Exploring the use of analgesic medicines within rugby union: A cross-sectional approach

Title : Exploring the use of analgesic medicines within rugby union: A cross-sectional approach

Abstract:

Background: Analgesic medicine use is prevalent in rugby union and may be influenced by psychosocial, cultural, and behavioural factors. Despite increasing concern over non-medical use of painkillers in sport, limited research explores anticipatory use or differences between male and female players within the sport.

Aims: To investigate patterns in the frequency and type of analgesic use among male and female rugby union players in the UK and to explore the psychosocial factors influencing these behaviours, including the role of rugby culture and anticipatory use.

Methods: A cross-sectional, mixed-methods survey (n = 177) was distributed to active rugby union players. Quantitative data was analysed using descriptive statistics, bivariate correlations, and ordinal regression. Qualitative data was thematically analysed and interpreted using the COM-B behavioural model. Ethical approval was granted by the University of Nottingham Faculty of Medicine and Health Sciences Ethics Committee.

Results: Analgesic use was reported by 89% of respondents. Anticipatory use, that is medication taken in the absence of pain, was a strong predictor of both frequency (p < 0.001) and type (p = 0.003) of analgesic used. While female players were more likely to report stronger analgesic use (p = 0.016), sex and age were not significant predictors in the regression model for frequency. 80% of female respondents reported increased use around their menstrual cycle. Psychosocial drivers, including cultural pressure, expectations of toughness, and external influences, were significantly correlated with more frequent and anticipatory use. These behavioural trends were supported by qualitative themes, including “Cultural Expectations of Toughness,” “Pressure to Perform,” and “Normalisation of Analgesic Use,” which mapped to COM-B domains of social opportunity and reflective motivation.

Discussion: This study highlights the normalisation of analgesic use in rugby union, particularly anticipatory use driven by cultural and psychosocial pressures. These behaviours may compromise player welfare and call for greater education, awareness, and regulation at community levels.

Biography:

Paddy McClintock is a fourth-year medical student at Barts and The London School of Medicine and Dentistry with a strong academic and professional interest in sports and exercise medicine and orthopaedics. He completed a Master’s degree in Sports and Exercise Medicine at the University of Nottingham with distinction, where his dissertation explored the pattern of use of analgesic medications within rugby union through a cross-sectional research approach. With a longstanding background in endurance sport, he has competed in six Ironman races, multiple ultramarathons, and HYROX events, experiences that continue to shape his clinical perspective and commitment to athlete health and performance. He is currently training and preparing to run the length go the UK (JOGLE) this summer for charity. He is also the founder of Check-In on a Mate (CIOM), a mental health awareness charity dedicated to improving wellbeing through community engagement, open conversation, and the unifying power of sport. His work aims to bridge clinical practice, research, and advocacy to promote both physical and psychological health. He intends to pursue a career in sports and exercise medicine and/or orthopaedics, with a particular interest in the interface between injury prevention, rehabilitation, and athlete welfare.