"Are you really in that much pain? It goes away once you start the training": Focus group discussions on perceptions of pain among amateur male and female football players.

Objectives: To explore amateur football players' perceptions of pain during or related to sport participation and handling of the pain.

Design: Qualitative study utilising focus group discussions with amateur football players from one regional football district in Sweden.

Methods: Six focus group discussions were conducted during 2023 with 34 amateur football players (19.3 ± 3.6 years), involving three female and three male teams. A semi-structured interview guide and conventional qualitative content analysis were used.

Results: The overarching theme, "Pain is part of the game-players' perspectives on handling pain in football", included three main categories: "Under pressure-the unseen struggles of playing through pain", "Doom and gloom-consequences of pain", and "Fighting back-strategies for preventing and managing pain." Players faced pressures to play through pain, often ignoring bodily warning signals and using pain relief to stay in the game. Pain led to frustration, missed training opportunities, and had negative impacts on physical fitness and mental health. Players with pain valued professional and social support, and emphasised the need for open and respectful communication within the team.

Conclusions: This study underscores the pervasive presence of pain in amateur football and the multifaceted challenges players face in managing it. The overarching theme encapsulates the complex interplay between external pressures, personal determination, and the inherent physical demands of the sport. The findings suggest that effective pain prevention and management strategies should adopt a biopsychosocial approach, including self-management, open and respectful communication, comprehensive training plans, injury prevention measures, and access to medical and social support.