-sign-up-2021-v16-issue/)","journal_id":2159,"cover":{"id":4682,"name":"photo-1618933974351-e38629016464","size":895313,"content_type":"image/jpeg","url":"https://s3.amazonaws.com/production.scholastica/issue/4682/cover/original/photo-1618933974351-e38629016464?1664506359","thumb":"https://s3.amazonaws.com/production.scholastica/issue/4682/cover/thumb/photo-1618933974351-e38629016464?1664506359","small":"https://s3.amazonaws.com/production.scholastica/issue/4682/cover/small/photo-1618933974351-e38629016464?1664506359","medium":"https://s3.amazonaws.com/production.scholastica/issue/4682/cover/medium/photo-1618933974351-e38629016464?1664506359","large":"https://s3.amazonaws.com/production.scholastica/issue/4682/cover/large/photo-1618933974351-e38629016464?1664506359","color1":"rgba(0,0,0,.07)","color2":"rgba(0,0,0,1)"},"published":true,"article_ids":[37675,36964,38166,38043,38252,38019,38045,38327,38017,37859,37861,38174,37907,38479,38172,37852,38015,38170,37865,38168,37863,38254,38396],"year":2022,"volume":"17","number":"6","created_at":"2022-09-30T02:52:38.894Z","updated_at":"2022-10-01T12:53:46.801Z","path":"https://ijspt.scholasticahq.com/issue/4682-vol-17-issue-6-2022","url":"https://ijspt.scholasticahq.com/issue/4682-vol-17-issue-6-2022","pretty_name":"Vol. 17, Issue 6, 2022","slug":"4682-vol-17-issue-6-2022","published_at":"2022-10-01T12:53:46.788Z","short_description":"Once again the IJSPT is excited to publish more than 20 high quality papers including tons of original research. This month's issue features our 2nd annual OSET Research Summit.","status":"Published","article_list_ids":[37675,36964,38166,38043,38252,38019,38045,38327,38017,37859,37861,38174,37907,38479,38172,37852,38015,38170,37865,38168,37863,38254,38396],"auto_pagination":false,"auto_pagination_start_page":null},"section":{"id":2111,"journal_id":2159,"name":"IFSPT International Perspective","slug":"2111-ifspt-international-perspective","published_articles_count":18,"active":true},"citations":[{"id":139338,"raw":"10. Mescouto K, Olson RE, Hodges PW, Setchell J. A critical review of the biopsychosocial model of low back pain care: time for a new approach? Disabil Rehabil. 2020;7:1–15. ","parsed":{"id":"139338","ISSN":"0963-8288","page":"1-15","type":"article-journal","title":"A critical review of the biopsychosocial model of low back pain care: time for a new approach?","author":[{"given":"Karime","family":"Mescouto"},{"given":"Rebecca E","family":"Olson"},{"given":"Paul W","family":"Hodges"},{"given":"Jenny","family":"Setchell"}],"issued":{"date-parts":[[2020]]},"volume":"7","container-title":"Disabil Rehabil"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=A+critical+review+of+the+biopsychosocial+model+of+low+back+pain+care%3A+time+for+a+new+approach%3F\u0026publication_year=2020\u0026pages=1-15\u0026journal=Disabil+Rehabil\u0026volume=7\u0026author=Karime+Mescouto\u0026author=Rebecca+E+Olson\u0026author=Paul+W+Hodges\u0026author=Jenny+Setchell","verification_method":"verified_by_docx_machina_mendeley_v2"},{"id":139329,"raw":"1. Caneiro JP, Alaiti RK, Fukusawa L, Hespanhol L, Brukner P, O’sullivan PPB. There is more to pain than tissue damage: eight principles to guide care of acute non-traumatic pain in sport. Vol. 55, British journal of sports medicine. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine; 2021. p. 75–7. ","parsed":{"id":"139329","DOI":"10.1136/bjsports-2019-101705","URL":"https://doi.org/10.1136/bjsports-2019-101705","ISSN":"0306-3674","page":"75-77","type":"article-journal","issue":"2","title":"There is more to pain than tissue damage: eight principles to guide care of acute non-traumatic pain in sport","author":[{"given":"J P","family":"Caneiro"},{"given":"Rafael Krasic","family":"Alaiti"},{"given":"Leandro","family":"Fukusawa"},{"given":"Luiz","family":"Hespanhol"},{"given":"Peter","family":"Brukner"},{"given":"Peter PB","family":"O'sullivan"}],"issued":{"date-parts":[[2020,9,9]]},"source":"Crossref","volume":"55","language":"en","container-title":"British journal of sports medicine","container-title-short":"Br J Sports Med"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=There+is+more+to+pain+than+tissue+damage%3A+eight+principles+to+guide+care+of+acute+non-traumatic+pain+in+sport\u0026publication_year=2020\u0026doi=10.1136%2Fbjsports-2019-101705\u0026pages=75-77\u0026journal=British+journal+of+sports+medicine\u0026volume=55\u0026issue=2\u0026author=J+P+Caneiro\u0026author=Rafael+Krasic+Alaiti\u0026author=Leandro+Fukusawa\u0026author=Luiz+Hespanhol\u0026author=Peter+Brukner\u0026author=Peter+PB+O%27sullivan","verification_method":"verified_by_doi_discovery"},{"id":139330,"raw":"2. 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Maher CG, O’Keeffe M, Buchbinder R, Harris IA. Musculoskeletal healthcare: Have we over-egged the pudding? International Journal of Rheumatic Diseases. 2019. 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Australia"},{"name":"Department of Epidemiology and Preventive Medicine School of Public Health \u0026amp; Preventive Medicine Monash University Melbourne Vic. Australia"}],"authenticated-orcid":false},{"given":"I. A.","family":"Harris","sequence":"additional","affiliation":[{"name":"Institute for Musculoskeletal Health Sydney NSW Australia"},{"name":"School of Public Health The University of Sydney Sydney NSW Australia"},{"name":"South Western Sydney Clinical School Ingham Institute for Applied Medical Research Sydney NSW Australia"}]}],"issued":{"date-parts":[[2019,11]]},"source":"Crossref","volume":"22","language":"en","container-title":"International Journal of Rheumatic Diseases","container-title-short":"Int J Rheum Dis"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=Musculoskeletal+healthcare%3A+Have+we+over-egged+the+pudding%3F\u0026publication_year=2019\u0026doi=10.1111%2F1756-185x.13710\u0026pages=1957-1960\u0026journal=International+Journal+of+Rheumatic+Diseases\u0026volume=22\u0026issue=11\u0026author=Christopher+G.+Maher\u0026author=Mary+O%27Keeffe\u0026author=Rachelle+Buchbinder\u0026author=I.+A.+Harris","verification_method":"verified_by_doi_lookup"},{"id":139332,"raw":"4. Hainline B, Derman W, Vernec A, Budgett R, Deie M, Dvók J, et al. International Olympic Committee consensus statement on pain management in elite athletes. British Journal of Sports Medicine. 2017. ","parsed":{"id":"139332","DOI":"10.1136/bjsports-2017-097884","URL":"https://doi.org/10.1136/bjsports-2017-097884","ISSN":"0306-3674","page":"1245-1258","type":"article-journal","issue":"17","title":"International Olympic Committee consensus statement on pain management in elite athletes","author":[{"given":"Brian","family":"Hainline","sequence":"first"},{"given":"Wayne","family":"Derman","sequence":"additional"},{"given":"Alan","family":"Vernec","sequence":"additional"},{"given":"Richard","family":"Budgett","sequence":"additional"},{"given":"Masataka","family":"Deie","sequence":"additional"},{"given":"Jiří","family":"Dvořák","sequence":"additional"},{"given":"Chris","family":"Harle","sequence":"additional"},{"given":"Stanley A","family":"Herring","sequence":"additional"},{"given":"Mike","family":"McNamee","sequence":"additional"},{"given":"Willem","family":"Meeuwisse","sequence":"additional"},{"given":"G","family":"Lorimer Moseley","sequence":"additional"},{"given":"Bade","family":"Omololu","sequence":"additional"},{"given":"John","family":"Orchard","sequence":"additional"},{"given":"Andrew","family":"Pipe","sequence":"additional"},{"given":"Babette M","family":"Pluim","sequence":"additional"},{"given":"Johan","family":"Ræder","sequence":"additional"},{"given":"Christian","family":"Siebert","sequence":"additional"},{"given":"Mike","family":"Stewart","sequence":"additional"},{"given":"Mark","family":"Stuart","sequence":"additional"},{"given":"Judith A","family":"Turner","sequence":"additional"},{"given":"Mark","family":"Ware","sequence":"additional"},{"given":"David","family":"Zideman","sequence":"additional"},{"given":"Lars","family":"Engebretsen","sequence":"additional"}],"issued":{"date-parts":[[2017,8,21]]},"source":"Crossref","volume":"51","language":"en","container-title":"British Journal of Sports Medicine","container-title-short":"Br J Sports Med"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=International+Olympic+Committee+consensus+statement+on+pain+management+in+elite+athletes\u0026publication_year=2017\u0026doi=10.1136%2Fbjsports-2017-097884\u0026pages=1245-1258\u0026journal=British+Journal+of+Sports+Medicine\u0026volume=51\u0026issue=17\u0026author=Brian+Hainline\u0026author=Wayne+Derman\u0026author=Alan+Vernec\u0026author=Richard+Budgett\u0026author=Masataka+Deie\u0026author=Ji%C5%99%C3%AD+Dvo%C5%99%C3%A1k\u0026author=Chris+Harle\u0026author=Stanley+A+Herring\u0026author=Mike+McNamee\u0026author=Willem+Meeuwisse\u0026author=G+Lorimer+Moseley\u0026author=Bade+Omololu\u0026author=John+Orchard\u0026author=Andrew+Pipe\u0026author=Babette+M+Pluim\u0026author=Johan+R%C3%A6der\u0026author=Christian+Siebert\u0026author=Mike+Stewart\u0026author=Mark+Stuart\u0026author=Judith+A+Turner\u0026author=Mark+Ware\u0026author=David+Zideman\u0026author=Lars+Engebretsen","verification_method":"verified_by_doi_lookup"},{"id":139333,"raw":"5. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003. ","parsed":{"id":"139333","DOI":"10.1097/j.pain.0000000000000160","URL":"https://doi.org/10.1097/j.pain.0000000000000160","ISSN":"0304-3959","PMID":"25844555","page":"1003-1007","type":"article-journal","PMCID":"PMC4450869","issue":"6","title":"A classification of chronic pain for ICD-11","author":[{"given":"Rolf-Detlef","family":"Treede","sequence":"first"},{"given":"Winfried","family":"Rief","sequence":"additional"},{"given":"Antonia","family":"Barke","sequence":"additional"},{"given":"Qasim","family":"Aziz","sequence":"additional"},{"given":"Michael I.","family":"Bennett","sequence":"additional"},{"given":"Rafael","family":"Benoliel","sequence":"additional"},{"given":"Milton","family":"Cohen","sequence":"additional"},{"given":"Stefan","family":"Evers","sequence":"additional"},{"given":"Nanna B.","family":"Finnerup","sequence":"additional"},{"given":"Michael B.","family":"First","sequence":"additional"},{"given":"Maria Adele","family":"Giamberardino","sequence":"additional"},{"given":"Stein","family":"Kaasa","sequence":"additional"},{"given":"Eva","family":"Kosek","sequence":"additional"},{"given":"Patricia","family":"Lavand'homme","sequence":"additional"},{"given":"Michael","family":"Nicholas","sequence":"additional"},{"given":"Serge","family":"Perrot","sequence":"additional"},{"given":"Joachim","family":"Scholz","sequence":"additional"},{"given":"Stephan","family":"Schug","sequence":"additional"},{"given":"Blair H.","family":"Smith","sequence":"additional"},{"given":"Peter","family":"Svensson","sequence":"additional"},{"given":"Johan W.S.","family":"Vlaeyen","sequence":"additional"},{"given":"Shuu-Jiun","family":"Wang","sequence":"additional"}],"issued":{"date-parts":[[2015,6]]},"source":"Crossref","volume":"156","language":"en","container-title":"Pain"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=A+classification+of+chronic+pain+for+ICD-11\u0026publication_year=2015\u0026doi=10.1097%2Fj.pain.0000000000000160\u0026pages=1003-1007\u0026journal=Pain\u0026volume=156\u0026issue=6\u0026author=Rolf-Detlef+Treede\u0026author=Winfried+Rief\u0026author=Antonia+Barke\u0026author=Qasim+Aziz\u0026author=Michael+I.+Bennett\u0026author=Rafael+Benoliel\u0026author=Milton+Cohen\u0026author=Stefan+Evers\u0026author=Nanna+B.+Finnerup\u0026author=Michael+B.+First\u0026author=Maria+Adele+Giamberardino\u0026author=Stein+Kaasa\u0026author=Eva+Kosek\u0026author=Patricia+Lavand%27homme\u0026author=Michael+Nicholas\u0026author=Serge+Perrot\u0026author=Joachim+Scholz\u0026author=Stephan+Schug\u0026author=Blair+H.+Smith\u0026author=Peter+Svensson\u0026author=Johan+W.S.+Vlaeyen\u0026author=Shuu-Jiun+Wang","verification_method":"verified_by_doi_discovery"},{"id":139334,"raw":"6. Wilson F, Ardern CL, Hartvigsen J, Dane K, Trompeter K, Trease L, et al. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med. 2021;55(11):601–7. ","parsed":{"id":"139334","DOI":"10.1136/bjsports-2020-102537","URL":"https://doi.org/10.1136/bjsports-2020-102537","ISSN":"0306-3674","page":"601-607","type":"article-journal","issue":"11","title":"Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis","author":[{"given":"Fiona","family":"Wilson"},{"given":"Clare L","family":"Ardern"},{"given":"Jan","family":"Hartvigsen"},{"given":"Kathryn","family":"Dane"},{"given":"Katharina","family":"Trompeter"},{"given":"Larissa","family":"Trease"},{"given":"Anders","family":"Vinther"},{"given":"Conor","family":"Gissane"},{"given":"Sarah-Jane","family":"McDonnell"},{"given":"JP","family":"Caneiro"},{"given":"Craig","family":"Newlands"},{"given":"Kellie","family":"Wilkie"},{"given":"David","family":"Mockler"},{"given":"Jane S","family":"Thornton"}],"issued":{"date-parts":[[2021]]},"source":"Crossref","volume":"55","abstract":"\u003cjats:sec\u003e\u003cjats:title\u003eObjectives\u003c/jats:title\u003e\u003cjats:p\u003eWe aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.\u003c/jats:p\u003e\u003c/jats:sec\u003e\u003cjats:sec\u003e\u003cjats:title\u003eDesign\u003c/jats:title\u003e\u003cjats:p\u003eSystematic review with meta-analysis.\u003c/jats:p\u003e\u003c/jats:sec\u003e\u003cjats:sec\u003e\u003cjats:title\u003eData sources\u003c/jats:title\u003e\u003cjats:p\u003eLiterature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.\u003c/jats:p\u003e\u003c/jats:sec\u003e\u003cjats:sec\u003e\u003cjats:title\u003eEligibility criteria\u003c/jats:title\u003e\u003cjats:p\u003eStudies evaluating prevalence of LBP in adult athletes across all sports.\u003c/jats:p\u003e\u003c/jats:sec\u003e\u003cjats:sec\u003e\u003cjats:title\u003eResults\u003c/jats:title\u003e\u003cjats:p\u003eEighty-six studies were included (30 732, range 20–5958, participants), of which 45 were of ‘high’ quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%–80% (95% CI 27% to 58%, I\u003cjats:sup\u003e2\u003c/jats:sup\u003e=97%). Lifetime prevalence across 13 studies was 63%; range 36%–88% (95% CI 51% to 74%, I\u003cjats:sup\u003e2\u003c/jats:sup\u003e=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%–94% (95% CI 41% to 61%, I\u003cjats:sup\u003e2\u003c/jats:sup\u003e=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6–4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.\u003c/jats:p\u003e\u003c/jats:sec\u003e\u003cjats:sec\u003e\u003cjats:title\u003eConclusion\u003c/jats:title\u003e\u003cjats:p\u003eLBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.\u003c/jats:p\u003e\u003c/jats:sec\u003e","language":"en","container-title":"British Journal of Sports Medicine","container-title-short":"Br J Sports Med"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=Prevalence+and+risk+factors+for+back+pain+in+sports%3A+a+systematic+review+with+meta-analysis\u0026publication_year=2021\u0026doi=10.1136%2Fbjsports-2020-102537\u0026pages=601-607\u0026journal=British+Journal+of+Sports+Medicine\u0026volume=55\u0026issue=11\u0026author=Fiona+Wilson\u0026author=Clare+L+Ardern\u0026author=Jan+Hartvigsen\u0026author=Kathryn+Dane\u0026author=Katharina+Trompeter\u0026author=Larissa+Trease\u0026author=Anders+Vinther\u0026author=Conor+Gissane\u0026author=Sarah-Jane+McDonnell\u0026author=JP+Caneiro\u0026author=Craig+Newlands\u0026author=Kellie+Wilkie\u0026author=David+Mockler\u0026author=Jane+S+Thornton","verification_method":"verified_by_doi_discovery"},{"id":139335,"raw":"7. Fischerauer SF, Talaei-Khoei M, Bexkens R, Ring DC, Oh LS, Vranceanu A-M. What is the relationship of fear avoidance to physical function and pain intensity in injured athletes? Clin Orthop Relat Res. 2018;476(4):754. ","parsed":{"id":"139335","DOI":"10.1007/s11999.0000000000000085","URL":"https://doi.org/10.1007/s11999.0000000000000085","ISSN":"0009-921X","PMID":"29480885","page":"754-763","type":"article-journal","PMCID":"PMC6260093","issue":"4","title":"What is the relationship of fear avoidance to physical function and pain intensity in injured athletes?","author":[{"given":"Stefan F.","family":"Fischerauer","sequence":"first"},{"given":"Mojtaba","family":"Talaei-Khoei","sequence":"additional"},{"given":"Rens","family":"Bexkens","sequence":"additional"},{"given":"David C.","family":"Ring","sequence":"additional"},{"given":"Luke S.","family":"Oh","sequence":"additional"},{"given":"Ana-Maria","family":"Vranceanu","sequence":"additional"}],"issued":{"date-parts":[[2018,2,16]]},"source":"Crossref","volume":"476","language":"en","container-title":"Clinical Orthopaedics \u0026amp; Related Research","container-title-short":"Clin Orthop Relat Res"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=What+is+the+relationship+of+fear+avoidance+to+physical+function+and+pain+intensity+in+injured+athletes%3F\u0026publication_year=2018\u0026doi=10.1007%2Fs11999.0000000000000085\u0026pages=754-763\u0026journal=Clinical+Orthopaedics+%26amp%3B+Related+Research\u0026volume=476\u0026issue=4\u0026author=Stefan+F.+Fischerauer\u0026author=Mojtaba+Talaei-Khoei\u0026author=Rens+Bexkens\u0026author=David+C.+Ring\u0026author=Luke+S.+Oh\u0026author=Ana-Maria+Vranceanu","verification_method":"verified_by_doi_discovery"},{"id":139336,"raw":"8. Forsdyke D, Smith A, Jones M, Gledhill A. Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review. Br J Sports Med. 2016;50(9):537–44. ","parsed":{"id":"139336","DOI":"10.1136/bjsports-2015-094850","URL":"https://doi.org/10.1136/bjsports-2015-094850","ISSN":"0306-3674","page":"537-544","type":"article-journal","issue":"9","title":"Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review","author":[{"given":"Dale","family":"Forsdyke"},{"given":"Andy","family":"Smith"},{"given":"Michelle","family":"Jones"},{"given":"Adam","family":"Gledhill"}],"issued":{"date-parts":[[2016,2,17]]},"source":"Crossref","volume":"50","language":"en","container-title":"British journal of sports medicine","container-title-short":"Br J Sports Med"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=Psychosocial+factors+associated+with+outcomes+of+sports+injury+rehabilitation+in+competitive+athletes%3A+a+mixed+studies+systematic+review\u0026publication_year=2016\u0026doi=10.1136%2Fbjsports-2015-094850\u0026pages=537-544\u0026journal=British+journal+of+sports+medicine\u0026volume=50\u0026issue=9\u0026author=Dale+Forsdyke\u0026author=Andy+Smith\u0026author=Michelle+Jones\u0026author=Adam+Gledhill","verification_method":"verified_by_doi_discovery"},{"id":139337,"raw":"9. Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma K, Vlaeyen JWS. The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine. 2007. ","parsed":{"id":"139337","DOI":"10.1007/s10865-006-9085-0","URL":"https://doi.org/10.1007/s10865-006-9085-0","ISSN":"0160-7715","page":"77-94","type":"article-journal","issue":"1","title":"The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence","author":[{"given":"Maaike","family":"Leeuw"},{"given":"Mariëlle E. J. B.","family":"Goossens"},{"given":"Steven J.","family":"Linton"},{"given":"Geert","family":"Crombez"},{"given":"Katja","family":"Boersma"},{"given":"Johan W. S.","family":"Vlaeyen"}],"issued":{"date-parts":[[2007]]},"source":"Crossref","volume":"30","language":"en","container-title":"Journal of Behavioral Medicine","container-title-short":"J Behav Med"},"scholar_lookup_link":"https://scholar.google.com/scholar_lookup?title=The+fear-avoidance+model+of+musculoskeletal+pain%3A+Current+state+of+scientific+evidence\u0026publication_year=2007\u0026doi=10.1007%2Fs10865-006-9085-0\u0026pages=77-94\u0026journal=Journal+of+Behavioral+Medicine\u0026volume=30\u0026issue=1\u0026author=Maaike+Leeuw\u0026author=Mari%C3%ABlle+E.+J.+B.+Goossens\u0026author=Steven+J.+Linton\u0026author=Geert+Crombez\u0026author=Katja+Boersma\u0026author=Johan+W.+S.+Vlaeyen","verification_method":"verified_by_doi_lookup"}]} </script> </body></html>