MOSCOW — Russian President Vladimir Putin has spent years building his reputation as a macho, athletic leader able to tackle any crisis, but continued rumors about his health have threatened to shatter his carefully constructed image.

Speculation began in late October after unidentified Kremlin sources told reporters that Mr. Putin, 60, had back problems that might require surgery.

A week later, the rumors gained credence when Mr. Putin canceled scheduled foreign visits and his annual televised question-and-answer session with the public.

The government insists he is fit.

“He has no injury. There is nothing to heal,” Kremlin spokesman Dmitry Peskov said. “He is doing sports, every day, like always.”

Mr. Putin’s predecessor in office, Prime Minister Dmitry Medvedev, also denied the reports.

He told journalists in mid-November that there was “nothing serious” in regard to the president’s health.

Speculation grew in late November after reporters in Tokyo cited officials as saying that Japanese Prime Minister Yoshihiko Noda postponed a trip to Moscow to meet with Mr. Putin because of the president’s “health issue.”

Rumors reached fever point this week when Turkish Prime Minister Recep Tayyip Erdogan appeared to help Mr. Putin into his chair during a visit to Turkey, the Russian leader’s first trip in more than a month.

The speculation rose at a bad time for Mr. Putin. An opinion poll by the Moscow-based independent Levada Center indicated that his credibility rating has fallen to 34 percent from 41 percent since the start of the year and his approval rating, in the same 11-month period, has slipped to 63 percent from 69 percent.

All of the negative press forced an exasperated Kremlin into a second and third round of denials.

“I’m fed up of explaining this, and I don’t see any point in doing it any further,” Mr. Peskov, the Kremlin spokesman, said Tuesday.

“Those who refuse to admit the evident would seem to be doing this in order to continue engaging in various forms of speculation.”

Mr. Peskov also dismissed reports that Mr. Putin injured himself in a much-mocked stunt in September when he rode a motorized hang glider in a failed attempt to coax endangered Siberian cranes to fly south for the winter.

New image?

Mr. Putin’s action-man image was forged in March 2000 when he flew into the war-torn republic of Chechnya in a fighter jet, bolstering his reputation just ahead of presidential elections that established him as the successor to the ailing President Boris Yeltsin.

Secure in the Kremlin, Mr. Putin set about consolidating his status as Russia’s “Alpha Male,” as a leaked U.S. Embassy cable described him. Whether swimming through Siberian rivers or shooting a tiger with a tranquilizer dart, Mr. Putin’s adventures were staples on state-run television throughout his first two terms in office, from 2000 to 2008.

Aside from the unsuccessful Siberian cranes stunt, Mr. Putin has largely steered clear of such photo ops since his return to the Kremlin in May for a third term as president.

“Putin and his advisers continue to stress his fitness because it served the president quite well for a long time,” Konstantin von Eggert wrote in a column for the RIA Novosti state news agency.

“But they never found themselves in a situation in which they had to deal with Putin’s health as an issue. It increasingly seems that they may have to look for a new approach.”

Russian journalists this week cited a leaked report that said Mr. Putin’s advisers are planning a gradual image makeover for the president, transforming him from a man of action into the “wise patriarch of Russian politics.”

Mr. Peskov, the president’s long-suffering spokesman, again denied the reports.

“This is from the realms of unsubstantiated fabrication. It’s not clear where this comes from,” he said.

Soviet style

Mr. Putin’s hold over political life in Russia is so complete that his well-being is a matter of utmost state importance.

“In a system that revolves around one man, his health is much more than just a private issue or a matter of public interest,” Mr. von Eggert said.

Russians have good reason to be suspicious of Kremlin assurances about the president’s health.

In the Soviet Union, Kremlin spokesmen insisted that all three Soviet leaders to die of illnesses in the 1980s – Leonid Brezhnev, Yuri Andropov and Konstantin Chernenko – were in fine health up until their demises.

“Putin is getting older, of course, and it’s normal that he isn’t perhaps as healthy as a decade ago,” said Oleg Pavlyuchenko, a Moscow businessman. “But if there was anything seriously wrong with him, they wouldn’t tell us anyway.”

Analysts suggest, however, that comparisons with geriatric Soviet leaders are unfair.

“Any public revelation of ill health would not be very good for Putin’s image,” said analyst Sergey Mikheyev of the Moscow-based Center for Political Assessment.

“But it’s clear that Putin is not Brezhnev, who could barely speak toward the end of his life. Putin’s not chewing on his tongue or anything.”

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