'We've just learnt to put up with it': an exploration of attitudes and decision-making surrounding playing with injury in English professional football

A number of psychological and sociocultural factors have been suggested to influence athletes’ willingness to play despite being injured. Investigation of this phenomenon is undertaken optimally at the time when athletes are injured; however, many studies have relied upon retrospective recall of feelings in individuals following recovery. This study aimed, through semi-structured existential-phenomenological interviews, to explore decision-making and attitudes surrounding playing with injury in professional footballers that were currently injured but continuing to play in matches in the English football leagues. Using deductive qualitative content analysis, cultural, situational and personal moderators that have been theorised to influence playing with injury in professional football were tested. The sample comprised nine professional footballers from three different playing leagues that were identified as playing whilst injured by team physiotherapists. There was a high level of agreement in the findings of this study with previous research. Personal and cultural moderators were stable across participants, and included conforming to the athlete role and operating in a culture where pain has been normalised. Situational factors, however, were unstable and were influenced by playing league, with constraints in squad size being an important influence for lower league players. These professional footballers sought windows of opportunity for treatment and recovery both within the season and at the end of the season. It appeared that a decline in performance, rather than the presence of pain, is used as a critical marker for injury. More research is needed to explore differences in presenteeism practices at different playing levels using larger number of participants.