###### Abstract  
The purpose of this study was to understand how weightlifting/powerlifting (WL/PL) influences low back pain (LBP) beliefs and pain-related fear, and the potential influence of training, individual, and injury characteristics on these psychological features. Responses to the Photographic Series of Daily Activities-Short Electronic Version (PHODA-SeV) and the Back Pain and Attitudes Questionnaire (Back-PAQ) were collected from 67 participants who train on WL/PL. Relevant statistics were conducted to (1) compare questionnaire scores to previously published values from the general population, (2) compare male versus female WL/PL participants, (3) estimate the correlation between PHODA-SeV and Back-PAQ, and (4) identify the most important associative factors of both scores. Only the Back-PAQ was significantly lower than the published score of 113 (\(p<0.001\)). Male participants had a significantly lower PHODA-SeV score compared to female participants (\(p=0.008\)), but no difference was observed for the Back-PAQ. Back-PAQ and PHODA-SeV scores were moderately correlated with each other (\(r=0.54\)). One of the most important association factors was back squat weight for both PHODA-SeV (\(p<0.001\)) and Back-PAQ (\(p=0.006\)). Future studies are required to investigate whether frequent WL/PL training improves pain-related fear and beliefs and reduces the risk of LBP occurrence.  
low back pain; pain-related fear; weightlifting; powerlifting +
Footnote †: journal:  
The FAM suggests that fear may result in avoidance behaviour, depressive symptoms, reduced function, ultimately driving the persistence of pain [9; 11]. The FAM has also been investigated in pain-free individuals, where it is a risk factor for the onset of LBP [12; 13; 14]. Excessive levels of fear, negative beliefs and attitudes about LBP, embodied when pain-free, could exacerbate such cognition and emotion during a painful episode. This could lead to the adoption of unhelpful behaviors (e.g., avoiding certain activities), thereby increasing the risk of disability. Interestingly, although fear and pain beliefs have been investigated in a pain-free general population, this has yet to be extended to WL/PL athletes who regularly expose themselves to postures and maneuvers involving not only high loads but also a high degree of spinal flexion. A meta-analysis of quantitative sensory testing studies reported that athletes have an increased pain tolerance and thresholds compared to non-athletes [15; 16]. This suggests that frequent exposure to high-load movements in WL and PL athletes may reduce fear and alter beliefs. It is likely that frequent WL/PL training (and in the process, repeatedly exposing subjects to potentially fear-provoking encounters) may result in the desensitisation of fear to strenuous spinal maneuvers, resulting in less fear and more positive beliefs compared to the general population [17].  
There is evidence for the existence of sex differences in pain-related fear [18] and pain tolerance and thresholds [19], although this has not been investigated within a cohort of athletes trained in WL/PL. It may be that, because male WL/PL athletes display greater relative and absolute strength than female WL/PL athletes [20; 21], the former are exposed to more frequent high-load movements than the latter. Hence, male athletes training in WL/PL could have lower fear compared to females training in WL/PL due to desensitisation.