title: Perception of Health Problems Among Competitive Runners: A Qualitative Study of Cognitive Appraisals and Behavioral Responses.
abstract: BACKGROUND
  Approximately 2 of every 3 competitive runners sustain at least 1 health problem each season. Most of these problems are nontraumatic injuries with gradual onset. The main known risk indicator for sustaining a new running-related injury episode is a history of a previous injury, suggesting that behavioral habits are part of the causal mechanisms.
  
  
  OBJECTIVE
  Identification of elements associated with purposeful interpretations of body perceptions and balanced behavioral responses may supply vital information for prevention of health problems in runners. This study set out to explore competitive runners' cognitive appraisals of perceived symptoms on injury and illness and how these appraisals are transformed into behavior.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  The study population consisted of Swedish middle- and long-distance runners from the national top 15 list. Qualitative research methods were used to categorize interview data and perform a thematic analysis. The categories resulting from the analysis were used to construct an explanatory model.
  
  
  RESULTS
  Saturation of the thematic classification required that data from 8 male and 6 female runners (age range, 20-36 years) were collected. Symptoms interpreted to be caused by illness or injury with a sudden onset were found to lead to immediate action and changes to training and competition programs (activity pacing). In contrast, perceptions interpreted to be due to injuries with gradual onset led to varied behavioral reactions. These behavioral responses were planned with regard to short-term consequences and were characterized by indifference and neglect of long-term implications, consistent with an overactivity behavioral pattern. The latter pattern was consistent with a psychological adaptation to stimuli that is presented progressively to the athlete.
  
  
  CONCLUSIONS
  Competitive runners appraise whether a health problem requires immediate withdrawal from training based on whether the problem is interpreted as an illness and/or has a sudden onset. The ensuing behaviors follow 2 distinct patterns that can be termed "activity pacing" and "overactivity."
authors.affiliation: Athletics Research Center, Linköping University, Linköping, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Jelvegård
authors.affiliation: Athletics Research Center, Linköping University, Linköping, Sweden.; Swedish Athletics Association, Stockholm, Sweden.
authors.forename: Toomas
authors.initials: T
authors.lastname: Timpka
authors.affiliation: Athletics Research Center, Linköping University, Linköping, Sweden.; Department of Orthopaedics and Rehabilitation, Moi University, Eldoret, Kenya.
authors.forename: Victor
authors.initials: V
authors.lastname: Bargoria
authors.affiliation: Athletics Research Center, Linköping University, Linköping, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Gauffin
authors.affiliation: Athletics Research Center, Linköping University, Linköping, Sweden.; Swedish Athletics Association, Stockholm, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Jacobsson
keywords: behavioral change; competitive runners; lay health beliefs; prevention; qualitative research