One in three reports pain in a given week: a one-season prospective study on prevalence of pain and analgesic use in amateur female and male football players.

Objectives: To study the prevalence of pain and analgesic use in amateur football players and explore sex-based and age-based differences. Methods: A prospective cohort study of 316 amateur football players (185 females, 131 males), mean age 20 years (range 15-54). Baseline data on demographics and pain history in the preceding season were collected. Players reported training/match participation, pain, analgesic use and injuries every 2 weeks over a 7-month season (April-October 2023). Results: 2439 weekly reports were analysed. Weekly pain prevalence was 40.7% (95% CI 36.4% to 45.4%) in female players and 37.2% (32.4% to 42.7%) in male players. Moderate to severe pain was more frequently reported in youth females than youth males (weekly prevalence 20.5% (15.8% to 26.8%) vs 13.1% (9.6% to 17.9%), p=0.032). Female players reported more analgesic use than male players (27.6% (23.8% to 32.1%) vs 11.2% (8.4% to 14.8%), p<0.001). Gradual-onset injuries were the predominant cause of pain (47% in females, 50% in males). Over-the-counter paracetamol (female 70%, male 61%) and non-steroidal anti-inflammatory drugs (female 67%, male 44%) were most commonly used. Analgesic use was primarily driven by non-injury-related pain in females and gradual-onset injuries in males. Conclusions: Pain was common among amateur football players, with more than one-third of players reporting pain in a given week. Female youth players reported higher prevalence of moderate to severe pain, and both female youths and female adults used more analgesics than male counterparts. These findings call for sex-specific pain strategies and educational programmes targeting pain and medication management in amateur sports.