Pain and injuries are inevitable occupational hazards and health risks in athletes’ working lives. The sport-related use of analgesics with and without injury is widespread. Taking analgesics to compete while injured is conceptualised as a sickness presenteeism problem. This study examines the complexity of the sport-related use of analgesics in elite sport. A mixed-method design was adopted consisting of a survey (n=775) and interviews (n=21) with elite athletes. Many athletes reported a sport-related use of analgesics. Analgesics had commonly been used to enable an injured athlete to: compete in an important match; train during an important period; qualify for an important match/final; and keep one’s position on the team or have one’s contract prolonged. In particular, team-sport athletes had experience of such use. Apart from the therapeutic use of analgesics, they were sometimes integrated into different routines: for example, enhancing performance, avoid lowering performance, aiding recovery, training/competing injured and prophylactic use. Simultaneously, many had refrained from using or sought to minimise their sport-related use of analgesics; reasons were related to: trust in/feeling the body, side-effects, knowledge and social norms. Social norms and interaction with support personnel played a key role. Physiotherapists and doctors often advised athletes on analgesics, but self-administered use was widespread. How risk cultures manifested themselves varied greatly between sports, and gender differences were scarce. Although ‘absenteeism’ is also present, a majority of athletes would be willing to ‘walk the line’, using analgesics to compete when injuries may threaten their career or sporting success.

疼痛和伤害是运动员工作生活中不可避免的职业危害和健康风险。与运动有关的使用止痛药和不使用止痛药的情况很普遍。在受伤时使用止痛药进行竞争被概念化为疾病表现主义问题。这项研究探讨了在精英运动中与止痛药有关的运动相关性的复杂性。采用了一种由调查（n = 775）和访谈（n= 21）与精英运动员一起使用。许多运动员报告了与运动有关的止痛药的使用。通常使用止痛药使受伤的运动员能够：在重要比赛中比赛；在重要时期进行训练；有资格参加重要比赛/决赛；并保持自己在团队中的位置或延长合同。尤其是团队运动运动员有这种使用经验。除止痛药的治疗用途外，它们有时还被整合到不同的常规操作中：例如，提高性能，避免降低性能，帮助康复，训练/竞争受伤和预防性使用。同时，许多人不使用或试图减少与运动有关的止痛药的使用；原因涉及：对身体的信任/感觉，副作用，知识和社会规范。社会规范和与支持人员的互动起着关键作用。物理治疗师和医生经常为运动员提供止痛药的建议，但自行管理的使用非常普遍。不同运动项目之间风险文化表现的方式差异很大，而且性别差异很少。尽管还存在“旷工”现象，但大多数运动员还是愿意“走线”，在伤病可能威胁其职业或体育事业成功时，使用止痛药进行比赛。