Exploring athlete pain assessment experiences and priorities; a two-part qualitative series of athlete and physiotherapist interactions. Part One. "Gauging and discerning" - Athlete & physiotherapist pain assessment experiences and interactions.

Abstract

Objectives: To explore the content (subjective questions, objective tools and outcome measures) and discuss the nature (qualitative elements and wider considerations) of the athlete pain assessment by facilitating shared understandings of athletes and sports physiotherapists.

Design: Qualitative research using a hermeneutic phenomenological approach.

Methods: We carried out focus groups comprising a deliberate criterion sample using a constructivist perspective. We developed a topic guide and used reflexive thematic analysis. We developed codes, candidate themes and finalised themes iteratively, and employed a critical friend to add depth to our analysis. Our paper follows the consolidated criteria for reporting qualitative research guidelines.

Results: We completed five focus groups comprising twelve athletes (five female, seven male) and four sports physiotherapists (four male). Three final themes (and eight subthemes) were created; (i) Measures, Scales and Dimensions (value and limitations of tools and scales, multidimensional methods, making sense and interpreting), (ii) Connect, Listen and Learn (the pain interview and athlete's story, forging the athlete-clinician connection), and (iii) Lighthouse in the Storm: providing direction for athletes in pain (information overload and indecision, a beacon of direction; the role of the physiotherapist, the burden of expectation; challenges for physiotherapists).

Conclusions: We described and explored the phenomenon of pain assessment in sport including current pain assessment strategies. Comprehensive multidimensional assessment methods that preserve the athlete-clinician therapeutic relationship and facilitate optimal communication are priorities for future research and practice.