Pain is an unpleasant experience combining sensorial, cognitive and affective dimensions (e.g., O`Reilly, 2011). It is a stressor with which athletes have to cope. The IOC has underlined the need to address acute and chronic pain management in elite athletes (EAs, Hainline, et al., 2018). Experts have searched literature and best practices seeking a consensus on guidance for clinical practice and athlete management. They have highlighted the need for better understanding of acute pain management, including post-injury pain management. Athletes are known to have higher pain tolerance than the general population (e.g., Tesarz et al., 2012), suggesting that they may have a specific coping mechanism for dealing with pain. According to the transactional model of stress (Lazarus & Folkman, 1987), coping has two main functions: problem-focused and emotion-focused coping. This study aims to: (a) formalise the coping strategies used by EAs when they are managing acute pain due to injury, and (b) compare the frequencies of these coping strategies. Semi-structured interviews were conducted individually with 12 EAs to ascertain their coping strategies while managing acute pain following a sport injury. Data were processed using the comparative method (Corbin & Strauss, 1990) and the transactional model of stress (Lazarus & Folkman, 1987). The results showed 14 pain management strategies relating to problem- or emotion-focused coping. Problem-focused strategies referred to: (a) modulating activity; (b) seeking instrumental support; (c) goal setting; (d) self-encouragement; (e) taking painkillers; and (f) reframing the perception of pain. Emotion-focused strategies referred to: (a) diverting attention; (b) acceptance; (c) relativizing pain; (d) repeating negative thoughts; (e) ignoring pain; (f) seeking emotional support; (g) hoping and praying; and (h) self-blame. The results highlighted that EAs reported greater use of problem-focussed (59% of occurrences of all strategies) than emotion-focussed strategies (41% of all strategies). EAs were shown to favour three strategies (49% of all strategies). Women and men reported problem-focussed and emotion-focussed coping strategies to a similar extent but the breakdown of emotion-focused coping strategies differed. Women more frequently reported strategies associated with "seeking emotional support" and "diverting attention" than men. The results reinforce the transactional model of coping (Lazarus & Folkman, 1987). The variety of coping strategies suggests flexibility in coping with acute pain. The results highlight the multifaceted nature of pain management, going beyond the strategies elicited for coping with chronic pain in the general population (Rosenstiel & Keefe, 1983). This study demonstrates that exploring pain management strategies provides useful insights into ways to improve our understanding of pain management and clinical practice for athlete pain management.
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